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Human milk and neurodevelopment in children with very low birth weight (810.31)
Author(s) -
Koo Winston,
Tank Surinder,
Tank Surinder,
Martin Sandra
Publication year - 2014
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.28.1_supplement.810.31
Subject(s) - medicine , breast milk , pediatrics , bayley scales of infant development , cohort , cohort study , infant formula , psychomotor learning , low birth weight , observational study , birth weight , pregnancy , cognition , biology , biochemistry , genetics , psychiatry
VLBW infants often have compromised neurodevelopment. Breast milk has many factors that could affect nervous system and might benefit neurodevelopment in VLBW infants. Methods. 7 databases searched for original studies on HM feeding and neurodevelopment in VLBW children. Results. Ten cohort observational studies reviewed. Three studies eliminated for no formal neurodevelopment assessment, no control group, earlier follow up data from the same cohort resp. Five studies based on secondary analysis of VLBW subjects in non‐breast milk studies. Control group from the same cohort and received variable amounts of HM (0‐80%). Final sample size 18 to 704 (median 219). Fortification of HM in 2 studies and use of preterm infant formula in 3 studies. HM intake from 4 weeks to 12 months. Donor milk use not specified. HM intake defined as dichotomous (cut point of 80% of HM) or arbitrary as 3 to 5 categories in volume or duration. Follow up for 3 studies were <3 years, one at 5 years and 3 at 6 years or more. Neurodevelopment assessment was within normal or low normal range in HM fed group. The advantage of HM feeding was not demonstrated consistently and was due to lower scores in the formula fed group. The greatest advantage of HM was reported in one secondary analysis study at 30 months with formula fed infants with significantly lower Bayley mental and psychomotor development index score by 13 and 12 points (>0.8 SD) resp. Whereas, the 3 follow up studies of neurodevelopment at 6 ‐ 11 years showed advantage of HM was limited to scores on subtests of cognitive function and with highest HM intake. No advantage demonstrated for breastfeeding beyond 4 months in one study and 8 months in another. In the 3rd study, HM intake is an independent predictor of reading but not mathematics attainment at 11 years. None of the studies used the current highly enriched preterm formulas or HM fortifier. Conclusion. In VLBW infants, the protective effect on neurodevelopment from HM remains to be defined.