Abstract
Whether breast milk influences later neurodevelopment has been explored in non-randomised studies, potentially confounded by social and demographic differences between feed groups. Here in a strictly randomised prospective multicentre trial, Bayley psychomotor and mental development indices (PDI and MDI) were assessed at 18 months postterm in survivors of 502 preterm infants assigned to receive, during their early weeks, mature donor breast milk or a preterm formula. These diets were compared as sole enteral feeds or as supplements to the mother's expressed breast milk. No differences in outcome at 18 months were seen between the two diet groups despite the low nutrient content of donor milk in relation to the preterm formula and to the estimated needs of preterm infants. These results contrast with those reported from our parallel two centre study that compared infants randomly assigned a standard term formula or the preterm formula during their early weeks; those fed standard formula, now regarded as nutritionally insufficient for preterm infants, were substantially disadvantaged in PDI and MDI at 18 months post-term. It is shown here that infants from that study fed solely on standard formula had significantly lower developmental scores at 18 months than those fed on donor breast milk in the present study; yet the standard formula had a higher nutrient content than the donor milk. Thus, donor milk feeding was associated with advantages for later development that may have offset any potentially deleterious effects of its low nutrient content for preterm infants. As these outcome advantages were not confounded by the social and educational biases usually associated with mothers' choice to breast feed, our data add significant support to the view that breast milk promotes neurodevelopment.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Broad F. E. The effects of infant feeding on speech quality. N Z Med J. 1972 Jul;76(482):28–31. [PubMed] [Google Scholar]
- Lucas A., Gibbs J. A., Baum J. D. The biology of human drip breast milk. Early Hum Dev. 1978 Dec;2(4):351–361. doi: 10.1016/0378-3782(78)90062-2. [DOI] [PubMed] [Google Scholar]
- Lucas A., Gore S. M., Cole T. J., Bamford M. F., Dossetor J. F., Barr I., Dicarlo L., Cork S., Lucas P. J. Multicentre trial on feeding low birthweight infants: effects of diet on early growth. Arch Dis Child. 1984 Aug;59(8):722–730. doi: 10.1136/adc.59.8.722. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Lucas A., Morley R., Cole T. J., Gore S. M., Davis J. A., Bamford M. F., Dossetor J. F. Early diet in preterm babies and developmental status in infancy. Arch Dis Child. 1989 Nov;64(11):1570–1578. doi: 10.1136/adc.64.11.1570. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Lucas A., Morley R., Cole T. J., Gore S. M., Lucas P. J., Crowle P., Pearse R., Boon A. J., Powell R. Early diet in preterm babies and developmental status at 18 months. Lancet. 1990 Jun 23;335(8704):1477–1481. doi: 10.1016/0140-6736(90)93026-l. [DOI] [PubMed] [Google Scholar]
- Lucas A., Morley R., Cole T. J., Lister G., Leeson-Payne C. Breast milk and subsequent intelligence quotient in children born preterm. Lancet. 1992 Feb 1;339(8788):261–264. doi: 10.1016/0140-6736(92)91329-7. [DOI] [PubMed] [Google Scholar]
- Morley R., Cole T. J., Powell R., Lucas A. Mother's choice to provide breast milk and developmental outcome. Arch Dis Child. 1988 Nov;63(11):1382–1385. doi: 10.1136/adc.63.11.1382. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Rodgers B. Feeding in infancy and later ability and attainment: a longitudinal study. Dev Med Child Neurol. 1978 Aug;20(4):421–426. doi: 10.1111/j.1469-8749.1978.tb15242.x. [DOI] [PubMed] [Google Scholar]
- Taylor B. Breast versus bottle feeding. N Z Med J. 1977 Mar 23;85(584):235–238. [PubMed] [Google Scholar]