Effect of breastmilk consumption on neurodevelopmental outcomes at 6 and 12 months of age in VLBW infants.
OBJECTIVE
To determine the influence of breastmilk consumption, as a dose response, in very low-birth-weight (VLBW) infants (< 1,500 g) on neurodevelopmental outcomes at 6 and 12 months corrected age, and to determine the influence of selected sociodemographic and infant variables on neurodevelopmental outcomes.


METHODS
VLBW infants (n = 148) who were fed mother's milk or formula by parental choice.


METHODS
Prospective cohort with longitudinal follow-up at 6 and 12 months corrected age.


METHODS
Self-administered questionnaires given to mothers at study entry, before discharge, and at 3-, 6-, and 12-month follow-up visits. During hospitalization, mothers recorded the 24-hour volume of expressed milk once per week. At each follow-up visit, the volume of a single feeding was assessed by pre- and postbreastfeeding test weights of infants measured on an electronic scale accurate to 1.0 g. The amount of breastfeeding was also assessed by feeding records and mother's report.


METHODS
The Bayley Scales of Infant Development (2nd Edition), the Mental Developmental Index (MDI), and the Psychomotor Developmental Index (PDI).


RESULTS
After controlling for specific sociodemographic and infant variables, this study of VLBW infants showed no statistically significant effect of predominantly breastfeeding compared with predominantly formula feeding on neurodevelopmental outcomes to 12 months corrected age. The most significant predictor of MDI scores at 6 and 12 months corrected age was birth weight, in which higher birth weights predicted higher MDI scores.


CONCLUSIONS
Despite the lack of statistically significant differences, the findings suggest a small but consistent advantage in developmental scores in infants who were fed their mother's milk compared with those who were predominantly formula fed. Supporting parents to breastfeed preterm infants may maximize the potential advantages of early nutrition in the neurodevelopmental outcome of VLBW infants.
Pinelli
Janet
J
School of Nursing, Department of Pediatrics, McMaster University, Faculty of Health Sciences-3N25D, 1200 Main St West, Hamilton, Ontario, Canada L8N 3Z5. pinellij@mcmaster.ca
Saigal
Saroj
S
Atkinson
Stephanie A
SA
D001942:Breast Feeding / Q000706:statistics & numerical data; D002657:Child Development / Q000502:physiology*; D015331:Cohort Studies; D004435:Eating / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007225:Infant Food; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight / Q000254:growth & development*; D008137:Longitudinal Studies; D008895:Milk, Human / Q000502:physiology*; D009420:Nervous System / Q000254:growth & development*; D009864:Ontario; D011446:Prospective Studies; D013997:Time Factors