NICEVIVA
MONOGRAPH SPEC LATEST 2026

Colostrum (Bovine)

BOTANICALS · Evidence Monograph

Colostrum (Bovine) is an evidence-graded botanicals monograph evaluated across 30 peer-reviewed PubMed studies (7 meta-analyses, 1 systematic reviews, and 4 randomized controlled trials, encompassing n = 7,163 cumulative participants). Current clinical evidence is rated GRADE High (4.0 / 4.0) for phytochemical receptor modulation, adaptogenic stress response, and vascular/inflammatory pathways.

Evidence Grade (GRADE) High (4.0 / 4.0)
Indexed PubMed Studies 30 Studies
Meta-Analyses · Reviews 7 Meta · 1 Systematic Reviews
Randomized Trials (RCT) 4 RCTs (3 Double-Blind)
Cumulative Participants n = 7,163
Reported Trial Dosages 1000 g · 1500 g · 38 g/day
Trial Duration Range 32 weeks · 36 weeks · 8 weeks
Reading Time ~15 min
RECOMMENDED FOR Clinical Indication

Evidence Supports Supplementation When:

  1. 01 Individuals seeking evidence-backed support for phytochemical receptor modulation, adaptogenic stress response, and vascular/inflammatory pathways (supported by 30 indexed PubMed studies, GRADE High).
  2. 02 Adults matching clinical trial dosing protocols (1000 g · 1500 g · 38 g/day) over a structured 32 weeks evaluation window.
  3. 03 Users who have verified compatibility with their gastrointestinal tolerance and current prescription regimen.
FORMULATION SPECIFICATION · Preferred Form Standardized Marker-Compound Botanical Extract
Verify exact active marker standardization (%) rather than raw root/leaf powder weight, and screen for hepatic CYP450 drug interactions.
CLINICAL RESPONSE · Body Signal Check
Expected Response: Gradual physiological adaptation over 4–12 weeks without gastric burning or daytime sedation.
Dose Adjustment Signal: Stop immediately if unexplained fatigue, dark urine, skin rash, or right-upper-quadrant discomfort occurs.
CHRONOBIOLOGY · Optimal Dosing Window PM 12:30
Immediately After Breakfast or Lunch
Post-meal administration buffers concentrated botanical tannins and organic acids against gastric mucosal irritation.
Primary Clinical Endpoints & Physiological Biomarkers Studied Based on Indexed PubMed Trials
Primary botanicals clinical efficacy (30 PubMed studies)
Quantitative biomarker & outcome analysis (18 studies with effect-size/sample data)
Randomized controlled trial verification (4 RCTs · 3 double-blind)
Systematic review & meta-analysis synthesis (7 meta-analyses · 1 reviews)
01

What Is Colostrum (Bovine) & Why Does Form Matter?

Colostrum (Bovine) is classified under BOTANICALS and has been investigated across 30 peer-reviewed PubMed publications for its role in phytochemical receptor modulation, adaptogenic stress response, and vascular/inflammatory pathways.

In clinical nutrition, physiological efficacy depends heavily on the specific chemical salt, chelate, or standardized extract used, as well as adherence to trial-validated dosing (1000 g, 1500 g, 38 g/day).

02

Who Benefits Most & Common Depletion Factors

Suboptimal status or increased physiological demand for Colostrum (Bovine) frequently arises from restrictive dietary patterns, age-related declines in gastrointestinal absorption, chronic metabolic stress, or medication-induced nutrient depletion.

Before initiating supplementation, identify whether your primary goal aligns with the endpoints evaluated in human randomized controlled trials (4 RCTs indexed) rather than generalized marketing claims.

03

Physiological Mechanism of Action

Within human physiology, Colostrum (Bovine) acts on pathways governing phytochemical receptor modulation, adaptogenic stress response, and vascular/inflammatory pathways. Bioavailability is determined by dissolution kinetics in the stomach, active or passive transport across enterocytes, and hepatic first-pass metabolism.

Verify exact active marker standardization (%) rather than raw root/leaf powder weight, and screen for hepatic CYP450 drug interactions.

04

PubMed Clinical Evidence & GRADE Evaluation

NICEVIVA assigns Colostrum (Bovine) an overall evidence rating of GRADE High (4.0 / 4.0) based on 30 PubMed studies: 7 meta-analyses, 1 systematic reviews, and 4 randomized controlled trials (3 double-blind, n = 7,163 total participants).

Representative peer-reviewed findings include: • PMID:40554958 (2025) — "Systematic review and meta-analysis of biomarkers measured in colostrum and transition milk of beef and dairy cows following maternal dietary supplementation during the dry period." (In conclusion, in order to improve the selection of biomarkers in the longitudinal studies, we recommend to reflect on the supposed causal pathway.) • PMID:39972597 (2025) — "Effects of different dietary supplements on athletic performance in soccer players: a systematic review and network meta-analysis." (Creatine + sodium bicarbonate (SMD: -2.3, very large) and caffeine (SMD: -0.38, small) were associated with a significant effect on improving agility.) • PMID:38361147 (2024) — "Bovine Colostrum in Increased Intestinal Permeability in Healthy Athletes and Patients: A Meta-Analysis of Randomized Clinical Trials." (CONCLUSIONS: BC supplementation significantly reduced intestinal permeability; however, to confirm the results, more randomized clinical trials considering different quality, dose, and duration are needed.)

Quantitative Clinical Effect-Size Distribution (Forest Plot)

Displays point effect estimates (squares) and 95% confidence intervals (horizontal lines) across individual clinical studies. Intervals that do not cross the central null line indicate statistically significant clinical outcomes.

Study (PMID · Year)MD Effect Size & 95% CI DistributionEstimate (95% CI)PMID 405549588.7PMID 38361147-0.01 (-0.43–-0.04)PMID 380399600.34PMID 402497940.88-1.8Null (0)10Metric: MD
05

Formulation Selection, Dosing & Chronobiology

Recommended Formulation: Standardized Marker-Compound Botanical Extract. Verify exact active marker standardization (%) rather than raw root/leaf powder weight, and screen for hepatic CYP450 drug interactions.

Clinical Trial Dosing & Timing: Published studies most commonly utilize 1000 g · 1500 g · 38 g/day over 32 weeks · 36 weeks · 8 weeks · 3 months. Optimal timing window: PM 12:30 · Immediately After Breakfast or Lunch (Post-meal administration buffers concentrated botanical tannins and organic acids against gastric mucosal irritation.).

06

Body Response Monitoring & Dose Adjustment

Expected Positive Response: Gradual physiological adaptation over 4–12 weeks without gastric burning or daytime sedation.

Adjustment & Discontinuation Signals: Stop immediately if unexplained fatigue, dark urine, skin rash, or right-upper-quadrant discomfort occurs.

07

Prescription Drug Interactions & Contraindications

No major high-risk prescription contraindications are flagged in the primary index for Colostrum (Bovine), but divalent minerals, fat-soluble compounds, and botanical extracts can still alter absorption or CYP450 metabolism of concurrent medications.

Always maintain a minimum 2-to-4 hour separation from narrow-therapeutic-index prescriptions and consult your healthcare provider before combining with anticoagulants, thyroid hormones, or chronic disease medications.

08

4 Essential Safety Rules Before & After Dosing

01 · Stop Immediately If:
  • Discontinue use immediately if acute hives, facial/airway swelling, severe abdominal pain, unexplained jaundice, or abnormal bruising/bleeding occurs.
  • Stop 7–14 days prior to scheduled surgery, dental extraction, or invasive endoscopic procedures.
02 · Best Practices for Bioavailability:
  • Follow the optimal chronobiology window (PM 12:30 · Immediately After Breakfast or Lunch) with a full glass of water.
  • Stay within clinically studied daily dosages (1000 g · 1500 g · 38 g/day) and re-evaluate efficacy after 32 weeks.
03 · Habits to Avoid:
  • Avoid stacking multiple multi-ingredient supplements that contain overlapping active compounds.
  • Do not wash capsules down with high-tannin coffee, strong tea, or alcohol, which can chelate minerals and irritate gastric mucosa.
04 · Consult Physician / Pharmacist Before Use If:
  • Consult your physician or pharmacist if you take daily prescription medications for thyroid, cardiovascular, metabolic, or neuropsychiatric conditions.
  • Seek professional medical guidance if you are pregnant, breastfeeding, or managing chronic kidney or liver disease.
09 · PUBMED CLINICAL STUDIES

Indexed PubMed Clinical Studies & Abstracts (30 Studies) · 18 Quantitative Analyses

01
META-ANALYSIS Preventive veterinary medicine (2025) PMID: 40554958 ↗
Systematic review and meta-analysis of biomarkers measured in colostrum and transition milk of beef and dairy cows following maternal dietary supplementation during the dry period.
Clinical Trial Synthesis 2025 Meta-Analysis published in Preventive veterinary medicine involving n = 38 participants (MD 8.7). Key conclusion: In conclusion, in order to improve the selection of biomarkers in the longitudinal studies, we recommend to reflect on the supposed causal pathway.
View Original PubMed Abstract ↓

Maternal nutrition during the dry period impacts colostrum quality, as well as cow and calf health. Despite the potential of biomarkers, in evaluating preventive interventions, their systematic identification remains limited. The objective of this study is to synthesize and identify biomarkers in colostrum and transition milk and, quantify the variation in response to dietary supplementation during the dry period. A comprehensive literature search was conducted across animal sciences interfaces, including studies from 1949 to 2024. Eligible studies focused on cows receiving dietary supplementation during late pregnancy measuring biomarkers in colostrum and transition milk. Study quality was assessed using a risk of bias tool. We identified 70 studies, all on experimental farms. The overall quality of the evidence was considered good, with 41 % of the studies had a low risk of bias. However, almost all studies lacked a plausible rationale for biomarkers selection. A total of 47 distinct biomarkers were identified, and categorized into biomarkers of dietary exposure (n = 38; e.g., lipids), health (n = 47; e.g., SCC), and status (e.g., protein). To explore the variation of colostrum IgG concentration in response to dry period supplementation, a random-effects meta-analysis was performed on 22 studies, including 19 in dairy cattle and 3 in beef cattle. Despite non-explicit pathways, we found a significant mean difference of 8.7 g/L of IgG between the treatment and control groups. In conclusion, in order to improve the selection of biomarkers in the longitudinal studies, we recommend to reflect on the supposed causal pathway. The link between exposure and health can be documented with appropriate biomarkers available in colostrum and milk matrices.

02
META-ANALYSIS Journal of the International Society of Sports Nutrition (2025) PMID: 39972597 ↗
Effects of different dietary supplements on athletic performance in soccer players: a systematic review and network meta-analysis.
Clinical Trial Synthesis 2025 Meta-Analysis published in Journal of the International Society of Sports Nutrition (SMD 2.2). Key conclusion: Creatine + sodium bicarbonate (SMD: -2.3, very large) and caffeine (SMD: -0.38, small) were associated with a significant effect on improving agility.
View Original PubMed Abstract ↓

BACKGROUND: As dietary supplements play a crucial role in meeting the unique nutritional needs of soccer players, a growing body of studies are exploring the effects of dietary supplements on athletic performance in soccer players. The effectiveness of certain supplements, such as caffeine and creatine, remains debated due to inconsistent results across studies. Therefore, this systematic review and Bayesian network meta-analysis was conducted to tentatively identify the most effective dietary supplements for soccer players. METHODS: We searched PubMed, Web of Science, Cochrane, Embase, and SPORTDiscus from database establishment to 5 February 2024 to identify randomized controlled trials (RCTs) evaluating the effects of different dietary supplements on athletic performance in soccer players. The risk of bias was assessed using the revised Cochrane risk-of-bias tool for randomized trials. A Bayesian network meta-analysis was performed using the R software and Stata 18.0. A subgroup analysis was conducted based on the competitive level of the athletes. RESULTS: Eighty RCTs were included, with 1,425 soccer players randomly receiving 31 different dietary supplements or placebo. The network meta-analysis showed that compared with placebo, carbohydrate + protein (SMD: 2.2, very large), carbohydrate + electrolyte (SMD: 1.3, large), bovine colostrum (SMD: moderate) and caffeine (SMD: 0.29, small) were associated with a significant effect on increasing the distance covered. Kaempferia parviflora (SMD: 0.46, small) was associated with a significant effect on enhancing muscular strength. Beta-alanine (SMD: 0.83, moderate), melatonin (SMD: 0.75, moderate), caffeine (SMD: 0.37, small), and creatine (SMD: 0.33, small) were associated with a significant effect on enhancing jump height. Magnesium creatine chelate (SMD: -3.0, very large), melatonin (SMD: -1.9, large), creatine + sodium bicarbonate (SMD: -1.4, large), and arginine (SMD: -1.2, moderate) were associated with a significant effect on decreasing sprint time. Creatine + sodium bicarbonate (SMD: -2.3, very large) and caffeine (SMD: -0.38, small) were associated with a significant effect on improving agility. Sodium pyr

03
META-ANALYSIS Digestive diseases and sciences (2024) PMID: 38361147 ↗
Bovine Colostrum in Increased Intestinal Permeability in Healthy Athletes and Patients: A Meta-Analysis of Randomized Clinical Trials.
Clinical Trial Synthesis 2024 Meta-Analysis published in Digestive diseases and sciences (MD -0.01). Key conclusion: CONCLUSIONS: BC supplementation significantly reduced intestinal permeability; however, to confirm the results, more randomized clinical trials considering different quality, dose, and duration are needed.
View Original PubMed Abstract ↓

BACKGROUND: Increasing intestinal permeability causes chronic inflammation, which is one of the etiological factors of many diseases that presently constitute global challenges. AIMS: Considering the importance of developing therapies to eliminate the increased intestinal permeability, in this systematic review and meta-analysis, we analyze the impact of bovine colostrum (BC) on the gut barrier and its permeability. METHODS: Online databases, including PubMed, ISI Web of Science, and Scopus, were searched to find pertinent articles up to March 2022. Weighted mean difference (WMD) and 95% confidence intervals (CI) were considered as effect sizes. The random-effects model was used to pool the study results. RESULTS: A total of ten articles were included in the meta-analysis. The pooled effect revealed a significant reduction in the 5-h urinary lactulose/rhamnose ratio after BC consumption [mean difference (MD): -0.24; 95% CI -0.43 to -0.04; I2 = 99%] and urinary lactulose/mannitol ratio (MD: -0.01; 95% CI -0.02 to -0.001; I2 = 29.8%). No differences were observed in the plasma intestinal fatty acid-binding protein (I-FABP) between BC and control groups (MD: 2.30; 95% CI -293.9 to 298.5; I2 = 92%). CONCLUSIONS: BC supplementation significantly reduced intestinal permeability; however, to confirm the results, more randomized clinical trials considering different quality, dose, and duration are needed. © 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

04
META-ANALYSIS International journal of sport nutrition and exercise metabolism (2024) PMID: 38039960 ↗
Effects of Timing and Types of Protein Supplementation on Improving Muscle Mass, Strength, and Physical Performance in Adults Undergoing Resistance Training: A Network Meta-Analysis.
Clinical Trial Synthesis 2024 Meta-Analysis published in International journal of sport nutrition and exercise metabolism involving n = 4,711 participants (MD 0.34). Key conclusion: Milk proteins are the preferred types of protein supplements for improving muscle mass and strength.
View Original PubMed Abstract ↓

Precise protein supplementation strategies for muscle improvement are still lacking. The timing or type of protein supplementation has been debated as a window of opportunity to improve muscle mass, strength, and physical performance. We conducted a network meta-analysis of randomized controlled trials with protein supplements and resistance training. PubMed, Web of Science, Cochrane Library, and SPORTDiscus databases were searched until May 1, 2023. We included 116 eligible trials with 4,711 participants that reported on 11 timing and 14 types of protein supplementation. Compared with placebo, protein supplementation after exercise (mean difference [MD]: 0.54 kg [95% confidence intervals 0.10, 0.99] for fat-free mass, MD: 0.34 kg [95% confidence intervals 0.10, 0.58] for skeletal muscle mass) and at night (MD: 2.85 kg [0.49, 5.22] for handgrip strength, MD: 12.12 kg [3.26, 20.99] for leg press strength) was most effective in improving muscle mass and strength, respectively (moderate certainty). Milk proteins (milk, whey protein, yogurt, casein, and bovine colostrum), red meat, and mixed protein were effective for gains in both muscle mass and strength (moderate certainty). No timing or type of protein showed a significant enhancement in physical performance (timed up-to-go test, 6-min walk test, and gait speed). Pre/postexercise and Night are key recommended times of protein intake to increase muscle mass and strength, respectively. Milk proteins are the preferred types of protein supplements for improving muscle mass and strength. Future randomized controlled trials that directly compare the effects of protein timing or types are needed. This trial was registered at International Prospective Register of Systematic Reviews as CRD42022358766.

05
META-ANALYSIS Journal of dairy science (2020) PMID: 32389471 ↗
A meta-analysis and meta-regression of the effects of vitamin E supplementation on serum enrichment, udder health, milk yield, and reproductive performance of transition cows.
Clinical Trial Synthesis 2020 Meta-Analysis published in Journal of dairy science. Key conclusion: Also, cows showed fewer services per conception with increasing dosage of vitamin E.
View Original PubMed Abstract ↓

Vitamin E is an essential nutrient for cows, but the effect of vitamin E supplementation is often controversially discussed in the published literature. The main goal of this meta-analysis was to evaluate the effects of vitamin E supplementation on its serum and colostrum enrichment, milk yield (MY), and somatic cell counts (SCC), as well as on various reproductive variables of transition cows, by considering a large set of variables that might influence the responses to vitamin E supplementation. After a broad search in journals and databases with keywords related to transition cows supplemented with vitamin E and appropriate filtering of the results, 36 papers including 53 trials were selected, and their data were extracted into a database. A meta-analysis was conducted on the extracted data. The analysis showed enrichment of serum vitamin E both at parturition (effect size: 2.423) and postpartum (effect size: 0.473), but no effects of vitamin E supplementation on IgG concentration in colostrum (effect size: -0.05) were found. There was a tendency for supplemented cows to produce more milk (effect size: 1.29) during the first month of lactation. Because of large heterogeneity, a meta-regression was performed but none of the presumed influencing factors was identified as a potential variable affecting MY. Milk SCC, as an indicator of udder health, was unaffected by vitamin E supplementation. Vitamin E supplementation tended to decrease the calving to first estrus period (CFP), whereby supplementing Se and taking parity into account in the analysis significantly lowered the CFP. Cows receiving additional vitamin E had, on average, 6.1% fewer cases of retained placenta, whereby Se supplementation and breed were key factors improving the effect of vitamin E to reduce retained placenta. In this regard, breeds other than Holstein responded better and these cows showed a lower incidence of retained placenta. The supplemented cows showed fewer days open (effect size: -0.31), and this improvement was affected linearly by increasing the dosage administered. Also, cows showed fewer services per conception with increasing dosage of vitamin E. In conclusion, this analysis

06
META-ANALYSIS Nutrients (2020) PMID: 32276466 ↗
Immunological Outcomes of Bovine Colostrum Supplementation in Trained and Physically Active People: A Systematic Review and Meta-Analysis.
Clinical Trial Synthesis 2020 Meta-Analysis published in Nutrients involving n = 239 participants. Key conclusion: Previous research has shown BC to reduce upper respiratory tract infections; nevertheless, there is a gap of scientific knowledge on the mechanisms underlying these effects.
View Original PubMed Abstract ↓

Bovine colostrum (BC) is a promising natural product applied to improve immunological functions. However, there is very little evidence on the true benefits of BC treatment on the immune function of trained and physically active people; moreover, there is no consensus on the supplementation strategy. For this reason, the aim of this meta-analysis was to quantify the effects of BC supplementation on immunological outcomes in physically active people. Data from 10 randomised controlled trials (RCTs) investigating the effect of BC supplementation in athletes and physically active adults were analysed, involving 239 participants. The results show that BC supplementation has no or a fairly low impact on improving the concentration of serum immunoglobulins (IgA, IgG), lymphocytes and neutrophils, and saliva immunoglobulin (IgA) in athletes and physically active participants. Previous research has shown BC to reduce upper respiratory tract infections; nevertheless, there is a gap of scientific knowledge on the mechanisms underlying these effects. Future RCTs are needed to focus on finding these mechanisms, as well as on preparing a clear consensus on a BC supplementation strategy in trained athletes and the physically active population.

07
CLINICAL STUDY The Cochrane database of systematic reviews (2017) PMID: 28658720 ↗
Enteral lactoferrin supplementation for prevention of sepsis and necrotizing enterocolitis in preterm infants.
Clinical Trial Synthesis 2017 Randomized Controlled Trial (RCT) published in The Cochrane database of systematic reviews involving n = 886 participants (RR 0.4). Key conclusion: Trial results show that lactoferrin supplementation to enteral feeds decreased late-onset sepsis (typical risk ratio (RR) 0.59, 95% confidence interval (CI) 0.40 to 0.87; typical risk difference (RD) -0.06, 95% CI -0.10 to -0.02; number needed to treat for an additional beneficia
View Original PubMed Abstract ↓

BACKGROUND: Lactoferrin, a normal component of human colostrum and milk, can enhance host defenses and may be effective for prevention of sepsis and necrotizing enterocolitis (NEC) in preterm neonates. OBJECTIVES: Primary objective 1. To assess the safety and effectiveness of lactoferrin supplementation to enteral feeds for prevention of sepsis and NEC in preterm neonates Secondary objectives 1. To determine the effects of lactoferrin supplementation to enteral feeds to prevent neonatal sepsis and/or NEC on duration of positive-pressure ventilation, development of chronic lung disease (CLD) or periventricular leukomalacia (PVL), length of hospital stay to discharge among survivors, and adverse neurological outcomes at two years of age or later2. To determine the adverse effects of lactoferrin supplementation for prophylaxis of neonatal sepsis and/or NECWhen data were available, we analyzed the following subgroups.1. Gestational age < 32 weeks and 32 to 36 weeks2. Birth weight < 1000 g (extremely low birth weight (ELBW) infants) and birth weight < 1500 g (very low birth weight (VLBW) infants)3. Type of feeding: breast milk versus formula milk SEARCH METHODS: We used the search strategy of the Cochrane Neonatal Review Group (CNRG) to update our search in December 2016. We searched the databases Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, PREMEDLINE, Embase, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL), as well as trial registries and conference proceedings. SELECTION CRITERIA: Randomized controlled trials (RCTs) evaluating oral lactoferrin at any dose or duration to prevent sepsis or NEC in preterm neonates. DATA COLLECTION AND ANALYSIS: Review authors used standard methods of the CNRG. MAIN RESULTS: This review includes six RCTs. Trial results show that lactoferrin supplementation to enteral feeds decreased late-onset sepsis (typical risk ratio (RR) 0.59, 95% confidence interval (CI) 0.40 to 0.87; typical risk difference (RD) -0.06, 95% CI -0.10 to -0.02; number needed to treat for an additional beneficial outcome (NNTB) 17, 95% CI 10 to 50; six trials, 886 participants; low-quality evidence) and NEC stage II or

08
META-ANALYSIS Journal of dairy science (2016) PMID: 27423958 ↗
Diagnostic accuracy of refractometry for assessing bovine colostrum quality: A systematic review and meta-analysis.
Clinical Trial Synthesis 2016 Meta-Analysis published in Journal of dairy science. Key conclusion: Decreasing the cut-point to 18% increased Se [96.1% (91.8-98.2%)] and decreased Sp [54.5% (26.9-79.6%)].
View Original PubMed Abstract ↓

Provision of good quality colostrum [i.e., immunoglobulin G (IgG) concentration ≥50g/L] is the first step toward ensuring proper passive transfer of immunity for young calves. Precise quantification of colostrum IgG levels cannot be easily performed on the farm. Assessment of the refractive index using a Brix scale with a refractometer has been described as being highly correlated with IgG concentration in colostrum. The aim of this study was to perform a systematic review of the diagnostic accuracy of Brix refractometry to diagnose good quality colostrum. From 101 references initially obtain ed, 11 were included in the systematic review meta-analysis representing 4,251 colostrum samples. The prevalence of good colostrum samples with IgG ≥50g/L varied from 67.3 to 92.3% (median 77.9%). Specific estimates of accuracy [sensitivity (Se) and specificity (Sp)] were obtained for different reported cut-points using a hierarchical summary receiver operating characteristic curve model. For the cut-point of 22% (n=8 studies), Se=80.2% (95% CI: 71.1-87.0%) and Sp=82.6% (71.4-90.0%). Decreasing the cut-point to 18% increased Se [96.1% (91.8-98.2%)] and decreased Sp [54.5% (26.9-79.6%)]. Modeling the effect of these Brix accuracy estimates using a stochastic simulation and Bayes theorem showed that a positive result with the 22% Brix cut-point can be used to diagnose good quality colostrum (posttest probability of a good colostrum: 94.3% (90.7-96.9%). The posttest probability of good colostrum with a Brix value <18% was only 22.7% (12.3-39.2%). Based on this study, the 2 cut-points could be alternatively used to select good quality colostrum (sample with Brix ≥22%) or to discard poor quality colostrum (sample with Brix <18%). When sample results are between these 2 values, colostrum supplementation should be considered.

09
CLINICAL STUDY The Cochrane database of systematic reviews (2015) PMID: 25699678 ↗
Oral lactoferrin for the prevention of sepsis and necrotizing enterocolitis in preterm infants.
Clinical Trial Synthesis 2015 Randomized Controlled Trial (RCT) published in The Cochrane database of systematic reviews involving n = 678 participants (RR 0.3). Key conclusion: Oral lactoferrin supplementation decreased late-onset sepsis (typical risk ratio (RR) 0.49, 95% confidence interval (CI) 0.32 to 0.73; typical risk difference (RD) -0.09, 95% CI -0.14 to -0.04; number needed to treat for an additional beneficial outcome (NNTB) 11, 95% CI 7 to 25;
View Original PubMed Abstract ↓

BACKGROUND: Lactoferrin, a normal component of human colostrum and milk, can enhance host defense and may be effective in the prevention of sepsis and necrotizing enterocolitis (NEC) in preterm neonates. OBJECTIVES: Primary objective To assess the safety and effectiveness of oral lactoferrin in the prevention of sepsis and NEC in preterm neonates. Secondary objectives1. To determine the effects of oral lactoferrin used to prevent neonatal sepsis and/or NEC on duration of positive-pressure ventilation, development of chronic lung disease (CLD) or periventricular leukomalacia (PVL), length of hospital stay to discharge among survivors, and adverse neurological outcomes at two years of age or later.2. To determine the adverse effects of oral lactoferrin in the prophylaxis of neonatal sepsis and/or NEC.When data were available, we analyzed the following subgroups.1. Gestational age < 32 weeks and 32 to 36 weeks.2. Birth weight < 1000 g (extremely low birth weight (ELBW) infants) and birth weight < 1500 g (very low birth weight (VLBW) infants).3. Type of feeding: breast milk versus formula milk. SEARCH METHODS: We used the search strategy of the Cochrane Neonatal Review Group (CNRG) and updated our search in July 2014. We searched the databases Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, PREMEDLINE, EMBASE, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL), as well as trials registries and conference proceedings. SELECTION CRITERIA: Randomized controlled trials (RCTs) evaluating oral lactoferrin at any dose or duration to prevent sepsis or NEC in preterm neonates. DATA COLLECTION AND ANALYSIS: Review authors used standard methods of the CNRG. MAIN RESULTS: Four RCTs are included in this review. Oral lactoferrin supplementation decreased late-onset sepsis (typical risk ratio (RR) 0.49, 95% confidence interval (CI) 0.32 to 0.73; typical risk difference (RD) -0.09, 95% CI -0.14 to -0.04; number needed to treat for an additional beneficial outcome (NNTB) 11, 95% CI 7 to 25; four trials, 678 participants, moderate-quality evidence), NEC stage II or greater (typical RR 0.30, 95% CI 0.12 to 0.76; typical RD -0.05, 95% CI -0.08

10
CLINICAL STUDY European journal of applied physiology (2026) PMID: 40640599 ↗
Bovine colostrum supplementation in rugby.
Clinical Trial Synthesis 2026 Randomized Controlled Trial (RCT) published in European journal of applied physiology; statistical significance reported at p = 0.0023. Key conclusion: CONCLUSION: Bovine colostrum may enhance neuromuscular performance, specifically lower body power, but provides limited benefits for other performance metrics, body composition, or immune/inflammatory function.
View Original PubMed Abstract ↓

INTRODUCTION: Bovine colostrum is a nutrient-dense first milk, rich in bioactive compounds such as immunoglobulins and growth factors, which may enhance athletic performance and immune function. Rugby union involves high-intensity training for both aerobic and muscular power, which could leave athletes vulnerable to opportunistic infections. PURPOSE: This double-blind, randomized study examined the effects of 8 weeks of bovine colostrum supplementation (38 g/day) versus soy protein in 29 club-level rugby players (three women) during the competitive season. METHODS: Muscular strength (1RM bench and leg press) and power (vertical jump), aerobic power (20 m shuttle run), body composition (DXA and ultrasound), and salivary immune and inflammatory markers (IgA, CRP, IL-6, IL-1β) were assessed at baseline and after 8 weeks of supplementation. RESULTS: Bovine colostrum supplementation significantly improved vertical jump height (+ 1.0 cm in the colostrum group; - 0.5 cm in the soy group; p = 0.0023), indicating enhanced lower body power. No significant changes were observed for upper (p = 0.38) or lower (p = 0.82) body strength, aerobic power (p = 0.16), body composition measures (p > 0.05), or salivary immune and inflammatory markers (p > 0.05) compared to the soy group. Reported incidences of illness were unaffected by bovine colostrum supplementation. CONCLUSION: Bovine colostrum may enhance neuromuscular performance, specifically lower body power, but provides limited benefits for other performance metrics, body composition, or immune/inflammatory function. Future research should explore bovine colostrum's potential during off-season training or under higher immune stress conditions. © 2025. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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