Drops of "Liquid Gold": Can a Mother's First Milk on a Premature Baby's Cheeks Help Fight Infection?

A plain-language look at a 2025 study testing whether small amounts of colostrum placed inside the mouth protect premature babies from late infection

A 2025 clinical trial from Iran tested a simple, gentle idea: placing a few drops of a mother's first milk inside her premature baby's mouth every few hours for a week. Babies who received the colostrum developed serious late infections about half as often as babies who did not, and they were ready for full milk feeds a little sooner — although the study was small enough that the infection difference could still have been due to chance. The approach caused no side effects, and it gives parents a real, hands-on way to help while their baby is still too tiny to feed [1].

Why This Question Matters

Babies born many weeks early face a long list of hurdles, and one of the most dangerous is infection. "Late-onset sepsis" is the term doctors use for a serious infection that appears after a baby's first three days of life, usually picked up from the hospital environment rather than passed from the mother. It is one of the leading causes of death and long-term problems in premature babies. Worldwide, millions of infants are affected by sepsis each year, and between about one in nine and one in five of those babies die from it [2]. Premature babies are especially vulnerable because their immune systems — the body's defense network — are still unfinished at birth.

For years, hospitals have fought these infections mainly by keeping germs away: careful handwashing, sterile techniques around the tubes and lines that tiny babies need, and encouraging breast milk. These measures help, but they do not fix the deeper problem, which is that a premature baby's own defenses are simply not ready yet. That gap is what researchers hoped a mother's earliest milk might help close.

How Families and Doctors Used to Face This

Before this line of research, there was little a parent could actively do about a premature baby's infection risk in the first days of life. The smallest babies often cannot be fed by mouth or even through a feeding tube at first, because their intestines are too immature. So the protective ingredients in a mother's milk — which are richest in the very first milk — went unused during exactly the window when the baby was most defenseless. Parents frequently describe those early days as helpless waiting, watching machines and monitors while feeling they have no role to play.

Colostrum, the thick golden milk a mother produces in the first days after birth, has long been nicknamed "liquid gold" for good reason. It is packed with antibodies, protective proteins like lactoferrin, special sugars, and signaling molecules that help train and calm a newborn's immune system [3]. Remarkably, the colostrum of mothers who deliver early is even richer in some of these protective factors than the milk of mothers who deliver at term. In the 2000s and 2010s, researchers asked a clever question: even if a tiny baby cannot digest milk yet, what if we simply place a few drops inside the mouth, where the protective ingredients can touch the immune tissue in the cheeks and throat? Early studies found that this "oropharyngeal" (mouth-and-throat) approach raised protective antibody levels in babies' saliva [4], and scientists mapped out how the milk's ingredients might block germs and coach the immune system from the mouth [5]. But different studies reached different conclusions about whether it actually prevents infection [6],[7], which is why researchers kept testing it.

What the Researchers Did

The 2025 study was carried out at a teaching hospital in Babol, Iran, over about a year [1]. It focused on babies born between 28 and 32 weeks of pregnancy — roughly two to three months early. Seventy babies took part. Using a method like a sealed-envelope lottery, and without the parents, the examining doctor, or the data analyst knowing who was in which group, the babies were split into two groups. One group received the colostrum treatment; the other received usual care without it.

The treatment itself was gentle and low-tech. Mothers were taught to hand-express their colostrum hygienically. Every three hours, a nurse drew up a tiny amount — about 0.4 milliliters, less than a tenth of a teaspoon — and dabbed half on each side of the baby's mouth, coating the gums, cheeks, and tongue, then softly massaged each cheek from the outside for at least ten seconds to help it absorb. This continued for seven days, starting within the first day or two of life once the baby was stable. Doctors then watched carefully for signs of infection, using both the baby's symptoms and blood tests, and also tracked how quickly each baby reached full milk feeds.

What They Found

Among the babies who received colostrum, about 15 in 100 developed a late infection, compared with about 32 in 100 who did not receive it — roughly half as many [1]. That is a large and encouraging difference. But because only 68 babies completed the study, the result did not quite reach the level of statistical certainty scientists require before saying an effect is definitely real (the technical measure, called a p-value, was 0.086, just above the usual 0.05 cutoff). In plain terms: the finding is promising and points clearly in a helpful direction, but the study was too small to be sure the difference was not partly luck.

The clearest benefit was in feeding. Babies who got the colostrum reached full milk feeds about a day and a quarter sooner than the others, a difference that was statistically solid [1]. Getting to full feeds sooner is meaningful, because it lets doctors remove intravenous lines earlier — and those lines are themselves a common doorway for infection. The babies also trended toward shorter hospital stays and earlier independent feeding, though those differences were not large enough to be certain. Importantly, the treatment caused no side effects at all, which fits with what other studies of this approach have found [8],[9].

What This Means for Families

If your baby is in a NICU, this research offers a hopeful and very practical message. Giving colostrum by mouth is safe, costs almost nothing, and gives you a genuine role in your baby's care during the hardest early days. Many parents find deep comfort in knowing that their own milk — even just a few drops that the baby cannot yet swallow — may be helping to protect and nourish their child. Ask your baby's care team whether they offer oropharyngeal colostrum care and how you can be involved; the real bottleneck is usually helping mothers express milk in the very first hours, so early lactation support is key.

It is also fair to be clear-eyed. This single small study does not prove that colostrum prevents infection on its own, and it does not replace the handwashing, careful line care, and other protections that remain the foundation of keeping premature babies safe. Think of oropharyngeal colostrum as a gentle, promising helper rather than a guaranteed shield.

What Researchers Are Working On Next

The scientists themselves say the most important next step is a larger study run across many hospitals, with enough babies to settle the infection question for certain and with a "dummy" comparison so the feeding benefit can be separated from the simple act of caring for the mouth [1],[6]. Researchers also want to include the very tiniest, earliest babies — who were not part of this study but may have the most to gain — and to measure exactly how the milk changes the baby's immune markers and the mix of friendly bacteria in the mouth and gut [10],[11]. For now, this study adds a warm and encouraging piece to a growing picture in which pooled analyses of many trials point toward fewer infections and faster feeding with this approach [12]: a mother's first milk, even placed drop by drop on a baby's cheeks, may be doing real good.

References

  1. Behrooj N, Aziznejadroshan P, Akbarian Rad Z, Nikbakht HA, Zabihi A. Investigating the effect of oropharyngeal colostrum in the prevention of late-onset sepsis in preterm infants: a randomized controlled trial. Sci Rep. 2025;15(1):17390. doi:10.1038/s41598-025-02309-z ↩
  2. Fleischmann-Struzek C, Goldfarb DM, Schlattmann P, et al. The global burden of paediatric and neonatal sepsis: a systematic review. Lancet Respir Med. 2018;6(3):223–230. doi:10.1016/S2213-2600(18)30063-830063-8) ↩
  3. Lee J, Kim HS, Jung YH, et al. Oropharyngeal colostrum administration in extremely premature infants: an RCT. Pediatrics. 2015;135(2):e357–e366. doi:10.1542/peds.2014-2004 ↩
  4. Glass KM, Greecher CP, Doheny KK. Oropharyngeal administration of colostrum increases salivary secretory IgA levels in very low-birth-weight infants. Am J Perinatol. 2017;34(14):1389–1395. doi:10.1055/s-0037-1603655 ↩
  5. Garofalo NA, Caplan MS. Oropharyngeal mother's milk: state of the science and influence on necrotizing enterocolitis. Clin Perinatol. 2019;46(1):77–88. doi:10.1016/j.clp.2018.09.005 ↩
  6. Panchal H, Athalye-Jape G, Patole S. Oropharyngeal colostrum for preterm infants: a systematic review and meta-analysis. Adv Nutr. 2019;10(6):1152–1162. doi:10.1093/advances/nmz033 ↩
  7. Nasuf AWA, Ojha S, Dorling J. Oropharyngeal colostrum in preventing mortality and morbidity in preterm infants. Cochrane Database Syst Rev. 2018;9(9):CD011921. doi:10.1002/14651858.CD011921.pub2 ↩
  8. Anne RP, Kumar J, Kumar P, Meena J. Effect of oropharyngeal colostrum therapy on neonatal sepsis in preterm neonates: a systematic review and meta-analysis. J Pediatr Gastroenterol Nutr. 2024;78(3):471–487. doi:10.1002/jpn3.12085 ↩
  9. OuYang X, Yang CY, Xiu WL, et al. Oropharyngeal administration of colostrum for preventing necrotizing enterocolitis and late-onset sepsis in preterm infants with gestational age ≤ 32 weeks: a pilot single-center randomized controlled trial. Int Breastfeed J. 2021;16(1):59. doi:10.1186/s13006-021-00408-x ↩
  10. Abd-Elgawad M, Eldegla H, Khashaba M, Nasef N. Oropharyngeal administration of mother's milk prior to gavage feeding in preterm infants: a pilot randomized control trial. JPEN J Parenter Enteral Nutr. 2020;44(1):92–104. doi:10.1002/jpen.1601 ↩
  11. Kelich F, Qalehsari MQ, Zabihi A, Jafarian Amiri SR, Danaee N. The effect of oropharyngeal mother's milk on nutritional outcomes in preterm infants: a randomized controlled trial. BMC Pediatr. 2024;24(1):155. doi:10.1186/s12887-024-04641-1 ↩
  12. Fu ZY, Huang C, Lei L, et al. The effect of oropharyngeal colostrum administration on the clinical outcomes of premature infants: a meta-analysis. Int J Nurs Stud. 2023;144:104527. doi:10.1016/j.ijnurstu.2023.104527 ↩