Document Type


Publication Date

Spring 2023


Title: Oropharyngeal Therapy with Breastmilk in Premature Neonates and its Implications for Neonatal Outcomes

Authors: Asma Qamruddin MD, and Kevin P Vlahovich MD MS

Background: Breastmilk contains protective immune factors which are antimicrobial, immunomodulatory, and pro-maturational. Early oropharyngeal therapy (OPT) with breastmilk helps to stimulate a neonate’s innate immune system which could potentially decrease the risk of infection and feeding intolerance in premature infants. We examined and compared the neonatal outcomes with or without OPT.

Intervention Description: This was a quasi-experimental study conducted at Advocate Children's Hospital Illinois. Infants born(n =56 infants) and those from June 2020 to November 2020 constituted the OPT group (n= 53 infants). For all infants in OPT group, 0.1ml of breastmilk was instilled into each right and left side of the oral cavity every 3 hours after birth until infants start oral feeding ~34 weeks. The outcomes as the time to full enteral feeding (130ml/kg/day), any breastfeeding on discharge, the central line days, and total parenteral nutrition (TPN) days, were compared in the OPT and pre-OPT groups.

Measures of Change: The baseline characteristics of birth weight, sex, and gestational age were comparable in both groups. There was a decrease in average time to full enteral feeds by 18% from 11.5 days in the pre-OPT group as compared to 9.4 days in the OPT group. A similar decrease was noted in the average central line days by 26% and TPN days by 20% for the OPT group. The rate of any breastfeeding on discharge increased from 69% to 88% in favor of the OPT group.

Results: Infants who received OPT were more likely to be breastfed on discharge, reached full enteral feeds sooner, and had fewer TPN & central line days compared to infants who did not receive OPT.

Public Health Implications: Implementation of OPT protocol in neonatal units might decrease the healthcare cost for preterm infants.

Data Source: Hospital records



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