Never‐breastfed children face a higher risk of suboptimal cognition at 2 years of corrected age: A multinational cohort of very preterm children. Issue 3 (16th March 2022)

• Record Type: Journal Article
• Authors: Rodrigues, Carina; Zeitlin, Jennifer; Zemlin, Michael; Wilson, Emilija; Pedersen, Pernille; Barros, Henrique
• Is Part Of: Maternal and child nutrition. Volume 18:Issue 3(2022)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2022-03-16
• Subjects: breastfeeding -- breast milk -- cognitive development -- neurodevelopment -- very preterm children; Children -- Nutrition -- Periodicals; Infants -- Nutrition -- Periodicals; Pregnancy -- Nutritional aspects -- Periodicals; Breastfeeding -- Periodicals; 363.8083
• DOI: 10.1111/mcn.13347
• Languages: English
• ISSNs: 1740-8695

Abstract

Abstract: In a cohort of children born very preterm (VPT), we investigated the association between breast milk feeding (BMF) initiation and its duration on cognitive development at 2 years of corrected age. Data were obtained from the Effective Perinatal Intensive Care in Europe population‐based prospective cohort of children born <32 weeks of gestation, in 11 European countries, in 2011–2012. The study sample included 4323 children. Nonverbal cognitive ability was measured applying the Parental Report of Children's Abilities, except for France where the problem‐solving domain of the Ages & Stages Questionnaire was used. Verbal cognition was based on the number of words the child could say. To determine the association between BMF (mother's own milk) and nonverbal and verbal cognition (outcome categorized as optimal and suboptimal), adjusted risk ratios (aRRs) were estimated fitting Poisson regression models, with inverse probability weights to account for nonresponse bias. Overall, 16% and 11% of the children presented suboptimal nonverbal and verbal cognition, respectively. Never BMF was associated with a significantly increased risk for suboptimal nonverbal (aRR = 1.29, 95% confidence interval [CI] = 1.09–1.53) and verbal (aRR = 1.45, 95% CI = 1.09–1.92) cognitive development compared with those ever breastfed, after adjustment for perinatal and sociodemographic characteristics. Compared with children breastfed 6 months or more, children with shorter BMF duration exhibited a statistically nonsignificant elevated aRR. VPT children fed with breast milk had both improved nonverbal and verbal cognitive development at 2 years in comparison with never breastfed, independently of perinatal and sociodemographic characteristics. This study encourages targeted interventions to promote BMF among these vulnerable children. Abstract : In a European cohort of children born very preterm, we investigated the association between breast milk initiation and its duration on cognitive development at 2 years of corrected age. We found that never‐breastfed children faced a higher risk of having suboptimal nonverbal and verbal cognition at 2 years of corrected age when compared with those who were breastfed, independently of perinatal and sociodemographic characteristics. Key messages: In a European cohort of children born very preterm, 16% and 11% presented suboptimal nonverbal and verbal cognitive development, respectively. Never‐breastfed children faced a higher risk of having suboptimal nonverbal and verbal cognition at 2 years of corrected age when compared with those who were breastfed, independently of perinatal and sociodemographic characteristics. Breastfeeding support is a modifiable factor regardless of perinatal and sociodemographic characteristics, which reinforces the importance of specifically targeted interventions to protect, promote and support breast milk feeding in neonatal intensive care units and after discharge.