The impact of breast milk feeding on early brain development in preterm infants in China: An observational study

Yao Zhang; Qingqi Deng; Jinhua Wang; Hua Wang; Qiufang Li; Binghua Zhu; Chai Ji; Xinfen Xu; Linda Johnston

doi:10.1371/journal.pone.0272125

The impact of breast milk feeding on early brain development in preterm infants in China: An observational study

PLoS One. 2022 Nov 21;17(11):e0272125. doi: 10.1371/journal.pone.0272125. eCollection 2022.

Authors

Yao Zhang^{1

2}, Qingqi Deng¹, Jinhua Wang³, Hua Wang⁴, Qiufang Li⁴, Binghua Zhu⁵, Chai Ji³, Xinfen Xu^{4

6}, Linda Johnston²

Affiliations

¹ Department of Midwifery, School of Nursing, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China.
² Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada.
³ Department of Radiology, Children's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
⁴ Neonatal Intensive Care Unit, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
⁵ Department of Nursing, The Fourth Affiliated Hospital Zhejiang University School of Medicine, Yiwu, Zhejiang, China.
⁶ Department of Nursing, Haining Maternal and Child Health Hospital, Haining, Zhejiang, China.

Abstract

Background: The prevailing consensus from large epidemiological studies is that breastfeeding is associated with improved IQ and cognitive functioning in later childhood and adolescence. Current research is exploring the association between breastfeeding and early brain development in preterm infants.

Objective: To explore the differences in brain gray matter between breastmilk-fed and formula-fed preterm infants using structural and functional magnetic resonance imaging.

Methods: A convenience sample of breastmilk-fed preterm infants(n = 34) and formula-fed infants (n = 22) aged approximately 32 weeks. At near term-equivalent age, MR scanning was performed. Gray matter structural and functional differences between the two groups were assessed using MATLAB software for voxel-based morphometry (VBM) and amplitude of low-frequency fluctuation (ALFF) analysis.

Results: Maternal and neonatal demographic characteristics showed no significant difference between the two groups. Breastmilk-fed infants had greater regional gray matter volume on MRI than formula-fed infants in multiple brain regions, including the bilateral frontal lobe (BA11, BA46), right temporal lobe (BA37), and left caudate nucleus, at a statistical threshold of p<0.01 (AlphaSim corrected) with a cluster size of >40 voxels. Compared with formula-fed infants, breastmilk-fed infants showed increased brain activation on fMRI in the right superior temporal gyrus (BA41).

Conclusion: Breastmilk-fed infants had greater regional gray matter development and increased regional gray matter function compared with formula-fed infants at near term-equivalent age, suggesting breastmilk feeding in the early period after birth may have some degree of influence on early brain development in preterm infants.

Copyright: © 2022 Zhang et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Publication types

Observational Study
Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Aged
Brain / pathology
Breast Feeding
Child
China
Female
Humans
Infant
Infant, Newborn
Infant, Premature*
Milk, Human*

Grants and funding

Our study was supported by Zhejiang Medicine and Health Technology Plan Project (Innovative Talent Support Plan Project)(2020RC024) and Major Medical and Health Science and Technology Program of Zhejiang Province of China (WKJ-ZJ-2008). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.