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Early breastfeeding is linked to higher intelligence quotient scores in dietary treated phenylketonuric children
E Riva1, C Agostoni, G Biasucci
1Department of Paediatrics, University of Milan Medical School, Italy.
Insights
Breastfeeding before diagnosis may improve neurodevelopmental outcomes for children with phenylketonuria (PKU). Breastfed infants showed higher intelligence quotient (IQ) scores compared to formula-fed infants, suggesting a significant benefit for PKU management.
Area of Science:
- Metabolic Disorders
- Pediatric Nutrition
- Neurodevelopmental Pediatrics
Background:
- Phenylketonuria (PKU) requires strict phenylalanine restriction for affected children.
- The impact of other early-life dietary factors on neurodevelopmental outcomes in PKU is not well understood.
- Early intervention is crucial for managing PKU and mitigating cognitive deficits.
Purpose of the Study:
- To investigate the association between early infant feeding (breastfeeding vs. formula feeding) and neurodevelopmental outcomes in children with PKU.
- To determine if breastfeeding prior to dietary intervention influences intelligence quotient (IQ) scores in treated PKU patients.
Main Methods:
- Retrospective study comparing IQ scores of 26 school-age children with PKU.
- Participants were categorized based on infant feeding: breastfed or formula-fed for 20-40 days before initiating dietary intervention.
- Statistical analysis adjusted for social and maternal education status to assess IQ score differences.
Main Results:
- Breastfed children with PKU achieved significantly higher IQ scores (14.0-point advantage, p=0.01) compared to formula-fed children.
- This IQ advantage persisted after adjusting for confounding factors (12.9 points, p=0.02).
- No significant association was found between IQ scores and age at treatment onset or plasma phenylalanine levels.
Conclusions:
- Early breastfeeding, even for a short period before diagnosis and dietary intervention, may positively impact neurodevelopmental performance in children with PKU.
- Breastfeeding could be a beneficial adjunct to standard dietary management for improving cognitive outcomes in PKU.
- Further research is warranted to elucidate the mechanisms behind this observed neurodevelopmental benefit.
Abstract:
Strict control of phenylalanine intake is the main dietary intervention for phenylketonuric children. Whether other dietary-related factors improve the clinical outcome for treated phenylketonuric children in neurodevelopmental terms, however, remains unexplored. We retrospectively compared the intelligence quotient (IQ) score of 26 school-age phenylketonuric children who were either breastfed or formula fed for 20-40 days prior to dietary intervention. Children who had been breastfed as infants scored significantly better (IQ advantage of 14.0 points, p = 0.01) than children who had been formula fed. A 12.9 point advantage persisted also after adjusting for social and maternal education status (p = 0.02). In this sample of early treated term infants with phenylketonuria there was no associated between IQ scores and the age at treatment onset and plasma phenylalanine levels during treatment. We conclude that breastfeeding in the prediagnostic stage may help treated infants and children with phenylketonuria to improve neurodevelopmental performance.