Colostrum Use and the Immune System of Premature Newborns: A Systematic Review and Meta-Analysis

Background: Human colostrum has been used in a number of investigations when preterm human infants cannot, for any reason, breastfeed directly from their mothers. One of the growing fields in these investigations is colostrum therapy, which consists of exposing the oropharyngeal mucosa of these preterm newborns to small amounts of raw colostrum. Research Aim: To critically review the scientific evidence about colostrum therapy in premature infants and to explore its influences on the immune system. Methods: This systematic review was performed according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA statement). The following databases were searched for potentially eligible studies up to March 10, 2021: Medline, Scopus, Web of Science, Cochrane Library, Embase. Two reviewers independently screened all titles, abstracts, and full texts for eligibility. Results: A total of 12 studies with 996 participants were included. A significant difference in lactoferrin levels in the urine was found ( SMD 0.70; 95% CI [0.03,1.36]; p = .04; I² = 65% two studies, 112 participants, very low-quality evidence). Conclusion: Colostrum seems to result in increasing lactoferrin levels in the urine of premature newborns after 1 week of intervention. Clinical Trial Registration: The study was registered at PROSPERO with the number CRD42017073624, submitted on August 9, 2017.