Effects of in-hospital breast feeding on brain function development in preterm infants in China: study protocol for a prospective longitudinal cohort study

Abstract

IntroductionDue to immature brain development, preterm infants are more likely to develop neurological developmental defects compared with full-term infants. Most preterm infants without neurodevelopmental damage can eventually reach the same scholastic level as their same-age peers; however, some show persistent impairment. Breast feeding (BF), which is an important public health measure, is of great significance for preterm infants. Various active substances in breast milk promote the development of the brain and central nervous system in premature infants. We present a protocol for a prospective longitudinal cohort study to explore the effect of in-hospital BF on brain development in preterm infants and possible influencing factors.Methods and analysisThis study will enrol 247 Chinese preterm infants (gestational age: 30–34 weeks) delivered in Women’s Hospital School of Medicine, Zhejiang University, and transferred to the neonatal intensive care unit. Demographic, clinical and in-hospital BF data will be collected through electronic medical records. Moreover, follow-up data will be obtained by telephone, interview or online. Measurements will be obtained using the Breastfeeding Self-Efficacy Scale-Short Form, neuroimaging with functional near-infrared spectroscopy, extrauterine growth restriction and the Ages and Stages Questionnaire. Follow-up will be performed at 3, 6 and 12 months after birth.Ethics and disseminationThis study has been approved by the Women’s Hospital School of Medicine Zhejiang University Medical Ethics Committee (2019-058). The study results are expected to be published in peer-reviewed journals and reported at relevant national and international conferences.Trial registration numberChiCTR1900027648; Pre-results.

Investigation Into the Current Situation and Analysis of the Factors Influencing Extrauterine Growth Retardation in Preterm Infants

“…In this hospital, in accordance with national trends in the national neonatal specialty, the ability to treat preterm infants has improved rapidly in recent years, and many very preterm infants and infants with very low birth weight survive. However, there are more complications in preterm than in full-term infants, most notably the high incidence of EUGR (5,11). The results of this study show that the incidence of EUGR in 691 preterm infants with a gestational age of <34 weeks born in our hospital over the past 3 years was 36.9% (255).…”

“…Studies have found that preterm infants with EUGR are at increased risk of developing respiratory disease after their discharge from the hospital. They are also prone to developing physical dysplasia in the short term and may encounter complications such as adolescent hypertension, metabolic and endocrine abnormalities, and serious neurological development problems in the long term, which may affect quality of life (2)(3)(4)(5). Therefore, EUGR is still a serious problem in preterm infants.…”

Early biomarkers of neurodevelopmental disorders in preterm infants: protocol for a longitudinal cohort study

“…In the cohort study, we assessed feed type and BF self-efficacy using the following methods: (i) according to the proportion of breast milk in total infant food intake, feeding type was divided into six categories—exclusive BF (=100%), almost exclusive BF (≈100%), high proportion BF (≥80%), medium proportion BF (≥20%), low proportion BF (>0%, <20%) and token BF (≈0%);67 68 (ii) the Chinese version of the breastfeeding self-efficacy scale-short form (BSES-SF) 69…”