By Sandy Hemphill, Contributing Writer, BabyMed
On May 3, 2016, researchers from the Washington University School of Medicine in St. Louis, Missouri, presented the findings of a study on prematurity, brain development, and breast milk to attendees at the annual conference of the Pediatric Academic Societies, meeting this year in Baltimore, Maryland. Current findings indicate preemie brains thrive on breast milk, growing bigger brains than their peers fed on formula. The researchers plan to extend the study until the preemies are several years old.
Even though babies are born early, their original estimated due date remains an important milestone. Due dates provide a valuable timeline marker for assessing a premature baby's physical and neurological maturity.
Dr. Cynthia Rogers, senior investigator of the study and assistnat professor of child psychiatry at the children’s hospital said, “The brains of babies born before their due dates usually are not fully developed but breast milk has been shown to be helpful in other areas of development so we looked to see what effect it might have on the brain.”
Rogers and her research team conducted magnetic resonance imaging (MRI) scans on 77 preterm infants born at least 10 weeks early. The average gestational age of the babies was 26 weeks (approximately 14 weeks premature). The MRI scans were taken as each baby neared its originally estimated due date.
The researchers also identified which babies had been fed 50% or more breast milk while in the neonatal intensive care unit (NICU) and which were fed less breast milk. The researchers did not distinguish between babies getting breast milk from their own mothers and/or getting it from donors. They compared babies getting 50% or more of their diet from breast milk from any source against babies getting less.
The due-date MRI scans indicated babies getting 50% or more breast milk had larger cortical surface areas of their brains. This area of the brain, the cortex, is closely associated with cognition (thinking). The Oxford English dictionary defines cognition as “the mental action or process of acquiring knowledge and understanding through thought, experience, and the senses.”
To increase cortical surface area and create the opportunity for fully developed cognitive skills, the brain develops wrinkles and furrows as the fetal brain matures. The fetal brain at 27 weeks is mostly a smooth surface but, by 38 weeks, the familiar furrowed peaks and valleys are well developed.
According to Rogers’ research team, children born prematurely are at increased risk for psychiatric and neurological problems in later childhood. The researchers plan to follow the 77 preemies in this study through later childhood to determine if the brain-building effect of breast milk in the NICU continues.
Nourishment in the NICU
The value of breast milk for premature infants was the topic of a 2014 paper by Dr. Mark A. Underwood, an associate professor of pediatrics at the University of California Davis. He described how the degree of prematurity has a significant effect on the nutritional needs of the baby.
Preemies born at 24 weeks and/or weighing 500 grams (1.1 pounds), for example, have dramatically different nutritional needs than another preemie born at 34 weeks, 2.5 kilograms (5.5 pounds). As the preemie grows closer to due date and becomes healthier, nutritional needs change, too.
Underwood further describes differences in the nutritional composition of amniotic fluid (“the optimal beverage of the fetus”), the breast milk from a mother who delivered a premature baby, and the breast milk from a mother who delivered a baby at full term. He also compared breast milk from a preterm birth mother with fortified pasteurized donor milk, which is often fed to babies in the NICU.
Breast milk from the preemie’s own mother is the optimum form of nourishment in the NICU but Underwood acknowledges producing enough of it can be challenging. Stress and depression are common among mothers of preemies and both emotional factors hinder milk production. Other reasons may make breastfeeding mother’s own milk impossible.
In his paper, Underwood offers suggestions for increasing milk supply when possible. He also suggests how donated milk can be made more compatible to the needs of the preemie at every stage of its journey out of the NICU.
Sources:
Dryden, Jim. "Breast milk linked to significant early brain growth in preemies."Washington University School of Medicine. Washington University in St. Louis, 29 Apr. 2016. Web. 4 May 2016.
Underwood, Mark A. "Human milk for the premature infant."PMC. Pediatric Clinics of North America / WB Saunders, Elsevier, 1 Feb. 2014. US National Library of Medicine / National Institutes of Health. Web. 4 May 2016.