Interesting, although we all know this.

BREAST MILK ASSOCIATED WITH GREATER MENTAL DEVELOPMENT IN 
PRETERM INFANTS, FEWER RE-HOSPITALIZATIONS
 Extremely low birth weight premature infants who received breast milk shortly 
after birth, while still in intensive care units, had greater mental development 
scores at 30 months than did infants who were not fed breast milk, reported 
researchers in an NIH network. Moreover, infants fed breast milk were less 
likely to have been re-hospitalized after their initial discharge than were the 
infants not fed breast milk.

The study is a follow up to a previous study in which the same infants were 
tested at 18 months, showing that the breast-fed infants held the 
developmental gains seen in the earlier study.

"These findings strongly suggest that, whenever possible, preterm infants 
should routinely be given breast milk during their stay in the intensive care 
unit," said Duane Alexander, M.D., Director of the NICHD, the NIH institute 
that conducted the study.

The study appears in the October 1 issue of "Pediatrics". Betty R. Vohr, M.D., 
of the Department of Pediatrics at Brown Medical School, led a team of 
researchers in the NICHD Neonatal Research Network, at her own and other 
institutions, to conduct the study.

Extremely low birth weight infants are the tiniest and most fragile of premature 
infants, weighing less than 1,000 grams, or 2.2 pounds, at birth, explained 
Rose Higgins, M.D., the NICHD author of the current study and the program 
officer for the NICHD Neonatal Research Network. This category of infants 
makes up about 1 percent of all U.S. births, or roughly 40,000 each year.

Researchers have long known the benefits of breast milk for full term infants, 
but its potential effects in preterm infants had not been well studied, Dr. 
Higgins added. Full term infants given breast milk are less likely to develop 
diarrheal diseases, skin allergies, ear infections, or upper respiratory infections. 
Some studies indicate that they are less likely to be overweight or obese as 
adults. To conduct the study, the researchers tracked the breast milk intake 
of 773 extremely low birth weight infants in the neonatal intensive care units 
at 12 sites in the NICHD Neonatal Research Network, between 1999 and 2001.

The children in the current study were divided into five groups by the quantity 
of breast milk they had ingested while in the NICU. The majority of the infants 
had been given at least some breast milk while in the NICU. Only about one-
fifth of the children in the study had not been fed any breast milk.

The researchers found that the benefits of breast milk first seen at 18 months 
were still present at 30 months. Children who had been given breast milk 
received higher scores on the Mental Developmental Index (MDI), a test 
measuring the children's overall intelligence. The average MDI score was 76.5 
for children who had not received any milk in the NICU, compared to a score 
of 89.7 for children who had received the greatest amount of breast milk. 
Children who had been given breast milk also showed greater ability to control 
and appropriately respond to emotions and were also less likely to have been 
readmitted to the hospital after their discharge and before 30 months.

There was no difference in the amount of growth or the rate of cerebral palsy 
in children who had received breast milk in the NICU compared with those who 
had not.

The researchers hypothesized that breast milk may boost the children's 
immunity against respiratory infections, the principal reason children who had 
not received breast milk were hospitalized.

"Breast milk offers immune advantages for the infant. It has natural 
substances that protect against infection," said Dr. Higgins.

Because they are unable to feed themselves, premature infants receive fluids 
and nutrients intravenously. Gradually, breast milk is dripped into their 
stomachs through a feeding tube. When the infants are healthy enough, the 
intravenous tube can be removed and the baby can receive all its nutrition 
from the feeding tube. In the previous study, the researchers found that 
infants who had ingested breast milk were able to leave the neonatal intensive 
care unit sooner and were able to make the transition faster from intravenous 
feeding to receiving all their nutrition through a feeding tube than were infants 
receiving formula.

Dr. Higgins explained that earlier studies of term infants had found that infants 
who were breastfed tended to score higher on tests of mental development 
than did those who were not. She noted that mothers who breast feed their 
infants tend to have more education than those who do not breast feed. For 
this reason, the researchers were unsure whether the breast fed infants' 
higher test scores resulted from their consumption of breast milk or from the 
fact that their more educated mothers were able to provide them with greater 
intellectual stimulation.

In the current study, mothers who provided breast milk for their infants also 
tended to have more education than those who did not. However, in their 
analysis of the data, the researchers mathematically compensated for the 
mothers' educational levels. With this adjustment, the researchers concluded 
that consumption of breast milk had a positive effect on infants' mental 
development scales, independent of mothers' educational levels.

The researchers concluded that all health care professionals -- obstetricians, 
neonatologists, lactation consultants and primary care providers -- who come 
in contact with pregnant women and with new mothers should explain to them 
the benefits of breast feeding.

Ellen Penchuk, IBCLC, RLC

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