Colostrum is the milk secreted by mammals in the first few days after birth. The composition of colostrum differs from the milk produced later in lactation due to its targeted support of the growth and immunological function of neonates. Almost all essential nutrients, including protein, fat, lactoferrin, immunoglobulins, vitamins, minerals, and growth factors, are present in higher concentrations in colostrum than in mature milk. Many biological activities of colostrum are shared across species. Supplementation with bovine colostrum (BC) has been popularized to support the immune and gastrointestinal (GI) systems in humans. Research also suggests potential benefits of BC in pediatric nutrition and gastroenterology.

Bovine colostrum is the first milk produced from cows after parturition and features higher protein content relative to fat and lactose, containing primarily casein and whey proteins, Immunoglobulins, and other bioactive compounds that have been shown to support growth, immune maturation, and GI health in infants and children. Oligosaccharides are one of the major carbohydrate sources in BC, which are largely undigested providing prebiotic, glycome-modifying, anti-adhesion, and anti-inflammatory activity. Its prebiotic effects support the colonization of beneficial gut bacteria and may act to inhibit the binding of pathogenic species on the mucosal surface of the enterocytes, potentially protecting the infant from infection. Immunoglobulin (IgG) G is the predominant immunoglobulin in BC. Newborn exposure to IgG and secretory IgA from colostrum is critical for modulating mucosal immune function and supporting a healthy inflammatory response. It is considered the first line of defense in neutralizing pathogenic bacteria in the intestinal lumen. Bovine IgG is also able to bind to an array of allergens and pathogenic bacteria and viruses in humans. 

A recent study published in the journal of Nutrients by Sangild and colleagues reviewed human and animal trials on the effects of BC on several pediatric subpopulations, including those with diarrhea, infection, growth failure, preterm birth, necrotizing enterocolitis (NEC), short-bowel syndrome, and mucositis. The researchers assessed the evidence on the safety and efficacy of BC as a nutritional supplement with antimicrobial and immunomodulatory actions as it relates to preterm birth, infections, and intestinal disorders.

Formula-fed preterm infants have an increased risk of disease (e.g., NEC) compared to infants fed human milk, as the formula-fed infants receive minimal amounts of immunoglobulins and other immunomodulatory proteins. As a supplement to infant formula or donor human milk, infants and children given BC showed limited adverse effects and improved protection against several GI disorders, such as virus-induced diarrhea, sepsis, NEC, and mucositis. Similar results were shown in preterm piglet models. However, the authors suggest that exclusive BC feeding is not recommended for infants, and it should be combined with human milk or formula. 

Few studies exist on infants and children. More clinical trials are needed to further investigate the potential benefits that BC supplementation has on supporting growth, immune function, and GI health, particularly in these subpopulations to help identify the most responsive patient groups and target diseases.

By Caitlin Higgins, MS, CNS