Breast Milk Feeding, Brain Development, and Neurocognitive Outcomes: A 7-Year Longitudinal Study in Infants Born at
Mandy B Belfort1, Peter J Anderson2, Victoria A Nowak3
1Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Boston, MA.
Insights
Breast milk intake in early life is linked to better brain development and cognitive function in very preterm infants. Higher breast milk consumption correlated with improved neurological outcomes and academic performance at age seven.
Area of Science:
- Neonatal research
- Neuroscience
- Pediatric development
Background:
- Very preterm infants face risks for impaired neurological development.
- Early life nutrition, particularly breast milk, is crucial for infant brain development.
- Long-term neurodevelopmental outcomes in preterm infants require further investigation.
Purpose of the Study:
- To examine the association between early breast milk intake and neurological outcomes in very preterm infants.
- To assess brain structure at term equivalent age and neurodevelopmental function at 7 years of age.
- To determine if breast milk consumption influences cognitive and motor development in this vulnerable population.
Main Methods:
- A cohort of 180 very preterm infants (born <30 weeks gestation or <1250g) was studied.
- Breast milk intake was quantified by the number of days receiving >50% enteral intake as breast milk within the first 28 days.
- Neurological outcomes included brain volumes (MRI) at term equivalent and 7 years, and cognitive/motor testing at 7 years, with adjustments for confounding factors.
Main Results:
- Increased days of >50% breast milk intake were associated with greater deep nuclear gray matter volume at term equivalent age.
- Higher breast milk intake correlated with improved performance at age 7 in IQ, mathematics, working memory, and motor function tests.
- No significant differences in regional brain volumes were observed at 7 years of age based on early breast milk intake.
Conclusions:
- Predominant breast milk feeding in the first 28 days is associated with enhanced deep nuclear gray matter volume at term equivalent age.
- Early breast milk intake positively impacts cognitive functions (IQ, academic achievement, working memory) and motor skills at 7 years in very preterm infants.
- These findings highlight the importance of promoting breast milk feeding for improving long-term neurodevelopmental outcomes in extremely preterm infants.
Objectives:
To determine the associations of breast milk intake after birth with neurological outcomes at term equivalent and 7 years of age in very preterm infants
Study Design:
We studied 180 infants born at <30 weeks' gestation or <1250 grams birth weight enrolled in the Victorian Infant Brain Studies cohort from 2001-2003. We calculated the number of days on which infants received >50% of enteral intake as breast milk from 0-28 days of life. Outcomes included brain volumes measured by magnetic resonance imaging at term equivalent and 7 years of age, and cognitive (IQ, reading, mathematics, attention, working memory, language, visual perception) and motor testing at 7 years of age. We adjusted for age, sex, social risk, and neonatal illness in linear regression.
Results:
A greater number of days on which infants received >50% breast milk was associated with greater deep nuclear gray matter volume at term equivalent age (0.15 cc/d; 95% CI, 0.05-0.25); and with better performance at age 7 years of age on IQ (0.5 points/d; 95% CI, 0.2-0.8), mathematics (0.5; 95% CI, 0.1-0.9), working memory (0.5; 95% CI, 0.1-0.9), and motor function (0.1; 95% CI, 0.0-0.2) tests. No differences in regional brain volumes at 7 years of age in relation to breast milk intake were observed.
Conclusion:
Predominant breast milk feeding in the first 28 days of life was associated with a greater deep nuclear gray matter volume at term equivalent age and better IQ, academic achievement, working memory, and motor function at 7 years of age in very preterm infants.
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