In the delicate early days of life, particularly for preterm babies, every decision about nutrition carries profound implications.
A groundbreaking study has revealed that the amount of breast milk a preterm baby receives in their first 28 days of life can significantly impact the development of their brain and cognitive abilities.
This finding underscores the critical role of breast milk in shaping the future of vulnerable newborns.
Babies who consumed more breast milk during this crucial window showed increased brain volume in key regions responsible for processing and transmitting neural signals.
By age seven, these children demonstrated better IQ scores, academic performance, memory, and motor skills compared to those whose early diet relied more on formula.
The study, led by Mandy Brown Belfort from Boston Hospital & Medical Centre, offers more than just data—it provides a beacon of hope and clarity for parents and caregivers navigating the challenges of preterm birth.
“Our data support current recommendations for using mother’s milk to feed pre-term babies during their neonatal intensive care unit (NICU) hospitalisation,” said Brown Belfort.
“This is not only important for mums, but also for hospitals, employers, and friends and family members, so that they can provide the support that’s needed during this time.”
But what exactly makes breast milk so transformative, and how can this information reshape the way we approach neonatal care?
The Science Behind Breast Milk’s Early Impact
The study examined 180 preterm babies born before 30 weeks gestation in the U.S. between 2001 and 2003.
Researchers analyzed how often the infants received more than 50% breast milk during their first 28 days.
This data was then correlated with mental and physical development milestones at key stages: term equivalent (when the babies would have been born) and seven years of age.
The findings were striking. Magnetic resonance imaging (MRI) scans revealed that babies receiving a higher proportion of breast milk developed larger volumes of deep nuclear grey matter and hippocampus—regions critical for neural communication and memory—by term equivalent.
This early advantage wasn’t fleeting. By age seven, every additional day of consuming more than 50% breast milk corresponded to a 0.5-point increase in IQ, while every 10 mL of breast milk consumed added 0.7 points to their score.
The benefits extended beyond intelligence, with improvements in motor skills, academic achievements in reading and math, and working memory.
Debunking Myths About Preterm Nutrition
Here’s a perspective shift: while many assume that formula, fortified with additional nutrients, is an adequate substitute for breast milk in preterm babies, this study reveals a stark contrast.
Breast milk’s unique composition goes far beyond basic nourishment, offering benefits that formula simply cannot replicate.
Why is this the case? Breast milk contains a complex mix of bioactive compounds, including:
- Essential fatty acids like DHA and ARA, which are critical for brain development.
- Hormones and enzymes that promote growth and repair.
- Immune-boosting antibodies that reduce the risk of infections—a major concern for preterm babies in NICUs.
These components work in synergy, creating a developmental environment that formula struggles to match.
The study also challenges the notion that early brain development advantages fade over time.
While the increase in brain volume observed by term equivalent seemed to level off by age seven, the long-term cognitive benefits persisted, highlighting that the early foundation laid by breast milk has enduring effects.
The Lifelong Impacts of Breast Milk
The benefits of breast milk extend far beyond the first few years of life. By age seven, children who received more breast milk as preterm infants displayed:
- Higher IQ scores: These gains weren’t marginal—they pointed to real, measurable academic and cognitive advantages.
- Better academic performance: Improvements in reading comprehension and mathematical ability were consistently observed.
- Enhanced working memory and motor function: These skills are critical for success in both academic and everyday tasks.
Importantly, the researchers accounted for variables such as maternal education, income, and IQ, ensuring that the results were truly attributable to breast milk’s impact.
The Hidden Challenge of Providing Breast Milk
Despite these remarkable findings, providing breast milk for preterm babies isn’t always straightforward.
Many mothers of preterm infants face significant challenges, including stress, physical recovery, and insufficient milk supply.
“Many mothers of preterm babies have difficulty providing breast milk for their babies,” Brown Belfort emphasized.
“We need to work hard to ensure that these mothers have the best possible support systems in place to maximise their ability to meet their own feeding goals.”
This support can take many forms:
- Hospital programs: Lactation consultants and access to breast pumps in NICUs can make a world of difference.
- Community networks: Friends, family, and local organizations can offer emotional and logistical support.
- Policy changes: Employers can play a vital role by providing paid maternity leave and accommodating pumping schedules for working mothers.
Why the Difference Matters
While formula provides vital nutrients and serves as a lifeline for many families, it cannot fully replicate the complex benefits of breast milk.
Studies suggest that breast milk contains unique nutrients and growth factors that are either absent or present in lower concentrations in formula.
This doesn’t mean formula-fed babies are destined for poorer outcomes.
Rather, it highlights the importance of supporting mothers who wish to breastfeed, particularly in high-stress situations like preterm births.
The Future of Preterm Care
As researchers continue to uncover the mysteries of breast milk’s impact, the implications for neonatal care are profound.
Future studies could explore:
- The specific nutrients in breast milk responsible for these cognitive and physical benefits.
- How to create formula that more closely mimics breast milk.
- Interventions to help more mothers produce and store breast milk, even under challenging circumstances.
For now, the message is clear: breast milk is an invaluable resource, particularly for preterm babies, and its benefits ripple far into the future.
An Early Gift with Lifelong Returns
The first 28 days of a preterm baby’s life are a critical window of opportunity.
Breast milk isn’t just food—it’s a lifeline, offering advantages that shape the brain, body, and future potential of the most vulnerable infants.
For mothers, this study is both empowering and reassuring. It underscores the incredible value of their efforts, even in the face of challenges, while emphasizing the need for a robust support system.
As Mandy Brown Belfort wisely noted, “There are so many factors that influence a baby’s development, with breast milk being just one.”
But as this research shows, it’s a factor that can make an extraordinary difference.
The journey of raising a preterm baby is often fraught with uncertainty, but one thing is clear: the gift of breast milk can set them on a path to thriving, not just surviving.
And that is a reward worth every effort.
