Kolostrum: Özellikleri ve Prematüre Bebeğe Faydaları

Anne sütü bebeklerin sağlıklı büyümesi ve gelişmesi için en uygun ve eşi benzeri olmayan bir besindir. Doğumdan sonraki ortalama ilk 5 günde salgılanan süte “kolostrum” denir. Kolostrumun miktarı, görünümü ve içeriği daha sonra gelen olgun sütten farklıdır ve yenidoğanın ilk günlerdeki gereksinimlerini karşılaması açısından büyük önem taşımaktadır. Kolostrum, olgun süte kıyasla daha yüksek konsantrasyonlarda IgA, büyüme faktörleri ve diğer koruyucu bileşenlere sahiptir. Orofarenks ve bağırsaktaki lenfoid doku sayesinde, kolostrum bağışıklık gelişimini uyarır. Orofaringeal ile ilişkili lenfatik dokunun uyarılması ve oral mikrobiyotaların gelişmesine katkı sağlamaktadır. Prematüre bebeklerin evrimsel olarak büyüme ve nörogelişimsel ihtiyaçları, en iyi anne sütünün sağlanması ile karşılanır. Bağışıklık güçlendirici faktörler, prematüre bebek doğuran annelerin kolostrumunda daha fazla yoğunlaşmıştır. Bu derleme de kolostrum: özellikleri ve prematüre bebeğe faydaları ele alınmıştır.

___

  • 1. Menekşe D, Çınar N. Çoğul Bebeklerde Emzirme Turkiye Klinikleri Journal of Pediatric Nursing Special Topics 2017; 3(2): 91-103.
  • 2. Bauer J, Gerss J. Longitudional analysis of macronutrients and minerals in human milk produced by mothers of preterm infants. Clinical Nutrition 2011; 30: 215-220. https://doi.org/10.1016/j.clnu.2010.08.003
  • 3. Karatas Z,Aydogdu SD,Dinleyici EC,Colak O, Dogruel N. Breastmilk ghrelin, lepin and fat levels changing foremilk to hindmilk: is that important for self-control of feeding? European Journal of Pediatrics 2011; 170: 1273-1280. https://doi.org/10.1007/s00431-011-1438-1
  • 4. Selimoğlu MA. Sağlıkta ve hastalıkta çocuk beslenmesi. İstanbul: Ömür Matbaacılık A.Ş; 2014.
  • 5. Kociszewska NB, Borek DB, Szpotanska SM, Wilkos E, Pietrzak B, Wielgos M. The creamatocrit, fat and energy concentration in human milk produced by mothers of preterm and term infants. The Journal of Maternal-Fetal & Neonatal Medicine 2012: 25; 1599-1602. https://doi.org/10.3109/14767058.2011.648239
  • 6. Lawrence RA, Lawrence RM. Breastfeeding: A Guide for the medical profession. 7th ed. Missouri: Mosby; 2011.
  • 7. Castellote C, Casillas R, Ramirez-Santana, C, Perez-Cano FJ, Castell M., Moretones MG. Premature delivery influences the immunological composition of colostrum and transitional and mature human milk. The Journal of Nutrition 2011: 141; 1181-1187. https://doi.org/10.3945/jn.110.133652
  • 8. Onat, D. Meme anatomisi ve fizyolojisi. Temel cerrahi el kitabı, Ankara: Güneş Tıp Kitapevleri; 2009.
  • 9. Shed M, McKinney ES, Gorrie T. Foundations of Maternal-Newborn Nursing. St Louis, MO: Saunders Elsevier; 2006.
  • 10. Topal S, Çınar N, Altınkaynak S. Süt çocukluğu döneminde beslenme. Düzce Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi 2016: 6(1); 63-70.
  • 11. Neyzi O, Ertuğrul T. Sağlıklı Çocuğun Beslenmesi. Pediatri (3. Baskı). İstanbul: Nobel Tıp Kitabevleri; 2002.
  • 12. Bilgen NKPDH, Türkyılmaz C. Term Bebeğin Beslenmesi Rehberi; 2018. Erişim adresi: http://www.neonatology.org.tr/wp content/uploads/2016/12/premature_rehber_2018.pdf
  • 13. Santoro JW, Martinez FE, Ricco RG, Jorge SM. Colostrum ingested during the first day of life by exclusively breastfed healthy newborn infants. The Journal of pediatrics 2010: 156(1); 29-32. https://doi.org/10.1016/j.jpeds.2009.07.009
  • 14. Gökduman M. 0-6 aylik bebeği olan annelerin anne sütünü artırmaya yönelik geleneksel uygulamaları (yükseklisans tezi). Adnan Menderes Üniversitesi, Sağlık Bilimleri Enstitüsü); 2009. Erişim adresi: http://adudspace.adu.edu.tr:8080/jspui/handle/11607/
  • 15. Hsu YC, Chen CH, Lin MC, Tsai CR, Liang JT, Wang TM. Changes in preterm breast milk nutrient content in the first month. Pediatr Neonatology 2014: 55; 449–454. https://doi.org/10.1016/j.pedneo.2014.03.002
  • 16. Lee J, Kim HS, Jung YH, Choi KY, Shin SH, Kim EK, Choi JH. Oropharyngeal colostrum administration in extremely premature infants: An RCT. Pediatrics 2015: 135; 357–366. https://doi.org/10.1542/peds.2014-2004
  • 17. Leifer, G. The family after birth. Introduction to maternity and pediatric nursing.Elsevier Saunders; 2010.
  • 18. Hassiotou F, Hepworth AR, Metzger P, Lai CT, Trengove N, Hartmann PE, Filgueria L. Maternal and infant infections stimulate a rapid leukocyte response in breastmilk. Clinical & Translational Immunology 2013: 2(4); e3. https://dx.doi.org/10.1038%2Fcti.2013.1
  • 19. Meier PP, Engstrom JL, Patel AL, Jegier BJ, Bruns NE. Improving the use of human milk during and after the NICU stay. Clinics in Perinatology 2010: 37(1); 217-245. https://doi.org/10.1016/j.clp.2010.01.013
  • 20. Rodriguez NA, Meier PP, Groer MW, Zeller JM. Oropharyngeal administration of colostrum to extremely low birth weight infants: theoretical perspectives. Journal of Perinatology 2009: 29(1); 1-7. https://dx.doi.org/10.1038%2Fjp.2008.130
  • 21. Rodriguez NA, Groer MW, Zeller JM, Engstrom J, Fogg L, Du H, Caplan M. A randomized controlled trial of the oropharyngeal administration of mother’s colostrum to extremely low birth weight infants in the first days of life. Neonatal Intensive Care 2009: 24(4); 31-35. https://dx.doi.org/10.1186%2Fs13063-015-0969-6
  • 22. Riordan J, Wambach K. Breastfeeding and human lactation (4th ed.). Sudbury, MA: Jones & Bartlett Publishers; 2010.
  • 23. Moreno FJ, Sánchez MB, Serrano LL, Martín AE, Diaz CJ, Peña CM, Hurtado‐Suazo, J.A. Enhancement of immune response mediated by oropharyngeal colostrum administration in preterm neonates. Pediatric Allergy and Immunology 2018: 30(2); 234-241. https://doi.org/10.1111/pai.13008
  • 24. Zhang Y, Ji F, Hu X, Cao Y, Latour JM. Oropharyngeal colostrum administration in very low birth weight infants: A Randomized Controlled Trial. Pediatric Critical Care Medicine 2017: 18(9); 869-875. https://doi.org/10.1097/PCC.0000000000001221
  • 25. Gephart SM, Weller M, Gephart S. Colostrum as oral immune therapy to promote neonatal health. Advances in Neonatal Care 2014: 14(1); 44-51. https://doi.org/10.1097/ANC.0000000000000052
  • 26. Sherman MP. Lactoferrin and necrotizing enterocolitis. Clinics in Perinatology 2013: 40(1); 79-91. https://doi.org/10.1016/j.clp.2012.12.006
  • 27. Tarnow MW, Isaacs D, Dutta S. Adjunctive immunologic interventions in neonatal sepsis. Clinics in Perinatology 2010: 37(2); 481-499. https://doi.org/10.1016/j.clp.2009.12.002
  • 28. Manzoni P, Mostert M, Stronati M. Lactoferrin for prevention of neonatal infections. Current Opinion in Infectious Diseases 2011: 24(3); 177-182. https://doi.org/10.1097/QCO.0b013e32834592e6b
  • 29. Pammi M, Abrams SA. Oral lactoferrin for the prevention of sepsis and necrotizing enterocolitis in preterm infants. Cochrane Database Syst Rev. 2011: (10); CD007137. https://doi.org/10.1002/14651858.CD007137.pub4
  • 30. Maia C, Brandao R, Roncalli A, Maranhao H. Length of stay in a neonatal intensive care unit and its association with low rates of exclusive breastfeeding in very low birth weight infants. The Journal of Maternal-Fetal & Neonatal Medicine 2011: 24(6); 774-777. https://doi.org/10.3109/14767058.2010.520046
  • 31. Demir T, Susuz Ç, Tufan M, Şengelen M. 17 Kasım dünya prematürite günü. hütf halk sağlığı ad toplum için bilgilendirme serisi-; 2017 [Internet] http://www.halksagligi.hacettepe.edu.tr/ Erişim:10.02.2019
  • 32. Patel AL, Johnson TJ, Engstrom JL, Fogg LF, Jegier BJ, Bigger HR, Meier PP. Impact of early human milk on sepsis and health-care costs in very low birth weight infants. Journal of Perinatology 2013: 33(7); 514-519. https://doi.org/10.1038/jp.2013.2
  • 33. Martin J, Hamilton B, Ventura S, Osterman MJ, Wilson EC, Mathews TJ. Births: final data for 2010. National Vital Statistics Reports 2012: 61(1); 1–100. https://www.ncbi.nlm.nih.gov/pubmed/24974589
  • 34. Sohn K, Kalanetra KM, Mills DA, Underwood MA. Buccal administration of human colostrum: impact on the oral microbiota of premature infants. Journal of Perinatology 2016: 36; 106-111. https://doi.org/10.1038/jp.2015.157ng and the use of human milk. Pediatrics 2012: 129(3); 827-841. https://pediatrics.aappublications.org/content/129/3/e827
  • 35. American Academy of Pediatrics. Policy Statement. Breastfeeding and the use of human milk. Pediatrics 2012: 129(3); 827-841. https://pediatrics.aappublications.org/content/129/3/e827
  • 36. Lee HC, Kurtin PS, Wight NE, Chance K, Cucinotta FT, Hanson TA, Nisbet C. A quality improvement project to increase breast milk use in very low birth weight infants. Pediatrics 2012: 130(6); 1679-1687. https://dx.doi.org/10.1542%2Fpeds.2012-0547
  • 37. Rasmussen SO, Martin L, Østergaard MV, Rudloff S, Li Y, Roggenbuck M, Bering, S.B. Bovine colostrum improves neonatal growth, digestive function, and gut immunity relative to donor human milk and infant formula in preterm pigs. American Journal of Physiology-Gastrointestinal and Liver Physiology 2012: 311(3); 480-491. https://doi.org/10.1152/ajpgi.00139.2016
  • 38. Underwood MA. Human milk for the premature infant. Pediatric Clinics 2013: 60(1); 189-207. https://dx.doi.org/10.1016%2Fj.pcl.2012.09.008
  • 39. Fares S, Sethom MM, Khouaja MC, Jabnoun S, Feki M, Kaabachi, N. Vitamin A, E, and D deficiencies in Tunisian very low birth weight neonates: prevalence and risk factors. Pediatr Neonatology 2014: 55; 196-201. https://doi.org/10.1016/j.pedneo.2013.09.006
  • 40. Fares S, Sethom MM, Kacem, S, Ksibi I, Feki M, Jebnoun S,Kaabachi N. Retinol and alpha-tocopherol in the colostrum of lactating Tunisian women delivering prematurely: Associations with maternal characteristics. Pediatrics & Neonatology 2016: 57(2); 120-126. https://doi.org/10.1016/j.pedneo.2015.06.003
  • 41. Szlagatys SA, Zagierski M, Jankowska A, Łuczak G, Macur K, Baczek T, Kamińska B. Longitudinal study of vitamins A, E and lipid oxidative damage in human milk throughout lactation. Early Human Development2012: 88; 421-424. https://doi.org/10.1016/j.earlhumdev.2011.10.007 42.
  • 42. Spiegler J, Preuß M, Gebauer C, Bendiks M, Herting E, Go¨pel W. Does breastmilk influence the development of bronchopulmonary dysplasia? The Journal of Pediatrics 2016: 169; 76-80.e4. https://doi.org/10.1016/j.jpeds.2015.10.080
  • 43. Zhou J, Shukla VV, John D, Chen C. Human milk feeding as a protective factor for retinopathy of prematurity: a metaanalysis. Pediatrics 2015: 136; 1576-1586. https://doi.org/10.1542/peds.2015-2372
  • 44. Snyder R, Herdt A, Mejias, CN, Ladino J, Crowley K, Levy P. Early provision of oropharyngeal colostrum leads to sustained breast milk feedings in preterm infants. Pediatrics & Neonatology 2017: 58(6); 534-540. https://doi.org/10.1016/j.pedneo.2017.04.003