The impact of breast milk feeding on early brain development in preterm infants in China: An observational study

Abstract

Background The prevailing consensus from large epidemiological studies is that breastfeeding is associated with improved IQ and cognitive functioning in later childhood and adolescence. Current research is exploring the association between breastfeeding and early brain development in preterm infants. Objective To explore the differences in brain gray matter between breastmilk-fed and formula-fed preterm infants using structural and functional magnetic resonance imaging. Methods A convenience sample of breastmilk-fed preterm infants(n = 34) and formula-fed infants (n = 22) aged approximately 32 weeks. At near term-equivalent age, MR scanning was performed. Gray matter structural and functional differences between the two groups were assessed using MATLAB software for voxel-based morphometry (VBM) and amplitude of low-frequency fluctuation (ALFF) analysis. Results Maternal and neonatal demographic characteristics showed no significant difference between the two groups. Breastmilk-fed infants had greater regional gray matter volume on MRI than formula-fed infants in multiple brain regions, including the bilateral frontal lobe (BA11, BA46), right temporal lobe (BA37), and left caudate nucleus, at a statistical threshold of p<0.01 (AlphaSim corrected) with a cluster size of >40 voxels. Compared with formula-fed infants, breastmilk-fed infants showed increased brain activation on fMRI in the right superior temporal gyrus (BA41). Conclusion Breastmilk-fed infants had greater regional gray matter development and increased regional gray matter function compared with formula-fed infants at near term-equivalent age, suggesting breastmilk feeding in the early period after birth may have some degree of influence on early brain development in preterm infants.

A Systematic Review over the Effect of Early Infant Diet on Neurodevelopment: Insights from Neuroimaging

“…These results are replicated in the preterm literature, with human milk optimizing overall neurodevelopment [43,45,49,51,52,57]. In Niu et al, functional brain network architecture in preterm infants who were BF or FF were analyzed for the first-time using fMRI.…”

Effect of breast milk intake volume on early behavioral neurodevelopment of extremely preterm infants

“…The results of this study show that the elicited dimension scores of the low breast milk feeding group were lower than those of the medium and high breast milk feeding groups, indicating that medium and high levels of breast milk feeding led to better development of EPIs’ responses to visual and auditory stimuli, defensive actions, trunk movement, and limb movement. A study by Zhang et al, showed that compared with infants fed with formula milk, those fed with breast milk had a larger volume of gray matter, especially in the bilateral frontal lobes, left caudate nucleus, and right temporal lobe [ 19 ]. The frontal lobe plays an important role in many processes, such as motor control, urination, cognition, attention, memory, language, and neuropsychiatric functions, while the temporal lobe is related to auditory, visual, memory, and language functions [ 20 ].…”

Mechanisms of Maternal Diet-Induced Obesity Affecting the Offspring Brain and Development of Affective Disorders

“…Initial studies on breastfeeding and its relationship with neurodevelopment focused on cognitive outcomes, whereby breastfeeding was generally associated with predicting greater academic achievements compared to formula feeding [ 224 , 225 ]. In preterm infants, breastmilk was also found to increase the rate of regional gray matter development when compared with formula-fed infants [ 226 ]. This observational study is the first to suggest that human milk exerts a direct and distinct effect on the brain structural development in humans.…”