Improved brain growth and microstructural development in breast milk-fed very low birth weight premature infants

Area of Science:

• Neuroscience
• Pediatrics
• Developmental Biology

Background:

• Breast milk feeding is associated with improved neurodevelopmental outcomes in very low birth weight (VLBW) infants.
• The precise mechanisms underlying these benefits remain incompletely understood.
• Quantitative magnetic resonance imaging (qMRI) offers a method to investigate brain development.

Purpose of the Study:

• To compare brain growth and white matter development in VLBW infants receiving primarily breast milk versus formula.
• To explore the neuroanatomical correlates of neurodevelopmental outcomes in VLBW infants.

Main Methods:

• Prospective enrollment of VLBW infants (<1500 g, <32 weeks gestational age).
• Quantitative MRI (volumetric segmentation and diffusion tensor imaging) performed at term-equivalent age.
• Correlation of brain volumes and white matter organization with nutritional data (breast milk vs. formula).

Main Results:

• Breast milk-fed VLBW infants showed significantly larger total brain volumes, including the amygdala-hippocampus and cerebellum.
• Greater white matter microstructural organization was observed in breast milk-fed infants within the corpus callosum, posterior limb of the internal capsule, and cerebellum.
• These findings were statistically significant (P < .05).

Conclusions:

• Primarily breast milk feeding is associated with enhanced regional brain volumes in VLBW infants by term-equivalent age.
• Breast milk feeding also promotes superior white matter microstructural organization in key brain regions.
• These findings suggest a neuroprotective role for breast milk in the development of VLBW infants.