[Effect of colostrum oral immune therapy on the the clinical outcomes in very low birth weight infants: a Meta analysis].

Summary

This meta-analysis of 14 RCTs (n=1,386) shows that colostrum oral immune therapy in very low birth weight infants significantly reduces late-onset sepsis, necrotizing enterocolitis, feeding intolerance, and mortality, and shortens time to full enteral feeds. Findings support COIT as a low-cost, biologically plausible preventive strategy in NICUs.

Key Findings

• Meta-analysis included 14 RCTs with 1,386 VLBW infants (690 COIT vs 696 control).
• COIT significantly reduced clinical late-onset sepsis incidence.
• COIT decreased necrotizing enterocolitis and feeding intolerance and reduced mortality.
• Time to achieve full enteral nutrition was shortened with COIT.

Clinical Implications

NICUs should consider implementing standardized COIT protocols for VLBW infants to reduce late-onset sepsis and mortality, with attention to dosing, timing, and hygiene to ensure safety.

Limitations

• Heterogeneity in COIT protocols (timing/dose) and study settings
• Potential publication and language bias; PRISMA adherence not explicitly stated

Future Directions

Conduct pragmatic multicenter trials to standardize COIT regimen and assess safety; perform individual participant data meta-analysis and evaluate long-term neurodevelopment.