IQ Was Not Improved by Post-Discharge Fortification of Breastmilk in Very Preterm Infants

Nutrients. 2022 Jun 29;14(13):2709. doi: 10.3390/nu14132709.


(1) Very preterm infants are at increased risk of cognitive deficits, motor impairments, and behavioural problems. Studies have tied insufficient nutrition and growth to an increased risk of neurodevelopmental impairment; (2) Methods: Follow-up study on cognitive and neuropsychological development at 6 years corrected age (CA) in 214 very preterm infants, including 141 breastfed infants randomised to mother's own milk (MOM) with (F-MOM) or without (U-MOM) fortification and 73 infants fed a preterm formula (PF-group), from shortly before discharge to 4 months CA. Infants with serious congenital anomalies or major neonatal morbidities were excluded prior to intervention. The Wechsler Intelligence Scale for Children IV was used for cognitive testing, and the children's parents completed the Five to Fifteen Questionnaire (FTF); (3) Results: Post-discharge fortification of MOM did not improve either full-scale intelligence quotient (FSIQ) with a median of 104 vs. 105.5 (p = 0.29), subdomain scores, or any domain score on the FTF questionnaire. Compared to the PF group, the MOM group had significantly better verbal comprehension score with a median of 110 vs. 106 (p = 0.03) and significantly better motor skills scores on the FTF questionnaire (p = 0.01); (4) Conclusions: The study supports breastfeeding without fortification as post-discharge nutrition in very preterm infants, and it seems superior to preterm formula.

Keywords: Five to Fifteen Questionnaire; Wechsler Intelligence Scale for Children IV; breastfeeding; cognitive development; fortification; post-discharge nutrition; preterm infant.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aftercare
  • Breast Feeding
  • Child
  • Female
  • Fetal Growth Retardation
  • Follow-Up Studies
  • Humans
  • Infant
  • Infant, Newborn
  • Infant, Premature
  • Infant, Premature, Diseases*
  • Milk, Human*
  • Patient Discharge

Grants and funding

This research was supported be the Research Foundation of the Region of Southern Denmark and the Health Science Research Foundation of the Region of Zealand.