Abstract
The aim of this study was to determine the effect of human milk feeding during NICU hospitalization on neurodevelopment at 24 months of corrected age in very low birth weight infants. A cohort of 316 very low birth weight newborns (weight ≤ 1500 g) was prospectively enrolled in a follow-up program on admission to the Neonatal Intensive Care Unit of S. Orsola Hospital, Bologna, Italy, from January 2005 to June 2011. Neurodevelopment was evaluated at 24 months corrected age using the Griffiths Mental Development Scale. The effect of human milk nutrition on neurodevelopment was first investigated using a multiple linear regression model, to adjust for the effects of gestational age, small for gestational age, complications at birth and during hospitalization, growth restriction at discharge and socio-economic status. Path analysis was then used to refine the multiple regression model, taking into account the relationships among predictors and their temporal sequence. Human milk feeding during NICU hospitalization and higher socio-economic status were associated with better neurodevelopment at 24 months in both models. In the path analysis model intraventricular hemorrhage—periventricular leukomalacia and growth restriction at discharge proved to be directly and independently associated with poorer neurodevelopment. Gestational age and growth restriction at birth had indirect significant effects on neurodevelopment, which were mediated by complications that occurred at birth and during hospitalization, growth restriction at discharge and type of feeding. In conclusion, our findings suggest that mother’s human milk feeding during hospitalization can be encouraged because it may improve neurodevelopment at 24 months corrected age.
Highlights
Neurodevelopment of infants born prematurely has been receiving a growing attention in the last decades
Evidence from studies about growth and development is controversial: some studies suggest that better growth in weight and head circumference has a positive effect on development, probably mediated by a better brain growth and neurological maturation [14,15,16,17], other studies report that the positive effect of human milk feeding overcomes the delayed weight gain associated to the lower protein and energy intake of human milk compared with formula milk [18, 19]
The other complications, namely NEC, mechanical ventilation and sepsis, had no significant direct effect on GQ. Even in this model the positive effect between human milk feeding and GQ was confirmed and maintained the same magnitude (β = 0.20). In this observational study we investigated the impact of human milk feeding on neurodevelopment using multiple linear regression and path analysis models and results of these models were compared
Summary
Neurodevelopment of infants born prematurely has been receiving a growing attention in the last decades. A high protein and energy nutritional regimen leads to better weight growth and to catch-up growth in head circumference [8], its effect on long-term neurodevelopment is controversial [9,10,11]. Evidence from studies about growth and development is controversial: some studies suggest that better growth in weight and head circumference has a positive effect on development, probably mediated by a better brain growth and neurological maturation [14,15,16,17], other studies report that the positive effect of human milk feeding overcomes the delayed weight gain associated to the lower protein and energy intake of human milk compared with formula milk [18, 19]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
