Colostrum (Colostrum) is the milk secreted by the mother within 7 days after delivery and is yellowish in color because it is rich in beta-carotene. Compared to mature milk, colostrum contains more proteins and minerals, as well as many antibodies, especially secretory lgA (SlgA), and is therefore called the “first vaccine” for infants. Although a delay of only a few hours in breastfeeding can put a baby’s health at risk, approximately 78 million (about 3 in 5) newborns worldwide are not breastfed within one hour of birth. Why are colostrum feeding rates so low? According to WHO, there are many reasons why newborns miss colostrum, but there are 3 main reasons. 1. Feeding other foods or drinks, including formula A common practice is for elderly people to feed honey to their babies, or for health professionals to feed newborns specific liquids such as sugar water or infant formula. 2. Increase in cesarean births A study of 51 countries noted that newborns born by cesarean section had significantly lower rates of early milk initiation. In Egypt, for example, 39% of babies born naturally were breastfed within one hour of birth, compared to 19% of babies born by cesarean section. 2010, a survey by the World Health Organization showed that the cesarean section rate in China was as high as 46%, so the decline in the early initiation rate is understandable. 3. The quality of care provided to mothers and newborns is poor Data from 58 countries show that from 2005 to 2017, despite an 18% increase in the rate of hospital births, the rate of early milk initiation increased by only 6%. This is because in many cases, babies are separated from their mothers immediately after birth, with limited guidance from health workers. What’s in colostrum? Colostrum is the most effective natural immune booster known, containing over 13 growth factors, 68 cytokines, 415 proteins, and over 200 oligosaccharides. In addition, colostrum is rich in various immunoglobulins, lactoferrin, lysozyme and a large number of immunologically active cells, which are also essential for preventing related diseases and promoting the growth of normal intestinal colonies. Why is colostrum so important? Early studies have shown that compared to newborns who started breastfeeding within 1 hour after birth, those who started only 2 to 23 hours after birth had a higher risk of death; and if it was extended to 1 day or even longer, the risk of death was 2 times higher. (1) Enhancement of neonatal immunity Colostrum is rich in SlgA, up to 10 mg/mL, which is known to constitute an important link in the local immune mechanism. （Colostrum contains pancreatic enzyme inhibitors that act on the epithelial cells and mesenchymal cells of the gastrointestinal tract to promote their proliferation, which is essential for the growth and development of the gastrointestinal tract and repair of damage in newborns. In addition, colostrum significantly reduces E. coli infections in the intestinal tract and reduces infant mortality due to diarrhea-related diseases. (3) Nutritional effects of colostrum on newborns Colostrum contains more comprehensive and richer growth factors than mature milk and colostrum, which can promote overall growth. Colostrum is also rich in vitamins, amino acids, minerals and other small molecules, such as β-carotene, which is converted into vitamin A in the body and promotes the development of the newborn’s vision. 2, the role of colostrum for the mother breastfeeding as soon as possible is not only conducive to the establishment of a harmonious and healthy relationship between parents and children, the maternal body recovery is also vital. (1) Help prevent postpartum hemorrhage. Babies constantly sucking on the nipple, stimulating the production of contraction hormone, which in turn can promote uterine contraction, thereby reducing postpartum bleeding. (2) Lactational amenorrhea. The higher content of progesterone and estrogen during breastfeeding delays the return of menstruation, and protein, iron and other nutrients in the body can be stored, which facilitates postpartum recovery. (3) By breastfeeding, it can also reduce the occurrence of breast cancer, endometrial cancer and ovarian cancer. Do you really know how to feed colostrum? The feeding reflex can appear 10 minutes after birth and is strongest 20-30 minutes after birth, so it is fine to breastfeed early after birth. But here is a question, how to feed colostrum in the end? Suckling is an important reason to keep the mammary glands lactating and the ducts unclogging quickly, and it is also the most common clinical breastfeeding method. When breastfeeding a full-term child, colostrum first comes into contact with the oral mucosa of the full-term child; then through swallowing action, it enters the digestive tract and interacts with visceral related lymphoid tissues, thus promoting an immune response. 2.Micro enteral feeding (MEF) For newborns with gastrointestinal dysfunction but no contraindications to enteral feeding, MEF can be started as early as possible. 10-20 mL/(kg-d) of colostrum can be infused via nasogastric tube for 3-5 d by continuous or intermittent infusion with an infusion pump. This method can promote esophageal and gastrointestinal peristalsis, stimulate the secretion of gastrointestinal hormones, improve gastrointestinal motility, and improve feeding tolerance, and also reduce It can also reduce the occurrence of complications such as hypoglycemia and feeding intolerance. This method belongs to the category of oral immunotherapy and does not involve swallowing breast milk. It is mainly used in the following cases: respiratory distress or even the need for mechanical ventilation; lack of sucking power required for oral feeding, coordinated swallowing ability or lack of synchronization of esophageal motility, resulting in difficulties in the establishment of normal gastrointestinal nutrition; several days or even weeks after birth need nasal feeding or even total intravenous nutrition outside the gastrointestinal tract of preterm infants, especially very low and ultra-low birth mass children. A small amount of colostrum is applied to the newborn’s mouth through a syringe or sterile cotton swab to stimulate and activate the immune system of the preterm infant by using the oropharyngeal mucosa to absorb and interact with the lymphatic tissue in the mouth and oropharynx. 4. Oral application of colostrum Oral application of colostrum in neonates who are mechanically ventilated with ventilators or very low birth weight can reduce the occurrence of ventilator-associated pneumonia and avoid the abuse of antimicrobial drugs. Although the concept of breastfeeding is well established, no more than 35% of infants are exclusively breastfed during the first 4 months of life, and the percentage of newborns receiving colostrum in the first hour of life is even lower. It is important to choose safe and effective means of colostrum application and actively pursue colostrum administration by oral suckling, MEF, transoral route and other routes, so that newborns with different conditions can truly taste the precious colostrum.