Fortification of human donor milk with bovine colostrum is superior to formula-based fortifiers when it comes to prevent gut dysfunction, necrotizing enterocolitis, and systemic infection in preterm pigs. This raises the expectation to the current clinical trials.
Human donor milk fortification is required for preterm infants to support postnatal growth and development of very preterm infants, but addition of formula-based fortifiers (FF) may increase the risk of gut dysfunction, necrotizing enterocolitis (NEC), and sepsis, when provided shortly after birth when the gut is still immature.
Bovine colostrum (BC) is rich in protein and bioactive factors and is appear to be safe for preterm infants when used as supplement to mothers own milk during the first 1-2 weeks of life to increase protein intake as tested in the pilot study Bovine colostrum for preterm infants in the first days of life: A randomized controlled pilot study.
This study provides preclinical evidence that early fortification with BC is superior to FF-fortification in preventing gut dysfunction, NEC, and systemic infections in preterm pigs. BC support gut function, nutrient absorption, and bacterial defense mechanisms in preterm pigs. Relative to preterm pigs fed BC-human donor milk with BC, preterm pigs fed FF-donor human milk had higher diarrhea score, lower hexose uptake, lower lactase activity, higher gut permeability, higher NEC score, more mucosa-adherent bacteria, lower gut microbiota diversity, higher expression of intestinal cytokine and inflammation-related genes, more gut-derived bacteria in the bone marrow, lower density of mucin-containing goblet cells, slightly higher colon lactate, stomach pH, acetate, and blood neutrophil-to-lymphocyte levels.
Bovine colostrum is currently tested as human donor milk fortifier for preterm infants in clinical trials in Denmark (FortiColos on ClinicalTrials.gov: NCT03537365) and China (PreColos-RCT on ClinicalTrials.gov: NCT03085277). The results are expected to be published in 2020!
Read the study here: Human milk fortification with bovine colostrum is superior to formula-based fortifiers to prevent gut dysfunction, necrotizing enterocolitis, and systemic infection in preterm pigs