| Abstrakt: |
Background: Upon birth, the extremely low birth weight (ELBW) infant experiences an abrupt cessation of amniotic fluid exposure. The ELBW infant's oropharynx is no longer exposed to immunoprotective biofactors, which modulate the immune system and promote maturation of the gastrointestinal tract. Many immune and trophic biofactors are also contained in the mother's own milk, and are especially concentrated in the milk expressed by mothers of ELBW infants; particularly in colostrum. Unfortunately, clinical instability precludes enteral feeding for ELBW infants in the first days of life. Once started, enteral feeds are administered via a nasogastric tube; therefore oropharyngeal exposure to protective milk biofactors cannot occur until the infant begins per oral feeds, with mother's milk; typically at 32 weeks corrected gestational age. The delay, or lack of, oropharyngeal exposure to protective milk biofactors, during the critical first weeks of life for the ELBW infant, may be contributing substantially to prematurity-associated infectious morbidities. Oro-Pharyngeal Therapy with Mother's Own Milk (OPT-MOM)-placing drops of mother's milk onto the infant's oral mucosa to provide early postnatal modulation of the immune system-can serve as a potential substitute for amnioticfluid (biofactor) exposure. Purpose: To describe how OPT-MOM may protect the ELBW infant against prematurity-associated infectious morbidities including Late-Onset Sepsis, necrotizing enterocolitis (NEC), and also Ventilator-Associated Pneumonia. This manuscript will provide neonatal clinicians with the latest evidence to guide clinical practice. Important implications, in terms of patient safety, will also be addressed. [ABSTRACT FROM AUTHOR] |
