Breast Milk versus Formula Milk and Neuropsychological Development and Sleep

Abstract

A cohort study including 14000 newborns, about half of them were exclusively breast fed for the first four months of their lives, this percentage dropped down to about 4% by the end of the fourth month of age. One third of these babies were not breast fed at all; 9% of them were identified with a degree of gross motor delay, 6% with fine motor delay by the age of 9 months. The proportion of infants who acquired their milestones overtime increased with exclusivity of breastfeeding. Infants who had never been breastfed were 40-50% more prone to have some sort of motor delay than breast fed infants (10.7% vs 7.3%). These findings did not decrease with adjustment of other confounders, e.g. biological, socioeconomic or psychosocial factors [1]. Neuro-physiological outcomes in breast fed infants was evaluated through flash Visual Evoked Potential (VEP), Brainstem Auditory Evoked Potential (BAEP) and Somato-Sensory Evoked Potential (SSEP) and showed significant prolongation of P-100 wave latencies in formula fed infants, in addition to that, prolongation of absolute waves I, III, V wave latencies of BAEP was also seen in formula fed infants in comparison with breast fed infants. SSEP showed similar findings to VEP and BAEP. This concludes that maturation and brain myelination patterns in breast fed infants is more mature than formula fed infants [2]. Small for Gestational Age (SGA) born babies are at high risk for neuro-developmental delay. Studies have shown that enriched formula fed to term SGA infants improve their growth and their neuro-developmental outcome. A multicenter randomized controlled study in United Kingdom showed that there was no significant intergroup difference in Bayley Mental Development Index (MDI) or Psychomotor Development Index (PDI) scores at 18 months. Though, breast fed infants have significantly higher MDI and PDI scores than formula fed infants. Confounding factors accounted for one third of the resulted association with MDI score and none of the association with PDI score. It is previously reported that enriched formula do have significant effect on enhancing linear growth, though this was not correlated with neurodevelopmental benefit [3]. Breast feeding should be encouraged for best neurodevelopmental outcome in infants born SGA. Behavioral assessment of neonates was done for 83 neonates at their ninth day of life, though special assessment scale “Brazelton Neonatal Behavioral Assessment Scale”. 42 neonates were exclusively breast fed and 42 were formula fed, the study showed that breast fed infants exhibited fewer abnormal reflexes, signs of depression, and withdrawal. This proves that breast feeding