Effects of cow milk versus extensive protein hydrolysate formulas on infant cognitive development
Julie A Mennella1, Jillian C Trabulsi2, Mia A Papas2
1Monell Chemical Senses Center, 3500 Market Street, Philadelphia, PA, 19104-3308, USA. mennella@monell.org.
Insights
Infant formula protein type impacts cognitive development. Extensively hydrolyzed formulas showed benefits in gross motor and visual reception skills compared to cow milk formula.
Area of Science:
- Pediatric Nutrition
- Infant Development
- Cognitive Science
Background:
- Limited research exists on infant developmental outcomes, excluding growth, related to formulas with differing protein structures.
- Cow milk formula (CMF) is a common infant nutrition source.
- Extensively hydrolyzed formula (EHF) has altered protein composition.
Purpose of the Study:
- To investigate the effects of infant formulas with varying free amino acid content on infant development.
- To compare developmental trajectories between infants fed CMF and EHF.
Main Methods:
- Randomized controlled trial involving 79 infants from 0.5 months of age.
- Infants were assigned to either a control group (CMF8) or experimental groups (EHF1-3, EHF8).
- The Mullen Scales of Early Learning assessed motor, language, and visual reception skills monthly from 1.5 to 8.5 months.
Main Results:
- Infants fed EHF (EHF1-3 and EHF8) showed significantly higher gross motor scores compared to CMF8 infants.
- Visual reception scores were also higher in EHF-fed infants (EHF1-3) versus CMF8.
- EHF8 infants exhibited lower receptive language scores than CMF8 infants.
Conclusions:
- The protein form in infant formula may influence cognitive development.
- Higher free amino acid content in breast milk could contribute to observed cognitive differences between breastfed and formula-fed infants.
Unlabelled:
Little research has focused on infant developmental effects, other than growth, of formulas that differ substantially in the form of protein. To examine development of infants fed formulas differing in free amino acid content, we randomized 0.5-month-old infants (n = 79) to either a control group who fed only cow milk formula (CMF) during the first 8 months (CMF8), or to one of two experimental groups: one experimental group fed extensively protein hydrolyzed formula (EHF) for 1-3 months during first 4.5 months (EHF1-3) of life, and the other fed EHF for 8 months (EHF8). The Mullen Scales of Early Learning were administered monthly from 1.5 to 8.5 months to assess fine (FM) and gross (GM) motor control, receptive (RL) and expressive (EL) language, visual reception (VR), and an early learning composite (ELC). Across the 5.5-8.5-month time period, when compared to CMF8 infants, GM scores in EHF1-3 infants averaged 1.5 points higher (95 % CI 0.1, 3.0) and in EHF8 infants 2.2 points higher (95 % CI 0.3, 4.0). Similarly, VR scores averaged 1.9 points higher (95 % CI 0.1, 3.8) in EHF1-3 infants and 2.2 points higher (95 % CI -0.2, 4.5) in EHF8 infants. EHF8 infants' RL scores averaged 1.8 points lower (95 % CI 0.1, 3.6) than CMF8 infants. These data suggest that the form of protein in infant formula may impact cognitive development and that the higher free amino acid content in breast milk may be a contributing factor to the differential cognitive development between breastfed and CMF-fed infants.
Clinical Trial Registration:
clinicaltrials.gov NCT00994747.
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