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Developmental biology - Breast Feeding

Breast Milk Best For Premature Babies' Brain

Babies born before their due date show better brain development when fed breast milk...

Helping mothers provide breast milk in the weeks following birth could improve long-term outcomes for children born pre-term (prior to 33 weeks). Premature birth is linked to increased problems with learning and thinking skills later in life. Problems thought linked to alterations in brain development.

Studies show pre-term birth is associated with changes in the brain structure known as white matter, which helps brain cells communicate with one another.

Research from the University of Edinburgh on MRI brain scans of 47 babies from Their world Edinburgh Birth Cohort.
The babies had been born before 33 weeks gestation and scans took place when they reached term-equivalent age, an average of 40 weeks from conception.

Researchers collected information on how infants were fed while in intensive care, either formula milk or breast milk from either the mother or a donor.

Structural connectivity network in the brain .

Babies who exclusively received breast milk for at least three-quarters of the days they spent in hospital showed improved brain connectivity when compared with others. The effects were greatest in babies fed breast milk for a greater proportion of their time spent in intensive care.

The study was funded by the charity Theirworld and was carried out in the Jennifer Brown Research Laboratory at the University's Medical Research Council Centre for Reproductive Health and published in the journal NeuroImage.
"Our findings suggest brain development in the weeks after preterm birth improves in babies who receive greater amounts of breast milk. Mothers of pre-term babies should be supported to provide breast milk while their baby is in neonatal care, if they are able to and if their baby is well enough to receive milk. This may give their children the best chance of healthy brain development."

Professor James Boardman, Director of the Jennifer Brown Research Laboratory at the University of Edinburgh.

Adds Sarah Brown, President and Trustee of Theirworld: "An immense debt of gratitude is due the families in the Theirworld Edinburgh Birth Cohort, who are dedicated to sharing information to support their own little ones, and benefit many other premature babies in the future."

Preterm infants are at increased risk of alterations in brain structure and connectivity, and subsequent neurocognitive impairment. Breast milk may be more advantageous than formula feed for promoting brain development in infants born at term, but uncertainties remain about its effect on preterm brain development and the optimal nutritional regimen for preterm infants. We test the hypothesis that breast milk exposure is associated with improved markers of brain development and connectivity in preterm infants at term equivalent age.

We collected information about neonatal breast milk exposure and brain MRI at term equivalent age from 47 preterm infants (mean postmenstrual age [PMA] 29.43 weeks, range 23.28-33.0). Network-Based Statistics (NBS), Tract-based Spatial Statistics (TBSS) and volumetric analysis were used to investigate the effect of breast milk exposure on white matter water diffusion parameters, tissue volumes, and the structural connectome.

Twenty-seven infants received exclusive breast milk feeds for >=75% of days of in-patient care and this was associated with higher connectivity in the fractional anisotropy (FA)-weighted connectome compared with the group who had < 75% of days receiving exclusive breast milk feeds (NBS, p = 0.04). Within the TBSS white matter skeleton, the group that received >=75% exclusive breast milk days exhibited higher FA within the corpus callosum, cingulum cingulate gyri, centrum semiovale, corticospinal tracts, arcuate fasciculi and posterior limbs of the internal capsule compared with the low exposure group after adjustment for PMA at birth, PMA at image acquisition, bronchopulmonary dysplasia, and chorioamnionitis (p < 0.05). The effect on structural connectivity and tract water diffusion parameters was greater with >=90% exposure, suggesting a dose effect. There were no significant groupwise differences in brain volumes.

Breast milk feeding in the weeks after preterm birth is associated with improved structural connectivity of developing networks and greater FA in major white matter fasciculi.

Manuel Blesa, Gemma Sullivan, Devasuda Anblagan, Emma J. Telford, Alan Quigley, Sarah Sparrow, Ahmed Serag, Scott Ian Kay Semple, Mark E. Bastin, James Boardman.

The research team also included Linda LaGasse, PhD, and James F. Padbury, MD, of Women & Infants Hospital/Warren Alpert Medical School; Elisabeth Condradt, PhD, of the University of Utah; Edward Tronick, PhD, of the University of Massachusetts Boston; and Carmen Marsit, PhD, of Emory University.

Women & Infants Hospital of Rhode Island, a Care New England hospital, is one of the nation's leading specialty hospitals for women and newborns. A major teaching affiliate of The Warren Alpert Medical School of Brown University for obstetrics, gynecology, and newborn pediatrics, as well as a number of specialized programs in women's medicine, Women & Infants is the ninth largest stand-alone obstetrical service in the country and the largest in New England with approximately 8,700 deliveries per year. Women & Infants is a Designated Baby-FriendlyŽ USA hospital, a U.S.News & World Report 2014-15 Best Children's Hospital in Neonatology, and a 2014 Leapfrog Top Hospital. The Department of Obstetrics and Gynecology ranked number 11 in U.S. News & World Report's 2019 Best Medical Schools specialty ranking.

Women & Infants has been designated as a Breast Imaging Center of Excellence by the American College of Radiography; a Center of Excellence in Minimally Invasive Gynecology; Centers of Biomedical Research Excellence in Perinatal Biology and in Reproductive Health by the National Institutes of Health (NIH); and a Neonatal Resource Services Center of Excellence. It is one of the largest and most prestigious research facilities in high risk and normal obstetrics, gynecology, and newborn pediatrics in the nation, and is a member of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Maternal Fetal Medicine Units Network, Neonatal Research Network, and Pelvic Floors Disorders Network, as well as the National Cancer Institute's Gynecologic Oncology Group.

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Oct 5, 2018   Fetal Timeline   Maternal Timeline   News   News Archive

Babies born before their due date show better brain development when fed breast milk. Brain maps (ABOVE) reflect information processing hubs (BLACK DOTS) widely distributed and connected with each other in complex ways. Connections are less well developed in babies (LEFT) fed breast milk only three quarters of their time spent in neonatal intensive care - as compared to babies (RIGHT) fed breast milk just under 90 per cent of their days in hospital. Data suggests brain connections in preterm babies improve with more breast feeding right after birth. Image Credit: Jennifer Brown Research Laboratory, the University of Edinburgh

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