Increased breast milk feeding is associated with improved neurodevelopmental outcomes for preterm infants

1. A higher dose of breast milk during the critical period from very early birth to term-equivalent age was associated with improved cognitive and academic outcomes and reduced school-age ADHD symptoms.

2. These associations were stronger for infants born before 30 weeks, suggesting that infants who are less mature at birth may benefit more from breastmilk feeding after birth.

Directory rating level: 2 (good)

Study rundown: Results from studies of term infants indicate that prolonged and exclusive breastfeeding in infancy is associated with improved neurodevelopmental outcomes in infancy and in later life. These results are not directly generalizable to the very premature population. This prospective cohort study aimed to investigate the association of breast milk feeding after preterm delivery with cognitive, academic and behavioral outcomes at school age. A total of 586 Australian infants born at less than 33 weeks’ gestation were included and evaluated at 7 years of age. The exposures were breast milk dose and duration. Neurodevelopmental outcome measures at age 7 years were IQ, academic achievement, attention-deficit/hyperactivity disorder (ADHD) symptoms, executive function, and behavior. It was found that ingestion of breast milk during hospitalization for the newborn was associated with higher IQ, reading, math, and ADHD symptoms. Longer duration of breast milk intake was associated with higher reading, spelling, and math scores. Breast milk was not associated with broad-based improvements in IQ, verbal IQ, executive function, or behaviour. Most of the associations were strongest among babies born at a lower gestational age, especially less than 30 weeks. These findings confirm current recommendations that breast milk should be the primary diet for preterm infants. An effort should be made to create policies and programs that promote and support lactation practices, especially for women who give birth very prematurely.

Click here to read the study at JAMA Network Open

Related reading: Neurodevelopmental outcomes of breastmilk-fed preterm infants: a systematic review

in depth [Prospective Cohort Study]: This study performed a secondary analysis of data on docosahexaenoic acid to improve neurodevelopmental outcomes (DINO) of a randomized clinical trial. A total of 657 infants born at less than 33 weeks’ gestation were enrolled from 5 Australian maternity centers from 1 January 2001 to 31 December 2005. After several exceptions, 586 participants’ baseline and 7-year follow-up data were available for analysis. Study exposure included the breastmilk dose, calculated as milliliters per kilogram fed per day per infant during his/her entire stay/recovery, and breastmilk duration, defined as the combined duration of breastmilk consumption while in the hospital plus the reported duration of visits Follow-up. The primary outcome measure was general intellectual ability, as assessed by the Wechsler Abbreviated Scale of Intelligence (WASI) overall IQ. Secondary outcome measures included academic achievement in reading, spelling, mathematics, and behavior as determined by the scores reported by parents in various validated questionnaires. The babies were born with a mean gestational age of 29.6 (2.3) weeks and a birth weight of 1323 (412) g. 314 (53.6%) were male and 387 (66.0%) were singleton pregnancies. It found that higher intake of breast milk in the neonatal intensive care unit (NICU) and longer duration of breast milk feeding were associated with higher IQ scores on a full scale, verbal and performance. Similarly, higher breast milk dose and duration were associated with higher reading, spelling, and math scores. These positive associations were strongest among babies born at the lowest gestational age (ie <30 weeks gestation). There was no association between breast milk and behavior or ADHD scores.

Photo: PD

© 2022 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without the express written consent of 2 Minute Medicine, Inc. Inquire about a license over here. No article should be construed as medical advice and is not intended by the authors or 2 Minute Medicine, Inc.

Leave a Comment