Maternal milk consumption is linked to improved school-age outcomes for preterm babies.
Children born prematurely have a higher chance of inferior academic ability in math, reading, and other abilities, as well as a higher risk of attention-deficit/hyperactivity disorder (ADHD). Recent research, however, reveals that intervention in the early weeks and months of a preterm infant’s existence may result in improved neurodevelopmental results later in life.
In a seven-year study of preterm infants, researchers from Brigham and Women’s Hospital and collaborators from the South Australian Health and Medical Research Institute discovered that children who received more maternal milk both during and after their time in the neonatal intensive care unit (NICU) had higher academic achievement, higher IQs, and fewer ADHD symptoms. The study’s findings were published in the journal JAMA Network Open.
“Our study finds that there may be long-term neurodevelopmental benefits to providing maternal milk to preterm infants,” said corresponding author Mandy Brown Belfort, MD, MPH, of the Department of Pediatric Newborn Medicine. “A lot of families are dedicated to the idea of providing maternal milk but may face steep challenges. Our findings emphasize the importance of providing support for initiating and sustaining lactation because maternal milk at this early age can provide benefits years later.”
Belfort and colleagues examined the neurodevelopmental outcomes of 586 children born at one of five Australian perinatal facilities at less than 33 weeks gestation. Children were evaluated at the age of seven (corrected for prematurity). The researchers examined data on maternal milk dosage (the amount of mother milk babies got each day) and maternal milk duration (how long parents remained nursing) to see whether they could predict certain neurodevelopmental outcomes. These outcomes included academic achievement, Verbal and Performance IQ, symptoms of ADHD, executive function, and behavior.
Overall, the team found that higher maternal milk intake was associated with higher Performance IQ and higher reading and math scores. Parents also reported fewer ADHD symptoms for children who consumed more maternal milk during infancy. Duration of maternal milk intake (up to 18 months corrected age) was also associated with higher reading, spelling, and math scores. The researchers controlled for confounders, including clinical and social factors. These beneficial associations were stronger for infants born at the lowest gestational ages, particularly those born below 30 weeks of gestation.
The authors note that their study is observational — they cannot determine causality as there may be other, unaccounted factors that influence both the ability to provide maternal milk and academic achievement. The study’s strengths include its large size, the range of outcomes examined, and that the researchers could assess school-age outcomes. Other studies have only followed children through preschool age, making it difficult to assess the full range of neurodevelopmental outcomes.
Overall, Belfort sees the team’s findings as an affirmation of guidance from the American Academy of Pediatrics and the World Health Organization, both of which recommend maternal milk for infants.
“Our study confirms recommended strategies for supporting parents to provide maternal milk for preterm infants,” said Belfort. “And it strengthens the call for health policies and parental leave policies that support rather than work against parents. As a society, we need to invest in families — it’s an investment that will continue to benefit children when they reach school age.”
Reference: “Associations of Maternal Milk Feeding With Neurodevelopmental Outcomes at 7 Years of Age in Former Preterm Infants” by Mandy B. Belfort, MD, MPH, Emma Knight, Ph.D., Shikha Chandarana, MS, Emmanuella Ikem, MS, Jacqueline F. Gould, Ph.D., Carmel T. Collins, RN, Ph.D., Maria Makrides, Ph.D., Robert A. Gibson, Ph.D., Peter J. Anderson, Ph.D., Karen Simmer, MD, Ph.D., Henning Tiemeier, MD, Ph.D. and Alice Rumbold, Ph.D., 13 July 2022, JAMA Network Open.