The focus of this Level l application is the identification and testing of strategies for using own mothers' milk (OMM) to provide protection from infection for extremely low-birthweight (ELBW; <1000g) infants. Immunoincompetence plus exposure to pathogenic microorganisms in the neonatal intensive care unit (NICU) predispose ELBW infants to nosocomial infections, which result in short-and long-term sequelae, and increase the cost of the NICU stay by a mean of $ 10,440 per infection. Clinical studies have documented a lower incidence and severity of nosocomial infections in OMM-fed than formula-fed preterm infants. Immunologic research has identified specific protective factors in OMM that provide passive and active immunity for the infant; many are concentrated more highly in OMM from mothers of preterm than term infants. Selected immunologic factors, such as secretory immunoglobulin A, are absorbed and excreted in the infant's urine; lactoferrin, with enhanced bacteriocidal properties, has been recaptured from feces. Thus, OMM may provide significant protection for ELBW infants; additionally, OMM is inexpensive, and facilitates mothers' participation in infant care. The dissertation will test strategies for using OMM to provide protection from infection during the early post-birth period when ELBW infants cannot tolerate enteral nutrition. An example is the use of OMM for routine infant mouth care and/or for gut-priming, e.g., minimal enteral feedings that stimulate maturation and barrier protection of the gastrointestinal tract. Outcome measures might include whether specific immune components of OMM are recaptured in infants' urine and feces.
|Rodriguez, Nancy A; Meier, Paula P; Groer, Maureen W et al. (2010) A pilot study to determine the safety and feasibility of oropharyngeal administration of own mother's colostrum to extremely low-birth-weight infants. Adv Neonatal Care 10:206-12|
|Rodriguez, N A; Meier, P P; Groer, M W et al. (2009) Oropharyngeal administration of colostrum to extremely low birth weight infants: theoretical perspectives. J Perinatol 29:1-7|
|Meier, P; Hurst, N; Rodriguez, N et al. (2004) Comfort and effectiveness of the Symphony breast pump for mothers of preterm infants: comparison of three suction patterns. Adv Exp Med Biol 554:321-3|