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IQ Was Not Improved by Post-Discharge Fortification of Breastmilk in Very Preterm Infants

Anja Klamer1, Line H Toftlund2, Kristjan Grimsson1

  • 1Hans Christian Andersen Children's Hospital, Odense University Hospital, 5000 Odense, Denmark.

Nutrients
|July 9, 2022
PubMed

Insights

Breastfeeding very preterm infants without fortification after discharge showed better verbal and motor skills compared to preterm formula. Post-discharge fortification of mother's own milk did not improve cognitive outcomes.

Area of Science:

  • Neonatal nutrition
  • Neurodevelopmental outcomes
  • Pediatric health

Background:

  • Very preterm infants face higher risks of cognitive, motor, and behavioral issues.
  • Inadequate nutrition and growth in early life are linked to neurodevelopmental impairments.

Purpose of the Study:

  • To evaluate the impact of post-discharge nutrition on neurodevelopmental outcomes in very preterm infants.
  • To compare cognitive and neuropsychological development at 6 years corrected age (CA) between infants receiving mother's own milk (MOM) with or without fortification and those fed preterm formula (PF).

Main Methods:

  • A follow-up study involving 214 very preterm infants assessed at 6 years CA.
  • Infants were randomized into groups: fortified MOM (F-MOM), unfortified MOM (U-MOM), or preterm formula (PF).
  • Cognitive function was assessed using the Wechsler Intelligence Scale for Children IV, and behavioral aspects were evaluated via the Five to Fifteen Questionnaire (FTF).

Main Results:

  • Post-discharge fortification of MOM did not significantly improve full-scale intelligence quotient (FSIQ) or FTF scores.
  • The MOM group (combined F-MOM and U-MOM) demonstrated significantly better verbal comprehension scores compared to the PF group (p=0.03).
  • Infants in the MOM group also showed significantly better motor skills scores on the FTF questionnaire than the PF group (p=0.01).

Conclusions:

  • Breastfeeding without fortification is supported as a superior post-discharge nutrition strategy for very preterm infants.
  • Mother's own milk, without post-discharge fortification, appears more beneficial for neurodevelopmental outcomes than preterm formula.
  • Further research may explore optimal fortification strategies for preterm infants.

Keywords:
Five to Fifteen QuestionnaireWechsler Intelligence Scale for Children IVbreastfeedingcognitive developmentfortificationpost-discharge nutritionpreterm infant

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