NICU Human Milk Dose and 20-Month Neurodevelopmental Outcome in Very Low Birth Weight Infants.
BACKGROUND
The association between human milk (HM) feeding in the NICU and neurodevelopmental (ND) outcome in very low birth weight (VLBW) infants is unclear. Limitations of previous studies include a lack of exact estimates of HM dose and of generalizability to minority populations.


OBJECTIVE
To determine the impact on ND outcome of an exact dose of HM received in the NICU in a diverse, contemporary cohort of VLBW infants.


METHODS
We included 430 VLBW infants born in the period 2008-2012 for whom the mean daily dose (DD) of HM received during the stay in the NICU (NICU HM-DD) was calculated prospectively from the daily nutritional intake from admission to discharge. Outcomes included Bayley-III index scores at 20 months' corrected age (CA) as assessed upon ND follow-up, which were collected retrospectively. Multivariable linear regression analyses controlled for neonatal and social risk factors.


RESULTS
Each 10 mL/kg/day increase in NICU HM-DD was associated with a 0.35 increase in cognitive index score (95% CI [0.03-0.66], p = 0.03), but no significant associations were detected for the language or motor indices.


CONCLUSIONS
There is a significant dose-dependent association between NICU HM intake and cognitive scores at 20 months' CA. Further follow-up will determine whether these findings persist at school age, and could help alleviate the special-education and health-care burden in this population.
['Patra|Kousiki|K|', 'Hamilton|Matthew|M|', 'Johnson|Tricia J|TJ|', 'Greene|Michelle|M|', 'Dabrowski|Elizabeth|E|', 'Meier|Paula P|PP|', 'Patel|Aloka L|AL|']
D000367:Age Factors D001724:Birth Weight D002657:Child Development D002663:Child Language D003071:Cognition D005260:Female D006801:Humans D007223:Infant D007227:Infant Nutritional Physiological Phenomena D007231:Infant, Newborn D019102:Infant, Very Low Birth Weight D007363:Intensive Care Units, Neonatal D016014:Linear Models D008297:Male D008895:Milk, Human D009043:Motor Activity D015999:Multivariate Analysis D009420:Nervous System D009752:Nutritional Status D009753:Nutritive Value D011446:Prospective Studies D012189:Retrospective Studies
Human milk Neurodevelopmental outcome Very low birth weight infants