Effect of intranasal breast milk administration on cerebral oxygenation, vital signs, and transition time to full oral feeding in preterm infants: a randomized controlled study

Clinical Snapshot

Key Findings

• P Value: Described as 'significantly higher' but specific p-values not provided

• Effect Size: Not reported in abstract

• Primary Outcome: Cerebral oxygenation (rSO₂) significantly higher in intervention group compared to control

• Nnt Or Sensitivity: Not calculable from available data

• Confidence Interval: Not reported

Clinical Application

High feasibility - simple, low-cost intervention using readily available breast milk with standard intranasal administration technique Relevant to Australian NICUs following established breastfeeding promotion policies. Would require local ethics approval and integration with existing breast milk handling protocols. No TGA approval required as using natural breast milk. Preterm infants 28-36 weeks gestation in NICU settings with access to fresh breast milk

Abstract

UNLABELLED: This study examined the effects of intranasal breast milk administration on cerebral oxygenation, vital signs, and time to transition to full oral feeding in preterm infants. This assessor-blinded, randomized controlled trial included 40 preterm infants with gestational ages between 28+0 and 36+6 weeks. Infants in the intervention group received 0.2 mL of fresh breast milk intranasally three times daily for 3 days. The control group continued to receive routine clinical care. During each intervention period, cerebral oxygenation and vital signs were recorded at baseline (T0), 5 (T1), 15 (T2), and 30 (T3) minutes after the intervention. The time required for preterm infants to achieve full oral feeding was monitored until discharge. Cerebral oxygenation levels of preterm infants who received intranasal breast milk were significantly higher than the control group and respiratory rate was lower at some measurement times. No significant differences were found between groups in oxygen saturation, heart rate, time to full oral feeding, length of hospital stay, vomiting frequency and defecation frequency. CONCLUSION: Intranasal breast milk administration has the potential to increase cerebral oxygenation in preterm infants. The maintenance of oxygen saturation and heart rate, along with good tolerance of the procedure, suggests that this intervention may be safe and feasible. TRIAL REGISTRATION: The trial was registered on ClinicalTrials.gov on 21 May 2024 (Identifier: NCT06706115). WHAT IS KNOWN: • Intranasal breast milk administration has been reported to have therapeutic potential in improving brain injury in preterm infants. • Intranasal administration of breast milk is known not to cause significant side effects in preterm infants diagnosed with intraventricular hemorrhage. WHAT IS NEW: • Intranasal breast milk administration may increase cerebral rSO₂ in preterm infants. • Intranasal breast milk administration did not affect preterm infants' heart rate, SpO₂ levels, time to transition to full oral feeding, length of hospital stay, daily vomiting, and stooling frequency.

References

1. 1.Yücel, A., Küçükoğlu, S., & Konak, M. (2026). Effect of intranasal breast milk administration on cerebral oxygenation, vital signs, and transition time to full oral feeding in preterm infants: a randomized controlled study. European Journal of Pediatrics. https://doi.org/10.1007/s00431-018-3279-7