Early diet in preterm babies and developmental status in infancy

Area of Science:

• Neonatal nutrition
• Developmental pediatrics
• Human infant nutrition

Background:

• Limited randomized prospective data exist on early diet's influence on later neurodevelopment in humans.
• Low birthweight infants require specific nutritional support during a critical early postnatal period.

Purpose of the Study:

• To investigate the impact of different early postnatal diets on neurodevelopmental outcomes in low birthweight infants.
• To compare the effects of preterm formula, donor breast milk, and mother's own milk supplementation on infant development.

Main Methods:

• A multicenter randomized trial involving 502 low birthweight infants.
• Infants were assigned to receive preterm formula, unfortified donor breast milk, or mother's expressed milk with supplementation for a median of 30 days.
• Neurodevelopmental assessment using developmental quotient (DQ) at nine months corrected age.

Main Results:

• Infants fed donor breast milk had a mean DQ 0.25 standard deviations lower than those fed preterm formula.
• Supplementation with donor breast milk, when exceeding half of total intake, resulted in a greater DQ disadvantage (approx. 0.5 standard deviations).
• Infants fed donor breast milk with fetal growth retardation showed the most significant disadvantage, with DQs 5.3 points lower.

Conclusions:

• Early postnatal diet in low birthweight infants has lasting developmental consequences.
• Preterm formula may support better neurodevelopmental outcomes compared to donor breast milk in this population.
• Infants who are small for gestational age are particularly vulnerable to suboptimal postnatal nutrition.