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Background: Previous studies have proposed that the maternal intake of pre/probiotics may affect the immune composition of breast milk. Nevertheless, the available findings are contradictory. This meta-analysis aimed to examine the impact of maternal supplementation with pre/probiotics on the levels of total immunoglobulin A (IgA), secretory IgA (SIgA), transforming growth factor beta 1 (TGF-β1), and TGF-2 in breast milk. Methods: PubMed and Scopus were systematically searched using a comprehensive search strategy for eligible randomized-controlled trials published up to February 2021. A random-effects model was applied to pool weighted mean difference and 95% confidence interval (CI) as effect size. Cochran's Q statistic and the I2 statistic were used to measure the between-study variance. Egger's regression test was used to assess publication bias. Results: A total of 12 different studies, with a total sample size of 1722 individuals (probiotic group: 858, placebo group: 864), were included in this meta-analysis. In the overall analysis, compared with placebo, maternal supplementation with pre/probiotics had no significant effect on concentrations of total IgA, SIgA, TGF-β1, and TGF-β2 in the breast milk. In the subgroup analysis, pre/probiotics did not affect total IgA, TGF-β1, and TGF-β2 in both colostrum/transitional and mature milk. However, a significant increase in SIgA was found in colostrum/transitional milk following pre/probiotic administration (WMD = 19.33, 95% CI: 0.83-37.83; p = 0.04), without evidence for remarkable heterogeneity (I2 = 0.0, p = 0.57). Conclusions: Maternal supplementation with pre/probiotics may increase SIgA in colostrum/transitional milk, without any effect on total IgA, TGF-β1, and TGF-β2.

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.

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.

BACKGROUND: Financial incentives are widely used strategies to alleviate poverty, foster development, and improve health. Cash transfer programs, microcredit, user fee removal policies and voucher schemes that provide direct or indirect monetary incentives to households have been used for decades in Latin America, Sub-Saharan Africa, and more recently in Southeast Asia. Until now, no systematic review of the impact of financial incentives on coverage and uptake of health interventions targeting children under 5 years of age has been conducted. The objective of this review is to provide estimates on the effect of six types of financial incentive programs: (i) Unconditional cash transfers (CT), (ii) Conditional cash transfers (CCT), (iii) Microcredit (MC), (iv) Conditional Microcredit (CMC), (v) Voucher schemes (VS) and (vi) User fee removal (UFR) on the uptake and coverage of health interventions targeting children under the age of five years. METHODS: We conducted systematic searches of a series of databases until September 1st, 2012, to identify relevant studies reporting on the impact of financial incentives on coverage of health interventions and behaviors targeting children under 5 years of age. The quality of the studies was assessed using the CHERG criteria. Meta-analyses were undertaken to estimate the effect when multiple studies meeting our inclusion criteria were available. RESULTS: Our searches resulted in 1671 titles identified 25 studies reporting on the impact of financial incentive programs on 5 groups of coverage indicators: breastfeeding practices (breastfeeding incidence, proportion of children receiving colostrum and early initiation of breastfeeding, exclusive breastfeeding for six months and duration of breastfeeding); vaccination (coverage of full immunization, partial immunization and specific antigens); health care use (seeking healthcare when child was ill, visits to health facilities for preventive reasons, visits to health facilities for any reason, visits for health check-up including growth control); management of diarrhoeal disease (ORS use during diarrhea episode, continued feeding during diarrhea, healthcare during diarrhea episod

Childhood vaccination is a cornerstone of public health, significantly reducing morbidity and mortality from vaccine-preventable diseases. However, immunization coverage remains suboptimal in many low-resource settings, including Ethiopia. Mobile health (mHealth) interventions, such as SMS reminders, have shown promise in improving healthcare service utilization, yet their effectiveness in enhancing childhood vaccination uptake remains underexplored in Ethiopia. This study assesses the impact of an mHealth intervention on childhood vaccination coverage and associated factors among mothers in the Gamo and Gofa zones of South Ethiopia. A cluster randomized controlled trial (cRCT) was conducted among 680 pregnant mothers recruited from 20 randomly selected health institutions in the Gamo and Gofa zones. Participants were assigned to either the intervention group (n = 340), which received SMS reminders and health education messages, or the control group (n = 340), which received standard care. Eligible participants were pregnant women (≥ 18 years old) with a gestational age of 16-28 weeks, literate, and able to use mobile phones. The primary outcome was childhood vaccination completion, while secondary outcomes included timely Bacillus Calmette-Guérin (BCG) vaccination at birth. Data were collected through structured interviews and analyzed using multilevel logistic regression and generalized linear mixed models. The intervention group demonstrated a significantly higher childhood vaccination completion rate (AOR = 4.80, 95% CI: 1.75-13.01, p < 0.01). Timely BCG vaccination at birth was also significantly improved in the intervention group (Log Odds = 2.19, 95% CI: 0.69-3.70, p < 0.01). Sociodemographic factors, such as maternal age, colostrum feeding, provider, and family planning, were significantly associated with vaccination uptake. The study suggests that mHealth interventions, such as SMS health information and reminders, might significantly enhance childhood vaccination coverage. Implementing mobile-based strategies could help bridge immunization gaps and support national vaccination programs. Future studies should explore the scalability of mHealth intervent

BACKGROUND: Human milk oligosaccharides (HMOs) are complex carbohydrates that act as prebiotics, supporting infants' gut microbial colonization and immune development. HMO levels are influenced by several maternal factors, including genetics, diet, and health status. In this study, we aim to investigate the effects of ω-3 PUFA (polyunsaturated fatty acids) and Limosilactobacillus (L.) reuteri supplementation on HMO levels in colostrum and mature milk. Another aim is to compare HMO levels between allergic and non-allergic mothers and to explore the correlation between HMOs and secretory immunoglobulin A (SIgA) in milk. METHODS: Milk samples (n = 136) were collected from mothers enrolled in a clinical trial (PROOM-3) designed to investigate the effect of pre- and postnatal supplementation with ω-3 PUFA and L. reuteri on allergy development in early childhood. HMOs were measured in colostrum and mature milk collected 3 months postpartum using high-performance anion exchange chromatography. SIgA was measured in colostrum, 1-, 2-, 3-, and 4-month milk using ELISA. RESULTS: The supplements did not affect HMO levels in colostrum or mature milk. However, maternal supplementation with ω-3 PUFA decreased the HMO diversity over time. Additionally, allergic mothers expressed significantly lower levels of several HMOs compared to non-allergic mothers. Additionally, SIgA correlated positively with fucosylated and negatively with sialylated HMOs. CONCLUSION: Supplementation with ω-3 PUFA could reduce the HMO diversity over the course of lactation. Also, maternal allergy seems to be associated with a reduction in levels of several HMOs. Furthermore, there is a possible dynamic interplay between HMOs and SIgA in milk. TRIAL REGISTRATION: ClinicalTrials.gov-ID: NCT01542970. © 2025 The Author(s). Pediatric Allergy and Immunology published by European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd.

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.

BackgroundOral care with mother's colostrum (OCC) for very-low-birth-weight (VLBW) preterm newborns may provide immune-protective effects that potentially reduce the risk of late-onset sepsis (LOS) and death. Our objective was to assess the effect of OCC on the risk of LOS and mortality in VLBW premature neonates.MethodsA single-center randomized clinical trial was conducted on 65 VLBW preterm neonates. The intervention was oral care administrated every 6 hours, starting in the first 24 hours of life and lasting for 5 days, using either own mother's colostrum (colostrum group) or sterile water (placebo group).ResultsNeonates in the colostrum group were significantly less likely to have LOS (62.5% vs 93.9%, RR = 0.66, p = 0.002), ventilator-associated pneumonia (VAP) (21.9% vs 48.5%, RR = 0.45, p = 0.025), feeding intolerance (56.3% vs 84.3%, RR = 0.66, p = 0.01), and mortality (18.8% vs 57.6%, RR = 0.3, p = 0.001). The time to start enteral nutrition in the colostrum group was shorter (p = 0.04) than in the placebo group. In multivariate analysis, OCC decreased the risk of LOS (OR = 0.12, p = 0.01) and death (OR = 0.14, p = 0.004). Moreover, OCC practice was associated with a faster time to regain birth weight (p = 0.027) and a shorter duration of hospitalization (p = 0.04) in surviving preterm infants.ConclusionOCC is a simple and safe practice that may yield a significant impact in reducing the risk of LOS, VAP, feeding intolerance, and mortality; can shorten time to start enteral feeding with faster regain to birth weight; and can shorten the length of hospital stay in VLBW preterm infants.

BACKGROUND: Bovine colostrum (COL) is assumed to be one of the strongest natural immune stimulants. Regular ingestion of COL may contribute to improved immune response in athletes exposed to high training loads. METHODS: Twenty-eight endurance-trained males aged 31.1 ± 10.2 years (body mass 81.9 ± 9.0 kg; height 1.82 ± 0.06 m) completed this randomized double-blind placebo(PLA)-controlled crossover study aimed at investigating the effect of 12-week COL supplementation (25gCOL·day-1) on resting (REST), exercise-induced (POST-EX), and short-term post-exercise recovery (REC; 1 h after test exercise) changes in selected saliva and blood immunoglobulins (Ig), white blood cell (WBC) count and differential; as well as blood hematological, nutritional status and muscle damage indices. The protocol assumed 4 study visits - before/after supplementation with COL (COLPRE and COLPOST ) and PLA (PLAPRE and PLAPOST ). During testing sessions, incremental rowing test to exhaustion and swimming-specific performance test were introduced as exercise stimuli. RESULTS: At COLPOST visit the secretory IgA (SIgA) concentration in saliva was significantly higher at POST-EX and REC compared to REST (p<0.05). COL supplementation had no effect on blood IgA, IgE, IgD, IgG, and IgM concentrations. Furthermore, after COL supplementation decrease of hematocrit at REC (p<0.05) was revealed. CONCLUSIONS: 12-week supplementation with 25 gCOL·day-1 in endurance-trained male athletes resulted in a favorable increase in post-exercise concentration of salivary SIgA. COL seems to be a potential stimulator of local immune defense after exercise-induced homeostasis disturbances. Nevertheless, the lack of effect on blood markers indicates the need for further research in the area of mechanisms underlying the effect of the supposed COL immunological capacity.

Background/Objectives: Colostrum Bovinum (COL) is recognized for its unique composition and potential ergogenic and immunological benefits. Unlike mature milk, COL is rich in immunoglobulins, lactoferrin, and various growth factors, making it one of the most potent natural immune stimulants. The purpose of this study was to evaluate the effects of 12-weeks of COL supplementation on swimming-specific performance (SSP) and exercise adaptations in endurance-trained male athletes. Methods: Twenty-eight male triathletes and swimmers (age: 31.1 ± 10.2 years; body mass: 81.9 ± 9.0 kg; height: 1.82 ± 0.06 m) participated in a randomized, double-blind, placebo (PLA)-controlled crossover study and received 25 g∙day-1 of COL or PLA for 12 weeks. The study assessed the effects of COL on SSP (8 × 100 m performed at various intensities) and exercise adaptations [heart rate (HR) and blood lactate concentrations ([La-])]. Four main study visits were conducted-before and after COL (COLPRE and COLPOST) and PLA (PLAPRE and PLAPOST) supplementation. Results: COL had no significant effect on SSP. Still, the total time of the SSP test was about ~3.04 s shorter after COL supplementation, and ~7.13 s longer after PLA supplementation. Neither COL nor PLA supplementation affected HR during the SSP test. Post-exercise blood [La-] was significantly reduced after both COL and PLA supplementation. The analysis of SSP results in the consecutive study visits revealed possible existence of the practice effect. Conclusions: Colostrum Bovinum and high-quality milk protein (PLA) seem to be comparably effective in evoking exercise adaptation in endurance-trained male athletes. Long-term crossover supplementation protocols in athletes must consider the impact of possible practice effect when interpreting the outcomes related to exercise performance, but not biochemical or physiological markers of exercise adaptation.

BACKGROUND: Premature infants have higher risks of infection due to their underdeveloped immune systems and changes to the oral cavity's normal flora colonization. PURPOSE: To assess the effect of oral colostrum application on the condition of the mouth and the incidence of late-onset sepsis (LOS) among premature infants. METHODS: In this randomized controlled trial, 70 newborn premature infants were randomly allocated to colostrum or sterile water groups. The Mouth Care Assessment Tool was used to evaluate the condition of the mouth for 5 days after oral colostrum application. The incidence of LOS was measured using clinical and laboratory indicators from 72 hours after birth until discharge. RESULTS: The condition of the mouth was significantly different on days 4 and 5, demonstrating that the colostrum group had less need for oral care ( P < .001) compared to the control group. There was no significant difference between the 2 groups in clinical symptoms and laboratory values related to LOS ( P > .05). IMPLICATIONS FOR PRACTICE: Oral colostrum application can benefit oral mucosal health and reduce the need for oral care among premature infants. It is also safe alternative oral care for premature infants who cannot breastfeed during the first few days of life. Future research should include infants of different gestational ages and mechanically ventilated infants to assess the effect of oral colostrum application on serum immune factors.

BACKGROUND: For very preterm infants, human milk is often fortified with formula products based on processed bovine milk. Intact bovine colostrum (BC), rich in anti-inflammatory milk factors, is considered an alternative. We investigated if BC affects anti-inflammatory/TH2 immunity and infection risk in very preterm infants. METHODS: For a secondary analysis of a multicenter, randomized controlled trial (NCT03537365), very preterm infants (26-31 weeks gestation, 23% small for gestational age, SGA) were randomized to receive BC (ColoDan, Biofiber, Denmark, n = 113) or conventional fortifier (PreNAN, Nestlé, Switzerland, n = 116). Infection was defined as antibiotic treatment for five or more consecutive days and 29 cytokines/chemokines were measured in plasma before and after start of fortification. RESULTS: In general, infection risk after start of fortification was associated with low gestational age, SGA status and antibiotics use prior to fortification. Adjusted for confounders, infants fortified with BC showed more infection episodes (20 vs 12%, P < 0.05) and higher cumulative infection risk (hazard ratio, HR 1.9, P = 0.06), particularly for SGA infants (HR 3.6, P < 0.05). Additionally, BC-fortified infants had higher levels of TH2-related cytokines/chemokines (IL-10, MDC, MCP4) and reduced levels of cytokines related to TH1/TH17-responses (IL-15, IL-17, GM-CSF). The differences were most pronounced in SGA infants, displaying higher levels of TH2-related IL-4, IL-6, and IL-13, and lower interferon-γ and IL-1α levels in the BC group. CONCLUSION: Infants fortified with BC displayed a delayed shift from TH2- to TH1-biased systemic immunity, notably in SGA infants, possibly influenced by multiple confounding factors, alongside elevated antibiotic use, suggesting increased susceptibility to infection. © 2024. The Author(s).

OBJECTIVES: Patients with femur fracture after surgery are at risk of malnutrition, weight loss, disability, and mobility complications. In the present study the role of colostrum supplementation on physical disability, and some nutritional variables after surgery has been investigated. RESEARCH METHODS & PROCEDURES: Patients were randomly assigned to two groups. The intervention group received 45 g colostrum and the control group received 15 g whey protein daily for 21 days (each containing 12 g of protein). The trend comparison during 30 days of variables including weight, appetite, serum albumin level, hemoglobin and lymphocytes between the two groups was modeled with the generalized estimation equation. Moreover, the trend comparison during 90 days of Oswestry Disability Index (ODI) between the two groups was calculated. RESULTS: The basic characteristics were the same between the two groups (colostrum, n = 46; control, n = 48). Protein intake was the same in both groups during the study period. There was a significant difference in weight gain (ß = 0.32, 95 % CI: 0.09-0.54; P = 0.005) within 30 days after operation between the colostrum and control groups in favor of the increase in the colostrum group. Compared to the control group, patients in the colostrum group had a 0.31 score more appetite (P < 0.001), 0.17 g/dL higher serum albumin level (P = 0.001), 0.5 mg/dL higher hemoglobin level and 440 more blood lymphocytes (P < 0.001) during the 30 days of intervention. Regarding physical function disability, patients in the colostrum group had about 4 ODI scores lower than the control group during the study period. CONCLUSION: Colostrum supplement can increase appetite, hemoglobin, serum albumin level and the number of blood lymphocytes more than the control group. It can also accelerate weight gain and physical performance after surgery.

Physical exercise, especially of high intensity, is a significant burden on an athlete's body. It should be emphasized that achieving high results in competitive sports requires the use of significant, sometimes extreme, exercise loads during training, which may result in homeostasis disorders, adversely affecting the fitness of athletes. This study aims to investigate the effects of 6 months of bovine colostrum supplementation on indicators of immune system functioning, selected parameters related to iron management, and anabolic/catabolic balance in young football players. Twenty-eight male football players completed a double-blind, placebo-controlled crossover protocol (24 weeks of colostrum/placebo). A standardized exercise test was executed at the beginning of the trial and after 3 and 6 months of supplementation. Blood samples were taken before and after the exercise test and after 3 h of recovery. Markers of iron homeostasis, pro- and anti-inflammatory balance, and hormonal responses were determined. A significant increase in immunoglobulin G concentration was observed, accompanied by a decrease in inflammatory markers in supplemented athletes. Bovine colostrum supplementation had no significant effect on athletes' performance or on iron management and hormonal response. The use of bovine colostrum, which is characterized by a high content of immunologically active compounds, can be an element of a relatively mild and safe intervention for reducing inflammation induced by intense physical exercise.

Abstract: Bovine colostrum contains high concentrations of cytokines, and colostral cytokines are considered to be an important factor in stimulation of maturation of the immune system in newborns. In this study, 5 proinflammatory cytokines (IL-1beta, IL-6, TNF-alpha, IFN-gamma and IL-1 receptor antagonist, IL-1ra) present in colostrum were tested for their potential to enhance mitogenic response and to elicit expression of IL-2 mRNA and CD25 in peripheral blood mononuclear cells (PBMC) from newborn calves before being fed colostrum. PBMC were pretreated with each recombinant bovine cytokine for 2 hr before stimulation with concanavalin A (ConA). Pretreatment of PBMC from newborn calves with IL-1beta, TNF-alpha or IFN-gamma significantly enhanced the ConA response, whereas IL-1ra inhibited the response. The degree of enhancement or inhibition of mitogenic response by these cytokines was more pronounced in PBMC from newborn calves than in those from adult cows. Although IL-2 mRNA expression in ConA-stimulated PBMC from newborn calves was weaker than that in those from adult cows of ConA-stimulated controls, the expression levels became comparable after pretreatment with IL-1beta, TNF-alpha or IFN-gamma. The CD25 expression in PBMC from newborn calves was also enhanced by pretreatment with IL-1beta, TNF-beta and IFN-gamma. These results suggest that pretreatment of neonatal PBMC with IL-1beta, TNF-alpha or IFN-gamma promotes mitogenic response to ConA through up-regulating the production of IL-2 and the expression of the mature IL-2 receptor.

The coexistence of interleukin (IL)-1beta with IL-1 receptor antagonist (ra) in bovine colostrum and the possibility of simultaneous transfer of these cytokines to neonates via colostrum have been demonstrated. In the present study, we investigated the effect of IL-1ra on the mitogenic response of calf peripheral blood mononuclear cells (PBMC) stimulated by concanavalin A (ConA), which was mediated by IL-1. Pretreatment of PBMC with recombinant bovine (rb) IL-1ra alone significantly suppressed the proliferation of ConA-stimulated cells. However, in the presence of rbIL-1beta, the suppressive activity of rbIL-1ra was counteracted. These results suggest that coexistence of IL-1ra with IL-1 in colostrum may have no effect on the activation of the neonatal immune system by IL-1beta.

BACKGROUND: Maternal milk-borne transforming growth factor (TGF-β plays a potential role in the development of the mucosal immune system in infants. However, it remains unclear what factors determine TGF-β levels in breast milk. We hypothesized that microbial pressures during pregnancy might affect the expression levels of TGF-β in colostrum. OBJECTIVE: This study compared TGF-β2 levels in colostrum of lactating women living in Japan and Nepal with contrasting hygiene statuses. Additionally, we identified environmental and intrinsic factors influencing TGF-β levels in colostrum. METHODS: Breast milk samples and structured questionnaires were collected from 80 women living in Japan and 208 women living in Nepal. A robust regression model was used to identify factors associated with colostral TGF-β levels. RESULTS: Analysis using the Mann-Whitney U test showed that TGF-β levels were significantly higher in Japanese women than in Nepalese women. Japanese women who consumed animal milk daily during pregnancy and had atopic dermatitis expressed lower levels of TGF-β in colostrum, as compared to Japanese women who did not. Among Nepalese women, large family size and higher birth order were associated with lower TGF-β levels and women who gave birth to infants with low birth weight had higher expression of TGF-β levels in milk than women who gave birth to infants with normal birth weight. CONCLUSION: The results suggest that induction of TGF-β levels in colostrum depends on differences in the ethnicity of lactating women. Consumption of animal protein and parturition characteristics may affect TGF-β levels in breast milk, and may explain differences in these levels in breast milk between countries.

OBJECTIVE: This study aimed to assess the impact of bovine colostrum (BC) on the gut health of the pediatric population. METHODOLOGY: The systematic review was conducted in accordance with Preferred Reporting Items for Systematic Review and Meta-analysis guidelines 2020. Full-text articles such as randomized control trials, cohort prospective studies, and pilot studies were identified from the following databases: PubMed, Web of Science, ProQuest, Clinicaltrial.gov, and Cochrane. After assessing for inclusion and exclusion criteria, eight studies were finally included and assessed for quality using the Effective Public Health Practice Project scale. RESULTS: Some studies reported a positive impact of BC on the duration and frequency of diarrheal infection in children, but the overall clinical benefits of BC in the gut health of children remain inconclusive. The studies were heterogeneous with regard to methodology, dose, form of BC used, and outcomes studied; hence, a meta-analysis could not be performed in terms of outcomes assessed. CONCLUSION: No conclusion can be drawn regarding the clinical benefits of BC in the gut health of children. Further studies are needed in the pediatric population using BC as an intervention for a variety of gastro-intestinal problems. © 2025 European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition.

BACKGROUND: Breastfeeding maintains the maternal-fetal immune link after birth, favors the transmission of immunological competence, and is considered an important contributing factor to the development of the babies' immune system. OBJECTIVE: This study aimed to obtain data related to the effects of gestational diabetes on immunoglobulin A (IgA) and cytokines levels in the colostrum, before and during the pandemic of the new coronavirus, in order to study the possible outcomes regarding the immunological characteristics of human milk. METHODS: This systematic review was registered in PROSPERO CRD42020212397, and the question elaborated using the PICO strategy was: does maternal hyperglycemia associated or not with Covid-19 influence the immunological composition of colostrum? Electronic searching and reference lists of published reports were used to identify studies that reported the influence of gestational diabetes on colostrum and milk composition. RESULTS: Seven studies were selected from the 51 found, six of them were cross-sectional and one was a case report. Six studies included Brazilian groups and only one was conducted in USA. The mothers with gestational diabetes presented a reduced level of IgA and other immunoreactive proteins in colostrum. Those alterations could be related to changes in macronutrient metabolism and cellular oxidative metabolism. CONCLUSION: It was possible to conclude that diabetes changes the immunological composition of breast milk; however, data on the impact of the association between gestational diabetes and Covid-19 infection on the composition of antibodies and cytokines present in human milk are still scarce and inconclusive.

BACKGROUND: Myalgia reflects generalized inflammation and cytokine response and can be the onset symptom of 36% of patients with COVID-19. Interleukin-6 (IL-6) and tumor necrosis factor-α (TNF- α) levels in plasma and upper respiratory secretions directly correlate with the magnitude of viral replication, fever, and respiratory and systemic symptoms, including musculoskeletal clinical manifestations. OBJECTIVE: The aim of our work is to report literature scientific investigation clinical protocol to reduce the immunomodulation and inflammatory response nutraceutical therapy associated with dexamethasone and how can reduce the expression of Interlukina-6(IL-6) and myalgia due to COVID-19. METHODS: We searched in Pubmed and Cochrane the nautriceutical drugs to treat the immune modulation of organism to COVID-19. We put these keywords: immune inflammation, desease descriptions, epidemiology COVID-19; immunomodulations; IL-6; Rheumatic Symptoms; Joint; Musculoskeletal Disorders; dexamethasone; Polydatin; Zinc; Melatonin; N- Acetyl Cysteine; Colostrum; L- Glutamine; Vitamin D3. RESULTS: We found 61 papers. All the authors analyze them. After the Analyze we suggest the use of response nutraceutical therapy associated with dexamethasone can reduce the expression of Interlukina-6(IL-6) and myalgia due to COVID-19. CONCLUSION: According the scientific literature nutraceutical therapy associated with dexamethasone can reduce the expression of Interlukina-6(IL-6) and myalgia due to COVID-19. © 2022 Umberto Ripani, Michele Bisaccia, Luigi Meccariello.

BACKGROUND: Human colostrum has been used in a number of investigations when preterm human infants cannot, for any reason, breastfeed directly from their mothers. One of the growing fields in these investigations is colostrum therapy, which consists of exposing the oropharyngeal mucosa of these preterm newborns to small amounts of raw colostrum. RESEARCH AIM: To critically review the scientific evidence about colostrum therapy in premature infants and to explore its influences on the immune system. METHODS: This systematic review was performed according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA statement). The following databases were searched for potentially eligible studies up to March 10, 2021: Medline, Scopus, Web of Science, Cochrane Library, Embase. Two reviewers independently screened all titles, abstracts, and full texts for eligibility. RESULTS: A total of 12 studies with 996 participants were included. A significant difference in lactoferrin levels in the urine was found (SMD 0.70; 95% CI [0.03,1.36]; p = .04; I² = 65% two studies, 112 participants, very low-quality evidence). CONCLUSION: Colostrum seems to result in increasing lactoferrin levels in the urine of premature newborns after 1 week of intervention. CLINICAL TRIAL REGISTRATION: The study was registered at PROSPERO with the number CRD42017073624, submitted on August 9, 2017.

Colostrum is the first secretion of mammalian glands during the early period after birth giving. Its components are biologically active and have beneficial effects on new-born growth and well-being. Bovine colostrum has the highest concentration of these substances and its supplementation or application may provide health benefits. This systematic review was conducted to update current knowledge on bovine colostrum effects including all administration routes on healthy and sick subjects. Full texts or abstracts of twenty-eight papers as reports of systematic reviews, randomized controlled trials, observational studies and case series were included after searches in Medline, Embase, Cochrane Library and Cinahl databases. The full texts of selected studies were assessed for quality using validated tools and their results were summarized in different categories. Studies were highly heterogeneous as regards to population, intervention, outcome and risk of bias. Bovine colostrum topical application was shown effective on vaginal dryness related symptoms limitation. Its use as food supplement showed interesting effects preventing upper respiratory illness in sportsmen, modulating immune system response and reducing intestinal permeability in healthy and sick subjects. Conflicting results were provided in pediatric population and little evidence is available on its use with older adults. Further studies are mandatory to better understand all factors influencing its activity.

The nutritional and immunologic properties of human milk, along with clear evidence of dose-dependent optimal health outcomes for both mothers and infants, provide a compelling rationale to support exclusive breastfeeding. US women increasingly intend to breastfeed exclusively for 6 months. Because establishing lactation can be challenging, exclusivity is often compromised in hopes of preventing feeding-related neonatal complications, potentially affecting the continuation and duration of breastfeeding. Risk factors for impaired lactogenesis are identifiable and common. Clinicians must be able to recognize normative patterns of exclusive breastfeeding in the first week while proactively identifying potential challenges. In this review, we provide new evidence from the past 10 years on the following topics relevant to exclusive breastfeeding: milk production and transfer, neonatal weight and output assessment, management of glucose and bilirubin, immune development and the microbiome, supplementation, and health system factors. We focus on the early days of exclusive breastfeeding in healthy newborns ≥35 weeks' gestation managed in the routine postpartum unit. With this evidence-based clinical review, we provide detailed guidance in identifying medical indications for early supplementation and can inform best practices for both birthing facilities and providers.

BACKGROUND: Human milk (HM) transforming growth factor beta (TGF-β) is critical for inflammation regulation and oral tolerance promotion. Previous reports suggested that variations in HM TGF-β levels are associated with allergic outcomes. OBJECTIVE: We undertook a systematic review (PROSPERO 2017 CRD42017069920) to reassess the evidence on the relationships between HM TGF-β and allergic outcomes in children. METHODS: Electronic bibliographic databases (MEDLINE, EMBASE and Cochrane Library) were systematically searched. Two independent reviewers screened reference lists, extracted the data and assessed risk of bias using the National Institute for Clinical Excellence methodological checklist. RESULTS: A total of 21 studies were identified. Sixteen studies assessed relationships between HM TGF-β and risk of eczema; 14, allergic sensitization; nine, wheezing/asthma; six, food allergy; three, allergic rhinitis/conjunctivitis. Five cohorts (5/18, 28%) reported a protective effect of TGF-β1, while 3 (3/10, 30%) suggested increased risk of allergic outcomes development and 1 (1/10, 10%), a protective effect of TGF-β2 on eczema. Meta-analysis was not possible due to significant heterogeneity in methodology, age of outcome assessment and differing statistical approaches. 71% (15/21) of studies carried a high risk of bias. CONCLUSION AND CLINICAL RELEVANCE: In contrast with previous findings, we did not find strong evidence of associations between HM TGF-β and allergic outcomes. Differences in studies' methodology and outcomes do not allow unconditional rejection or acceptance of the hypothesis that HM TGF-β influences the risk of allergy development. Future studies on diverse populations employing standardized methods, accurate phenotyping of outcomes and evaluation of the effect of TGF-β in combination with other HM immune markers, microbiome and oligosaccharides are required. © 2019 John Wiley & Sons Ltd.

BACKGROUND: Placing a small volume of colostrum directly onto the buccal mucosa of preterm infants during the early neonatal period may provide immunological and growth factors that stimulate the immune system and enhance intestinal growth. These benefits could potentially reduce the risk of infection and necrotising enterocolitis (NEC) and improve survival and long-term outcome. OBJECTIVES: To determine if early (within the first 48 hours of life) oropharyngeal administration of mother's own fresh or frozen/thawed colostrum can reduce rates of NEC, late-onset invasive infection, and/or mortality in preterm infants compared with controls. To assess trials for evidence of safety and harm (e.g. aspiration pneumonia). To compare effects of early oropharyngeal colostrum (OPC) versus no OPC, placebo, late OPC, and nasogastric colostrum. SEARCH METHODS: We used the standard search strategy of the Cochrane Neonatal Review Group to search the Cochrane Central Register of Controlled Trials (CENTRAL; 2017, Issue 8), MEDLINE via PubMed (1966 to August 2017), Embase (1980 to August 2017), and the Cumulative Index to Nursing and Allied Health Literature (CINAHL; 1982 to August 2017). We also searched clinical trials registries for ongoing and recently completed trials (clinicaltrials.gov; the World Health Organization International Trials Registry (www.whoint/ictrp/search/en/), and the ISRCTN Registry), conference proceedings, and the reference lists of retrieved articles for randomised controlled trials and quasi-randomised trials. We performed the last search in August 2017. We contacted trial investigators regarding unpublished studies and data. SELECTION CRITERIA: We searched for published and unpublished randomised controlled trials comparing early administration of oropharyngeal colostrum (OPC) versus sham administration of water, oral formula, or donor breast milk, or versus no intervention. We also searched for studies comparing early OPC versus early nasogastric or nasojejunal administration of colostrum. We considered only trials that included preterm infants at < 37 weeks' gestation. We did not limit the review to any particular region or language. DATA COLLECTION