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Breast Milk Consumption in Preterm Neonates and Cardiac Shape in Adulthood
Adam J Lewandowski1, Pablo Lamata2, Jane M Francis3
1Oxford Cardiovascular Clinical Research Facility, and Oxford Centre for Clinical Magnetic Resonance Research, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom; paul.leeson@cardiov.ox.ac.uk.
Insights
Feeding preterm infants human breast milk is linked to improved long-term cardiac structure and function. This supports promoting breast milk to reduce cardiovascular risk in preterm-born individuals.
Area of Science:
- Neonatal care
- Cardiovascular development
- Nutritional science
Background:
- Preterm birth can lead to lasting changes in heart structure and function.
- The early postnatal period may be a critical window for influencing cardiovascular development through nutrition.
- Human breast milk may offer benefits over infant formula for long-term cardiac outcomes in preterm infants.
Purpose of the Study:
- To investigate the long-term effects of early postnatal nutrition on cardiac morphology and function in individuals born preterm.
- To compare the cardiac outcomes of preterm infants fed human milk versus infant formula.
Main Methods:
- A cohort of 926 preterm infants from a 1982-1985 UK trial were analyzed.
- 102 preterm individuals (30 exclusively human milk-fed, 16 exclusively formula-fed) were followed up.
- Cardiac morphology and function were assessed using MRI, with a comparison group of 102 term-born infants.
Main Results:
- Preterm individuals fed exclusively human milk showed increased left and right ventricular end-diastolic volume index compared to formula-fed preterm individuals.
- Stroke volume index was also significantly higher in the exclusively human milk-fed group.
- These findings suggest a positive impact of human milk on cardiac dimensions.
Conclusions:
- This study presents the first evidence linking early-life human milk consumption to improved cardiac morphology and function in adulthood for preterm-born individuals.
- Promoting human milk for preterm infants may be crucial for mitigating long-term cardiovascular risks.
- Nutritional interventions in early life can positively influence long-term health outcomes.
Background And Objectives:
Preterm birth relates to long-term alterations in cardiac morphology and function. Understanding whether preterm postnatal life is a tractable period of cardiovascular development that can be positively altered by nutrition is relevant to long-term outcomes. We hypothesized that being fed human breast milk during early postnatal life is beneficial to long-term cardiac structure and function in preterm-born individuals compared with infant formulas.
Methods:
A total of 926 preterm-born infants originally took part in a randomized controlled trial of postnatal milk-feeding regimens between 1982 and 1985 across 5 different UK centers. Preterm-born individuals were randomly assigned to either breast milk donated by unrelated lactating women or nutrient-enriched formulas. We followed 102 individuals from this cohort: 30 of whom had been randomized to being fed exclusively human milk and 16 to being fed exclusively formula. As a comparison group, we recruited an additional 102 individuals born term to uncomplicated pregnancies. Cardiac morphology and function were assessed by MRI.
Results:
Preterm-born individuals fed exclusively human milk as infants had increased left and right ventricular end-diastolic volume index (+9.73%, P = .04 and +18.2%, P < .001) and stroke volume index (+9.79%, P = .05 and +22.1%, P = .01) compared with preterm-born individuals who were exclusively formula fed as infants.
Conclusions:
This study provides the first evidence of a beneficial association between breast milk and cardiac morphology and function in adult life in those born preterm and supports promotion of human milk for the care of preterm infants to reduce long-term cardiovascular risk.
