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Breast Milk versus Formula Milk and Neuropsychological Development and Sleep

Authors:
  • Saint John Regional Hospital

Abstract

Neuro-protective effect of breastfeeding is reflected on major areas of infantile development, namely gross motor development, fine motor development, myelination patterns, etc. This is highly attributable to special components of breast milk or may be to a unique feature in breastfeeding.
J Pediatr Neonatal Care 2014, 1(2): 00005
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Journal of Pediatrics & Neonatal Care
Breast Milk versus Formula Milk and
Neuropsychological Development and Sleep
Editorial
Volume 1 Issue 2 - 2014
Tamer Mohamed Gaber Rizk*
Department of Pediatrics, Al-Takhassusi Hospital, Saudi
Arabia
*Corresponding author: Tamer Mohamed Gaber
Rizk, Department of Pediatrics, Al-Takhassusi Hospital,
Dr. Suleiman Al-Habib Medical Group (HMG), Riyadh,
Saudi Arabia, Tel: 96611-283-3733; Fax: 96611-283-
3033; E-mail: tamergaber2@yahoo.com
Received: April 14, 2014 | Published: May 16, 2014

areas of infantile development, namely gross motor development,

attributable to special components of breast milk or may be to a
unique feature in breastfeeding.
A cohort study including 14000 newborns, about half of
          
their lives, this percentage dropped down to about 4% by the
end of the fourth month of age. One third of these babies were

       
months. The proportion of infants who acquired their milestones
overtime increased with exclusivity of breastfeeding. Infants who
had never been breastfed were 40-50% more prone to have some
sort of motor delay than breast fed infants (10.7% vs 7.3%). These

e.g. biological, socioeconomic or psychosocial factors [1].
Neuro-physiological outcomes in breast fed infants was

    
       
wave latencies in formula fed infants, in addition to that,
        
was also seen in formula fed infants in comparison with breast

concludes that maturation and brain myelination patterns in
breast fed infants is more mature than formula fed infants [2].
Small for Gestational Age (SGA) born babies are at high risk
for neuro-developmental delay. Studies have shown that enriched
formula fed to term SGA infants improve their growth and their
neuro-developmental outcome. A multicenter randomized
controlled study in United Kingdom showed that there was no
  
Index (MDI) or Psychomotor Development Index (PDI) scores at
      
MDI and PDI scores than formula fed infants. Confounding factors
accounted for one third of the resulted association with MDI
score and none of the association with PDI score. It is previously
        
enhancing linear growth, though this was not correlated with

       
      
assessment of neonates was done for 83 neonates at their ninth
  
      
breast fed and 42 were formula fed, the study showed that
        
depression, and withdrawal. This proves that breast feeding
is much advantageous for neuro-behavioral development and
organization of infants [4].
Minimal duration of breast feeding, or exclusive breast
feeding duration that will be needed to provide optimal neuro-
behavioral and neuro-psychological outcomes for the newborns
was previously investigated through assessing the quality
of motor development of neonates. A directly proportional
     
       
        
life were found to have optimal gross motor milestones in 47%,
compared to 18% in the group of neonates who were breast fed
for less than 6 weeks [5,6].
Follow up randomized studies in Honduras for breast fed
infants for 4 months and older showed that exclusive breast
feeding for 6 months was linked to better developmental
milestones acquirement than introducing solid food. In addition
to breast feeding from the fourth month, they crawled sooner and
was more likely to walk by a maximum of 12 months, than other
infants who were exposed to solid food since the age of 4 months
even in addition to breast feeding [7].
Exclusive breast feeding should always be encouraged and

      
  
sleeping pattern, psychosocial development as well as other
critical areas of early infant development.
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Breast Milk versus Formula Milk and Neuropsychological Development and Sleep
Citation: Gaber Rizk TM (2014)     
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7.            
(1999) Duration of breastfeeding and developmental milestones
during the latter half of infancy. Acta Paediatr 88(12): 1327-1332.
... Exclusive breastfeeding acted as a protective factor against motor delay. Several previous studies had shown similar findings (Rizk, 2014;Sacker, Quigley, & Kelly, 2006). For example, Rizk (2014) found that the proportion of infants achieving their development milestones increased if the infants were nurtured through exclusive breastfeeding. ...
... Several previous studies had shown similar findings (Rizk, 2014;Sacker, Quigley, & Kelly, 2006). For example, Rizk (2014) found that the proportion of infants achieving their development milestones increased if the infants were nurtured through exclusive breastfeeding. Infants who were not breastfed possessed a 40-50% higher likelihood of developing motor delay when compared to their breastfed counterparts (Rizk, 2014). ...
... For example, Rizk (2014) found that the proportion of infants achieving their development milestones increased if the infants were nurtured through exclusive breastfeeding. Infants who were not breastfed possessed a 40-50% higher likelihood of developing motor delay when compared to their breastfed counterparts (Rizk, 2014). Michels et al. (2017) found that exclusively breastfed infants were walking and standing faster than non-exclusively breastfed infants. ...
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The development of cognitive and motor skills early in life is essential for a child's global development and learning, which in turn influences later health and well-being. This cross-sectional study aimed to determine the associations between sociodemographic factors and nutritional factors with cognitive and motor delays in infants aged 6-12 months. This study involved 200 mother-infant pairs from three randomly selected maternal and child health clinics. Results showed high prevalence of cognitive delay (37.0%) and motor delay (58.0%). Infants with small gestational age, anaemia, and single mothers had an increased likelihood of cognitive delay. Boys, anaemic infants, and non-exclusively breastfed infants were more likely to develop motor delay. Nutritional education programmes and interventions for mothers should emphasize early nutrition such as exclusive breastfeeding practices and the prevention of anaemia in infants in order to improve cognitive and motor development among infants.
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To examine whether the duration of exclusive breastfeeding affects maternal nutrition or infant motor development, we examined data from two studies in Honduras: the first with 141 infants of low-income primiparous women and the second with 119 term, low birth weight infants. In both studies, infants were exclusively breastfed for 4 mo and then randomly assigned to continue exclusive breastfeeding (EBF) until 6 mo or to receive high-quality, hygienic solid foods (SF) in addition to breast milk between 4 and 6 mo. Maternal weight loss between 4 and 6 mo was significantly greater in the exclusive breastfeeding group (EBF) group than in the group(s) given solid foods (SF) in study 1 (-0.7 +/- 1.5 versus -0.1 +/- 1.7 kg, P < 0.05) but not in study 2. The estimated average additional nutritional burden of continuing to exclusively breastfeed until 6 mo was small, representing only 0.1-6.0% of the recommended dietary allowance for energy, vitamin A, calcium and iron. Women in the EBF group were more likely to be amenorrheic at 6 mo than women in the SF group, which conserves nutrients such as iron. In both studies, few women (10-11%) were thin (body mass index <19 kg/m(2)), so the additional weight loss in the EBF group in study 1 was unlikely to have been detrimental. Infants in the EBF group crawled sooner (both studies) and were more likely to be walking by 12 mo (study 1) than infants in the SF group. Taken together with our previous findings, these results indicate that the advantages of exclusive breastfeeding during this interval appear to outweigh any potential disadvantages in this setting.
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To investigate the minimal duration of exclusive breastfeeding for optimal neurological outcome, we assessed the quality of general movements (GM) at 3 mo of 147 breastfed healthy term infants that were followed from birth. The quality of GM is a sensitive marker of neurological condition. The quality of GM was classified as normal-optimal, normal-suboptimal, mildly abnormal and definitely abnormal. Information on social and pre- and perinatal conditions and the duration of breastfeeding was collected prospectively. Logistical regression analyses were used to adjust for confounders. There was a positive association between breastfeeding duration and movement quality, with a saturation effect at the age of approximately 6 wk. In the group of infants breastfed for < or = 6 wk (n = 55), 18% exhibited normal-optimal GM, 47% normal-suboptimal GM, and 47% mildly abnormal GM. In contrast, in the group of infants breastfed for > 6 wk (n = 92), 43% exhibited normal-optimal GM, 45% normal-suboptimal GM, and 12% mildly abnormal GM. Exclusive breastfeeding for >6 wk was therefore associated with markedly less abnormal and more normal-optimal GM. Thus, we conclude that breastfeeding for > 6 wk might improve the neurological condition in infants.
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We investigated whether the duration and exclusivity of breastfeeding affects the likelihood of gross and fine motor delay in infants and examined the effect of factors that might explain any observed differences. The study sample included all term singleton infants who weighed > 2500 g at birth and were not placed in a special care infant unit and whose mothers participated in the first survey of the Millennium Cohort Study. Missing data reduced the sample to 14660 (94%) with complete data. Almost half (47%) of the infants initially were exclusively breastfed, but only 3.5% of these infants were still being fed exclusively on breast milk after 4 months of age, and 34% of infants were not breastfed at all; 9% of the infants were identified with delays in gross motor coordination and 6% with fine motor coordination delays at age 9 months. The proportion of infants who mastered the developmental milestones increased with duration and exclusivity of breastfeeding. Infants who had never been breastfed were 50% more likely to have gross motor coordination delays than infants who had been breastfed exclusively for at least 4 months (10.7% vs 7.3%). Any breast milk also was positively related to development: infants who had never been breastfed were 30% more likely to have gross motor delays than infants who were given some breast milk for up to 2 months (10.7% vs 8.4%). The odds ratios for gross motor delay were not attenuated after adjustment for biological, socioeconomic, or psychosocial factors. Infants who were never breastfed had at least a 40% greater likelihood of fine motor delay than infants who were given breast milk for a prolonged period. Our results suggest that the protective effect of breastfeeding on the attainment of gross motor milestones is attributable to some component(s) of breast milk or feature of breastfeeding and is not simply a product of advantaged social position, education, or parenting style, because control for these factors did not explain any of the observed association. In contrast, the association between breastfeeding and fine motor delay was explained by biological, socioeconomic, and psychosocial factors.
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Several studies have suggested that breastfeeding has a long-term influence on brain development. However, interpretation of these findings is complicated by the presence of many potential confounding factors. Only a few studies have examined infants before 1 y of age, although very early assessment might reduce the role of environmental influence. We investigated the association between exclusive breastfeeding and three developmental milestones related to general and fine motor skills and early language development at the age of 8 mo. We followed 1656 healthy, singleton, term infants, with a birthweight of at least 2500 g, born between May 1991 and February 1992 in Aarhus, Denmark. Information was collected at 16 wk gestation, at delivery and when the infant was 8 mo old. Motor skills were evaluated by measurement of crawling and pincer grip. Early language development was defined as the ability to babble in polysyllables. The proportion of infants who mastered the specific milestones increased consistently with increasing duration of breastfeeding. The relative risk for the highest versus the lowest breastfeeding category was 1.3 (95% CI: 1.0-1.6) for crawling, 1.2 (95% CI: 1.1-1.3) for pincer grip and 1.5 (95% Cl: 1.3-1.8) for polysyllable babbling. Little change was found after adjustment for confounding. In conclusion, our data support the hypothesis that breastfeeding benefits neurodevelopment.
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Many studies have shown that children born small for gestational age (SGA) are at a neurodevelopmental disadvantage. We have shown that nutrient enrichment of formula fed to term SGA infants improves their growth and hypothesized that it also would improve their neurodevelopmental outcome. A randomized, controlled trial of standard term-infant (n = 147) or nutrient-enriched (n = 152) formula for the first 9 months. A reference group of 175 breastfed SGA infants was also recruited. Subjects were recruited in 5 maternity hospitals in Cambridge, Nottingham, and Leicester, all in the United Kingdom. Healthy, term infants (gestation: > or =37 weeks) with birth weight <10th centile. Bayley mental and psychomotor scores at 18 months (primary) and developmental scores from Knobloch, Pasamanick, and Sherrard's developmental screening inventory at 9 months (secondary). There was no significant intergroup difference in Bayley Mental Development Index (MDI) or Psychomotor Development Index (PDI) scores at 18 months. However, at 9 months, children fed the enriched formula had a significantly lower developmental quotient (99.5 vs 102.0; 95% confidence interval [CI] for difference: -4.6, -0.4). A significant disadvantage was seen in girls (-5.1; 95% CI: -7.8, -2.4) but not in boys (0.9; 95% CI: -2.4, 4.2). Breastfed infants had significantly higher MDI and PDI scores at 18 months than formula-fed infants. Confounding factors accounted for approximately 34% of the observed association between breastfeeding and MDI score and none of the association between breastfeeding and PDI score. The previously reported enhanced linear growth in SGA children fed enriched formula was not matched by a neurodevelopmental advantage. At 9 months, girls fed the enriched formula had a significant developmental disadvantage, although this was not seen at 18 months. Later follow-up will determine any long-term effects on health or development. Meanwhile, use of enriched formula for term SGA children should not be promoted. It seems that breastfeeding may be especially beneficial for neurodevelopment in children born SGA.
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Following studies conducted during the immediate newborn stage, we investigated whether one-week-olds' neurobehavioral functioning was differentiated by feeding method. We also examined whether feeding-method effects differed among infants of adolescent mothers. Participants were infants (N = 83) of breast-feeding (N = 41) and formula-feeding (N = 42) mothers. Approximately half of each group's participants had adolescent mothers and half were infants of adult mothers. Assessments on the Brazelton Neonatal Behavioral Assessment Scale (BNBAS) were conducted on the infants when they were 8.95 days of age. Breast-fed infants surpassed formula-fed infants on items of the orientation, motor, range of state, and state regulation dimensions of the BNBAS. Breast-fed infants also exhibited fewer abnormal reflexes, signs of depression, and withdrawal. Infants of adolescent mothers did not differ from those of adult mothers, regardless of feeding method. These data provide compelling evidence that breast-feeding is advantageous to neonates' neurobehavioral organization.
Neural maturation Breast Milk versus Formula Milk and Neuropsychological Development and Sleep Citation: Gaber Rizk TM (2014) Breast Milk versus Formula Milk and Neuropsychological Development and Sleep
  • E M Khedr
  • W M Farghaly
  • D A Sel
  • A A Osman
Khedr EM, Farghaly WM, Sel-D A, Osman AA (2004) Neural maturation Breast Milk versus Formula Milk and Neuropsychological Development and Sleep Citation: Gaber Rizk TM (2014) Breast Milk versus Formula Milk and Neuropsychological Development and Sleep. J Pediatr Neonatal Care 1(2):
Breast Milk versus Formula Milk and Neuropsychological Development and Sleep
Breast Milk versus Formula Milk and Neuropsychological Development and Sleep Citation: Gaber Rizk TM (2014) Breast Milk versus Formula Milk and Neuropsychological Development and Sleep. J Pediatr Neonatal Care 1(2):