Human Milk Fortification with Bovine Colostrum Is Superior to Formula‐Based Fortifiers to Prevent Gut Dysfunction, Necrotizing Enterocolitis, and Systemic Infection in Preterm Pigs

Abstract

Used as a fortifier to DHM, BC is superior to FFs to support gut function, nutrient absorption, and bacterial defense mechanisms in preterm pigs. It is important to optimize the composition of nutrient fortifiers for preterm infants fed human milk.

Bovine Colostrum Before or After Formula Feeding Improves Systemic Immune Protection and Gut Function in Newborn Preterm Pigs

“…The close contact with bacteria and its toxins induces mucosal inflammation and further deteriorate gut integrity. In the current study, gut innate immunity-and hypoxia-related genes such as LBP, MYD88, IL8, and C3 were upregulated in formula-fed pigs as shown in previous studies (12,17,18,37). LBP regulates the transcription of LPS binding proteins in enterocytes, which binds and deactivates LPS during the acute phase response to endotoxin (38).…”

“…Systemically, early colostrum feeding prevented septic shock and ameliorated neuroinflammation in preterm piglets that received intraarterial Staphylococcus epidermidis (15). In the gut, piglets fed with colostrum as minimal enteral nutrition (12), full enteral nutrition (16), or supplementation to donor milk (17,19) showed improved digestive functions, integrity, antiinflammatory responses, and NEC resistance. Several clinical trials are being performed in very preterm infants to document this for its clinical application (14,27,28).…”

“…Bovine colostrum (indicated as colostrum below), the first milk from cows postpartum, contains high levels of trophic, antimicrobial, and immune-modulatory factors, such as insulin-like growth factor-I (IGF-I), immunoglobulins, lysozymes, transforming growth factor-β (TGF-β), and lactoferrin, similar to the bioactive components found in MM (14). It has been repeatedly shown that, in preterm pigs, a model for preterm infants, colostrum improves digestive and absorptive functions, dampens inflammation, protects against NEC, and improves systemic immunity, relative to formula (12,13,(15)(16)(17)(18)(19). Therefore, we investigated whether initial colostrum feeding protects against later suboptimal formula feeding and whether colostrum has any therapeutic effects on an impaired intestine caused by initial formula feeding.…”

Is Donated Breast Milk Better Than Formula for Feeding Very Low Birth Weight Infants? A Systematic Review and Meta‐Analysis

“…Numerous studies (Pillai et al, ; Sandhu, Fast, Bonnar, Baier, & Narvey, ; Schanler et al, ) have concluded that the combined use of human milk and compatible fortifier are more beneficial to infants in meeting their nutrients and intestinal tolerance needs. However, the formula or human milk‐based fortifiers may act differently in the gut function, nutrient absorption, and bacterial defense mechanisms (Sun et al, ). Therefore, optimizing the composition of nutrient fortifiers for infants fed human milk is essential.…”

Alpha-Lactalbumin Enriched Whey Protein Concentrate to Improve Gut, Immunity and Brain Development in Preterm Pigs

“…For the STANDARD-ALPHA diet, diluted milk was fortified with a WPC with a standard α-Lac content (Arla Foods Ingredients Group P/S), resulting in a final α-Lac concentration of 6.3 g/L, corresponding to an intake of 0.96-1.1 g α-Lac per kg body weight per day in the STANDARD-ALPHA group. Compared with normal porcine milk [32], the dilute REF diet had a lower content of all macronutrients, i.e., −44% energy, −51% protein, −44% carbohydrate, and −42% fat. The nutrient contents and osmolality of all three diets are listed in Table 1.…”