Bovine colostrum is being promoted for prevention of recurrent respiratory and gut infections. The nutrient profile of bovine colostrum includes higher amounts of immunoglobulins, growth factors, cytokines and nucleosides, than are found in milk(1). It is also rich in oligosaccharides, anti-microbials and immune regulating factors(1). The beneficial effects of supplementation of bovine colostrums in improving body composition, aspects of athletic performance, diarrhea in persons with immunedeficiency syndromes, and NSAID-induced gastrointestinal disturbances have been reviewed(1).

In a recent systematic review on the subject, no randomized controlled trials (RCT) were identified that had evaluated the role of bovine colostrum in respiratory illness in children(2). Only one study in which efficacy and tolerability of bovine colostrum was evaluated in preventing recurrent episodes of upper respiratory tract infections (URTI) and diarrhea in children was identified(3). The mean (SD) number of episodes of URTIs occurring 6 months prior to bovine colostrum therapy was 5.94 (3.88) which reportedly decreased significantly to 1.60 (1.74), 0.99 (1.20) and 0.52 (0.91) at the end of 4 wks, 8 wks and 12 wks of bovine colostrum therapy respectively (P<0.05). On critical appraisal of this study(3), there appear to be significant limitations. It is an intervention study. There is lack of clarity on the number of episodes in different time periods of observation used for comparison. The baseline is number of episodes in over 6 months. This data should have been converted to monthly episodes and then compared to the number of episodes at 4 weeks, 8 weeks and 12 weeks. Otherwise the number of episodes over 6 months cannot be compared with those in 4 weeks. Also, it is not clear if only children with more than 6 episodes of URTI were included as the range of episodes reported in the paper range from 0- 20(3). There are a few studies where bovine colostrum has been used in treatment of diarrheal diseases, some of which are in children(4-6).

Reviewing the literature, the routine use of bovine colostrum in care of children with recurrent infections cannot be recommended at present. More so, there are no studies in children with proven IgA deficiency. There is evidence for absorption of colostral immunoglobulins in newborn animals; this absorption significantly reduces after 24- 36 h of age(7). However, there are no studies in children to quantitate the absorption. The risk of hypersensitivity reactions with use of bovine colostrum in IgA deficient individuals is a theoretical possibility with no studies evaluating this aspect.

In the absence of convincing evidence of benefit for use of bovine colostrum and the lack of studies regarding the safety in IgA deficient individuals, caution is advised for use of bovine colostrum in these individuals.