Early enteral nutrition and neurodevelopment in very low birth weight preterm infants

Very low birth weight (VLBW) preterm infants are at increased risk of neurodevelopmental impairment. Although human milk may promote brain development, the association between type of feeding at discharge and neurodevelopmental outcomes remains uncertain. This study evaluated neurodevelopment at 12 months' corrected age according to type of feeding at discharge in VLBW infants.

This prospective single-center study included 40 VLBW infants (GA < 32 weeks) born at the University Hospital of Parma. Type of feeding at discharge was classified as exclusive human milk, formula feeding or mixed feeding. Neurodevelopment was assessed at 12 months' corrected age using the Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III), evaluating cognitive, motor, language, socioemotional and adaptive behaviour domains. Time of full enteral feeding achievement and duration of parenteral nutrition were analyzed as continuous variables. Correlation and ANOVA analyses were performed.

Type of feeding at discharge was not significantly associated with neurodevelopmental scores. Earlier achievement of enteral nutrition was associated with better cognitive, motor, and language outcomes, while longer duration of parenteral nutrition was associated with lower motor and language scores (p < 0.05).

In VLBW infants, type of feeding at discharge was not associated with neurodevelopmental outcomes at 12 months' corrected age. However, shorter time to full enteral feeding and shorter duration of parenteral nutrition were associated with more favorable neurodevelopmental performance, particularly in motor and language domains. These findings support the importance of optimizing early nutritional management and warrant confirmation in larger prospective studies.