If you want to increase the chances for survival and the intelligence rate of
your preterm child, breastfeed the baby!  This is the advice doctors are giving
today and it was a point stressed at the recent 3rd annual congress of the
Perinatal Society of Malaysia in Kuala Lumpur.  "Preterm infants fed human milk,
compared with those fed formula milk, were shown in randomised clinical trials
(RCTs) to have a higher developmental score at 18 months and a higher
intelligence quotient at eight years. An 8.3 point advantage in IQ (over half a
standard deviation) remained even after adjustment for mother's education and
social class," said one of the speakers at the congress, Prof Victor Y.H. Yu,
director of neonatal intensive care at Monash Medical Centre, Australia.  "The
greater the proportion of human milk in the hospital diet, the higher was the
subsequent IQ. Long-chain polyunsaturated fatty acids (LCPUFA) and numerous
factors potentially important for brain growth and development are present in
human milk but not in formula milk. It is possible that they account for the
neurodevelopmental benefit of human milk.  "No amount of tuition or special
classes can ever increase that amount of IQ for your child later when compared
to giving breastmilk when they are born," he stressed....

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"Preterm milk has a higher content of total nitrogen, protein nitrogen,
energy, sodium, chloride, calcium, magnesium, zinc, copper and iron....

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Survival rates for preterm babies increase if they
are fed breastmilk, especially from their mothers. RCTs have shown that such
infants have a significantly lower incidence of sepsis and necrotising
enterocolitis, potentially deadly diseases.  "Human milk has nutritional
advantages over formula milk in that it contains more cysteine and taurine,
results in better fat absorption, contains LCPUFA, and has a greater
bioavailability of certain trace elements," said Dr Yu.  "Gastric emptying is
faster and feeding tolerance is improved with human milk. In addition, it
confers to the infant immunological and antimicrobial protection, provides
digestive enzymes such as milk lipases and transfers breast milk hormones and
growth factors." He added that the early establishment of enteral nutrition
using fresh preterm breast milk from the infant's own mother following preterm
birth, supplemented by parenteral nutrition if necessary to maintain optimal
nutrition, are important goals. There is increasing evidence that early dietary
manipulation in preterm infants has significant long-term influences on their
health, growth and neurodevelopment.  In his presentation, Dr Yu said evidence
in developing countries is well established that human milk has a major benefit
in reducing the risk of infection in preterm infants including when its use is
partial.  "A number of enzymes in human milk could influence nutrient handling
in the gut. For example, lipase in human milk, activated by bile salts in the
duodenum, enhances intestinal lypolysis and improves fat absorption. Neonatal
metabolism and development might also be influenced by the hormones in human
milk. For example, it is known that epidermal growth factor in human milk is
absorbed from the gut into the circulation," he said....

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Copyright New Straits Times Press (Malaysia) Berhad, February  1,  1996, by
Juneita Johari

Arly Helm                                       [log in to unmask]
(MS, Nutrition & Food Sciences, CLE, IBCLC; LC for IHC)