Neurodevelopmental outcomes of extremely preterm infants fed an exclusive human milk-based diet versus a mixed human milk + bovine milk-based diet: a multi-center study

Amy B Hair; Aloka L Patel; Ursula Kiechl-Kohlendorfer; Jae H Kim; Richard J Schanler; Keli M Hawthorne; Elena Itriago; Steven A Abrams; Cynthia L Blanco

doi:10.1038/s41372-022-01513-3

Neurodevelopmental outcomes of extremely preterm infants fed an exclusive human milk-based diet versus a mixed human milk + bovine milk-based diet: a multi-center study

J Perinatol. 2022 Nov;42(11):1485-1488. doi: 10.1038/s41372-022-01513-3. Epub 2022 Sep 28.

Authors

Amy B Hair¹, Aloka L Patel², Ursula Kiechl-Kohlendorfer³, Jae H Kim⁴, Richard J Schanler⁵, Keli M Hawthorne⁶, Elena Itriago⁷, Steven A Abrams⁶, Cynthia L Blanco⁸

Affiliations

¹ Department of Pediatrics, Division of Neonatology, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA. abhair@texaschildrens.org.
² Department of Pediatrics, Neonatology, Rush University Medical Center, Chicago, IL, USA.
³ Department of Pediatrics II (Neonatology), Medical University of Innsbruck, Innsbruck, Austria.
⁴ Department of Pediatrics, Perinatal Institute, Division of Neonatology, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
⁵ Department of Pediatrics, Neonatal Perinatal Medicine, Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY, USA.
⁶ Department of Pediatrics, Dell Medical School, University of Texas at Austin, Austin, TX, USA.
⁷ Department of Pediatrics, Division of Neonatology, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA.
⁸ Department of Pediatrics, University of Texas Health Science Center, San Antonio, TX, USA.

Abstract

Objective: The objective of this multi-center study was to compare, in infants ≤1250 g birth weight (BW) with neurodevelopmental assessment at 18-22 months of corrected age (CA), whether their neurodevelopmental outcomes differed based on exposure to an exclusive human milk-based (HUM) or to a bovine milk-based fortifier and/or preterm formula (BOV).

Study design: Retrospective multi-center cohort study of infants undergoing neurodevelopmental assessment as to whether HUM or BOV exposure related to differences in outcomes of infants at 18-22 months CA, using the Bayley Scales of Infant Development III (BSID-III). BSID-III cognitive, language, and motor scores were adjusted for BW, sex, study site, and necrotizing enterocolitis.

Results: 252 infants from 6 centers were included. BSID-III cognitive scores were higher in the HUM group (96.5 ± 15.1 vs 89.6 ± 14.1, adjusted p = 0.0001). Mean BSID-III language scores were 85.5 ± 15.0 in HUM and 82.2 ± 14.1 in BOV (adjusted p = 0.09). Mean BSID-III motor scores were 92.9 ± 11.7 in HUM and 91.4 ± 14.6 in BOV (adjusted p = 0.32).

Conclusion: In this cohort of infants undergoing neurodevelopmental assessment, infants receiving HUM diet had significantly higher cognitive BSID-III scores at 18-22 months CA. Further investigation is needed of this potential for HUM to positively influence infant cognitive outcomes.

Publication types

Multicenter Study

MeSH terms

Birth Weight
Child
Cohort Studies
Diet
Enterocolitis, Necrotizing* / diagnosis
Enterocolitis, Necrotizing* / epidemiology
Enterocolitis, Necrotizing* / etiology
Humans
Infant
Infant, Extremely Premature
Infant, Newborn
Infant, Very Low Birth Weight
Milk, Human*