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A new study has revealed that breastfeeding as opposed to using infant formula could boost the

neurodevelopment of “very preterm” babies. Publishing their findings in the Journal of Pediatrics, an
international team of scientists discovered that infants born before 30 weeks gestation tended to
have a higher IQ at the age of seven if fed predominantly with their mothers’ milk during the first
month of their life, compared to those that received formula. This was also reflected in the volume
of grey matter in certain key regions of the brain.
Because of its high nutritional value, breast milk is a vital component of the diet of newborn babies,
helping them grow and develop. But premature babies often have different dietary requirement to
those that are born after a full nine months in the womb, and therefore often struggle to
gain weight when fed only on breast milk, which is why they are sometimes given preterm formula
instead.
However, after analyzing data relating to 180 babies born prior to 30 weeks, the study authors found
that by the time they reached term, those whose diets consisted of more than 50 percent breast milk
during their first 28 days of life had higher volumes of grey matter in their deep nuclei. These are
regions of the brain containing high concentrations of neurons, which play a major role in controlling
brain activity and regulating cognition.

The researchers then performed a second magnetic resonance imaging (MRI) scan on all 180
participants when they reached seven years of age, finding that in addition to having greater deep
nuclear grey matter, those who received more than 50 percent breast milk during their first month of
life also had larger hippocampi.

Since the hippocampus is involved in processes such as learning and memory, it is perhaps
unsurprising that when conducting intelligence and cognition tests, those who had been fed on high
proportions of milk were found to have a higher IQ than those who received mainly formula. In fact,
for each extra day that breast milk made up more than half of a baby’s diet, IQ was 0.5 points higher
by the age of seven.
It’s hard to pinpoint exactly how the nutrients in breastmilk stimulate this effect in preterm babies,
although it may have something to do with the fact that those born prematurely are often at a
different stage of neurodevelopment than those born at term. For instance, the final months of
gestation usually see the creation of new neurons and brain connections, as neuronal branches
called axons and dendrites rapidly develop at this time. In contrast, once a baby has been born, the
brain enters a new phase of readjustment during which many of these connections are strategically
“pruned” in order to make cognition more efficient.

e hippocampus, which plays a role in learning and memory, was larger by age seven among those who had received more than 50
percent breast milk during their first 28 days of life. decade3d - anatomy online/Shutterstock

https://www.iflscience.com/brain/premature-babies-who-are-breastfed-may-have-larger-brains-and-
higher-iq/all/
Preemies With Faster Brain Growth May End Up
Smarter
British study found growth rate of the cortex predicted scores on
intelligence tests
Please note: This article was published more than one year ago. The facts and conclusions presented
may have since changed and may no longer be accurate. And "More information" links may no longer
work. Questions about personal health should always be referred to a physician or other health care
professional.
En Español
By Mary Brophy Marcus
HealthDay Reporter
WEDNESDAY, Oct. 12, 2011 (HealthDay News) -- Growth in a particular part of a premature
baby's brain in the first weeks and months following birth may predict how well a youngster
is able to think, plan and pay attention later in childhood, new research suggests.

In a study published in the Oct. 12 issue of Neurology, British researchers used MRI to
measure the brains of 82 premature infants born before 30 weeks -- well ahead of the
typical 40-plus weeks a normal pregnancy involves.
In the study, MRI measured an area of the brain called the cerebral cortex, the outer layer
of "gray matter" that looks like deep folds and wrinkles, and which covers the cerebrum. It
is responsible for a variety of functions including memory, attention and language.
Scientists believe the winding outer covering's structural complexity, also referred to as the
"cortical ribbon" -- not just brain volume -- is a key to intelligence.

Brain images were taken during the early weeks and months that followed the premature
births -- the time frame during which the babies would have been carried by the mother if
born full-term. Later, at age 2, and again at age 6, the children were given intelligence and
developmental tests.

The greater the cerebral cortex growth was in early life, the better the child performed
complex tasks at age 6, said study author Dr. David Edwards, a professor of neonatal
medicine and director of the Centre for the Developing Brain at Imperial College, in London.

"The period before normal-term delivery is critical for the growth of the brain in quite
specific ways, and if this is disrupted by being born too early, it affects long-term cognitive
abilities," Edwards explained.

Edwards said a 5 percent to 10 percent reduction in the surface area of the cerebral cortex
at full-term age predicted a lower score on intelligence tests at age 6. However, he noted
that a child's motor skills were not linked with the rate of cerebral cortex growth, and
overall brain size was not connected to general cognitive ability either.

The research has merits, said Dr. Peter Rosenberger, a developmental neurologist who
wrote an accompanying editorial.
"What the study helps confirm is that it is not the size of the brain that matters, but rather
its complexity, which the authors have defined as number of folds or convolutions per unit
of brain mass. What we don't know yet is what this greater complexity confers upon the
brain," said Rosenberger, formerly director of the Learning Disorders Unit at Massachusetts
General Hospital, currently in private practice in Boston.

Because there was no group of full-term babies to compare the premature infants with, the
study reveals little about brain development in babies born early, said Rosenberger.

In his editorial, Rosenberger said the authors' frequent references to "rate of growth" are
somewhat misleading, and he noted that nearly 30 percent of the infants were only scanned
one time, which doesn't allow for tracking a growth rate.

"The results are not a huge surprise," said Dr. Judy Bernbaum, medical director of the
neonatal follow-up program at The Children's Hospital of Philadelphia. She agreed with
Rosenberger's editorial: "It helps to confirm that the better developed your brain is early on,
the more likely you're going to do better from a developmental standpoint later on."

Bernbaum said parents of preemies with lower brain volume shouldn't worry, though. "Brain
growth goes on for a couple of years. Even if at birth you have low brain volume, you still
have a lot of potential you can maximize," she said.

Good nutrition in the first two years of life, a healthy and low-stress home environment and
stimulation from parents and caretakers all contribute to the growth of the brain, Bernbaum
said.

The study doesn't provide answers to how to boost your baby's brain, however.

"For the public, they are always eager to know what can I do? But we don't really have a
handle on it here. This is not a study demonstrating the effect of an intervention," said
Raman Sankar, chief of pediatric neurology at Mattel Children's Hospital at the University of
California, Los Angeles. But, Sankar said, "people with preemies can go to development
centers and get a lot of therapy. It can't hurt and probably helps."

Building a healthy brain can begin well before birth, too, Bernbaum added. Pregnant women
who take a prenatal vitamin, eat a well-balanced diet low in salt and fat, and rich in calcium
and protein, are giving their children, even babies born prematurely, the best odds,
Bernbaum said.

https://consumer.healthday.com/cognitive-health-information-26/brain-health-news-80/preemies-
with-faster-brain-growth-may-end-up-smarter-657827.html
ew Study Says That Premature Babies Are Smarter
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Adolescents and adults who were born very prematurely may have “older” brains than those who were born
full term, a new study reveals.
Researchers identified changes in the brain structure of adults born between 28 and 32 weeks gestation that
corresponded with accelerated brain aging, meaning that their brains appeared older than those of their non-
preterm counterparts.
Lead study author Dr. Chiara Nosarti, of the Institute of Psychiatry, Psychology and Neuroscience at King’s
College London in the United Kingdom, and colleagues recently reported their findings in the journal
Neuroimage.

According to the Centers for Disease Control and Prevention (CDC), around 1 in 10 infants born in the United
States in 2015 were preterm, meaning that they were born before 37 weeks of pregnancy.
A baby’s brain fully develops in the final few weeks of gestation, so being born early disrupts this process. As
such, babies born preterm are at greater risk of developmental disabilities including impairments in learning,
language, and behavior.
But how does preterm birth affect the brain in adulthood? This is what Dr. Nosarti and colleagues sought to
find out with their new study.

Scientists once thought that brain maturation ceases in adolescence. But in recent years, studies have indicated
that this may not be the case, and that the brain may not fully mature until we reach our mid-20s.
According to Dr. Nosarti and team, their study is the first to investigate how preterm birth might affect this
adult brain maturation process.
Using MRI, the researchers analyzed the brain structure of 328 adults who had been born before 33 weeks
gestation. Subjects were assessed at two time points: adolescence (mean age 19.8 years) and adulthood (mean
age 30.6 years).

The brain scans of these participants were then compared with those of 232 adults who were born full term (the
controls), alongside 1,210 brain scans gathered from open-access MRI archives.
Specifically, the researchers looked at volume of gray matter in the participants’ brains, which they say can be
a marker of “brain age.”
Compared with the controls, the team found that subjects born very preterm had a lower volume of gray matter
in both adolescence and adulthood, particularly in brain regions associated with memory and emotional
processing.

http://www.fsnursing.com/new-study-says-premature-babies-smarter/
For Tiny Babies, Brain Growth Predicts
Intelligence
How fast a baby's brain grows, rather than how large it is, predicts the child's mental
abilities later in life, a new study of preterm infants suggests.

The faster the brain's cerebral cortex grew during the first months of life, the higher the
children scored at age 6 on intelligence tests designed to measure their abilities to think,
speak, plan and pay attention, the researchers found.

The cerebral cortex is an outer layer of the brain that is critical for language, memory,
attention and thought.

The study found no relationship between the size of a baby's brain and the child's later
test scores.
While it's not clear whether the results would also apply to babies born full-term,
researchers said the findings are helping them understand what might go wrong in the
brains of preterm babies that causes many of those infants to experience cognitive
problems later in life.

"It points us to the fact that the period before normal birth is a critical time for brain
growth," said study researcher David Edwards, a professor of neonatal medicine at
Imperial College in London. Anything that disrupts this growth, including preterm birth or
certain illnesses, may reduces cognitive abilities, Edwards said.

Tiny brains
Edwards and colleagues examined 82 infants born before 30 weeks of gestation. (Full-
term pregnancies generally last between 38 and 42 weeks.) The researchers used
magnetic resonance imaging to scan the brains of the tiny babies almost immediately
after birth — when some of whom weighed less than 1.5 pounds (700 grams) — and
again up until the date they would have been born if the pregnancy had been full-term.
None of the babies had been born with noticeable brain damage.

Some babies had their brains scanned only once, some two or three times, and some
as many as eight times over the course of the study. (MRIs use magnetism, not
radiation, to create images of the brain, so the babies in this study weren’t at risk for
harmful side effects from the imaging.)

The children took intelligence tests when they were 2 and 6 years old.

The growth rate of the cerebral cortex in infancy was linked, in particular, to scores on
tests that measured attention, language, memory, planning and the ability to
conceptualize numbers. Babies whose cerebral cortices grew 5 to 10 percent less than
those of other babies scored lower than average on the intelligence tests at age 6.
The results were true regardless of the children's social class. However, it's possible
that factors other than brain growth ? such as the interaction between the child and his
or her family ? influenced test scores, Dr. Peter Rosenberger, of Massachusetts
General Hospital, and Heather Adams, of the University of Rochester Medical Center,
wrote in an editorial accompanying the study.

Future therapies

The findings may help researchers know if therapies intended to treat preterm infants
will help them later in life, the study said. If a treatment increases the growth of the
cerebral cortex, then it could reduce the risk of cognitive problems in childhood.

The study and editorial were published today (Oct. 12) in the journal Neurology.

Pass it on: The more a preterm baby's brain grows in infancy, the better the child performs
on intelligence tests later in life.
This story was provided by MyHealthNewsDaily, a sister site to LiveScience. Follow
MyHealthNewsDaily staff writer Rachael Rettner on Twitter @RachaelRettner. Find us
on Facebook.
https://www.livescience.com/16527-preterm-babies-brain-growth-intelligence.html
re-term babies can be smarter if fed right
21-Apr-2011 (Thu) Mind Your Body, The Straits Times

By Ng Wan Ching

Breast milk alone is not good enough. Such babies need nutrition fortifiers for their brain
development.

It is important for a premature baby to get adequate nutrition because he will gain about 1.4
IQ points for each additional 10g of weight gain between term and one year, studies have
shown. -- PHOTO: ISTOCKPHOTO

What mother does not want a smart baby?

However, if a baby is born premature, does that impact his brain development? Yes, if you
do not feed him right, according to a United States doctor.

For pre-term babies, born before 37 weeks of gestation, how they are fed is closely tied to
their intelligence quotient (IQ) development.

According to Dr Ekhard Ziegler from the University of Iowa Children's Hospital, breast milk
alone is not enough for pre-term babies to have good brain development.

'We need nutrition fortifiers for their brain development,' he said during a media briefing here
last week.

'We now know that weight gain in hospital is very closely related to IQ later on. We know it
best from Bailey scores measured at two years of age.' A Bailey score comes from a mental
development index.

He cited studies that have measured teens' IQ when they were 19, which showed that those
who gained weight slowly when they were pre-term babies grew up to have lower IQs than
those who gained weight faster.

'The faster the weight gain, the higher the IQ. We can even give a number: 1.4 IQ points for
each additional 10g of weight gain between term and one year,' he said.

Breast milk is still important to protect pre-term babies from infections. Dr Ziegler
recommends that pre-term babies be fed fortified breast milk.

Dr Ziegler, a pre-term nutrition expert, highlighted to doctors here at last weekend's Asean
Paediatric Congress, that underweight premature babies must be fed up to three times more
protein than what their mothers' milk can provide.

'This is because of their need to achieve rapid weight gain,' he said.

Failing to receive the appropriate nutrition has led in the past to severe growth failure and
impaired neurocognitive development in premature babies, he said.

His research shows that because the energy and protein needs of pre-term infants are
unique and higher than those of full-term infants, only an optimal nutrition regimen will
enable pre-term babies to develop better cognitive and growth outcomes.

The key to that is to fortify a mother's milk with protein and mineral supplements.
Alongside breast milk, scientifically calculated fortified nutrition has been proven to generate
good growth for these fragile infants and, in turn, aid their long-term health and
development.

In his research, Dr Ziegler observed that until recently, premature infants were routinely
given inadequate amounts of nutrients, particularly protein.

At the same time, the gastrointestinal tracts of pre-term infants are not well developed,
making nutrition absorption a challenge in many instances.

For pre-term babies, every day counts in their growth progress.

More premature babies

Every year, about 13 million premature babies are born worldwide. In Singapore, a few
thousand babies a year are born at least three weeks earlier than their due date.

The number of pre-term babies born here has increased by possibly 10 to 20 per cent over
the last 10 years, said Dr Steven Ng, consultant paediatrician and neonatologist at
Gleneagles Medical Centre and president-elect, College of Paediatrics and Child Health,
Singapore.

'The increase is partially because mothers are getting married and having babies at a much
later age and some of these babies are conceived through assisted reproductive
techniques.

'Also, more pregnant mothers are working until they are almost due for delivery, which does
predispose them somewhat to more premature births,' he said.

According to Dr Lee Jiun, head and senior consultant at the department of neonatology at
National University Hospital (NUH), the national figure for pre-term births is 6 to 7 per cent
of all births here.

Dr Ng said babies born well before their due date 'lose out' on the nutrients which they
would otherwise have received if the pregnancy had been carried to term.

These extra calories and nutrients may need to be continually supplemented even after the
baby has been discharged from the hospital in order for them to catch up with their full-term
peers in terms of their growth, said Dr Ng.

Dr Yvonne Ng, consultant at the department of neonatology at NUH, said Dr Ziegler has
brought attention to the need to provide early parenteral nutrition with higher levels of
protein than previously given.

Parenteral nutrition is given through the veins of the circulatory system, rather than through
the digestive system.

'He also reminds us to pay attention to the need to continue to feed the pre-term baby
adequately after he is discharged.

'The data of his colleagues in the University of Iowa testifies to the progress that can be
made with these changes,' she said.

Risks a premature baby faces


Prematurity occurs when a baby is born before 37 weeks of gestation; full-term infants are
born from 37 to 42 weeks of gestation.

Because of their delicate constitution, premature babies are cared for in a neonatal intensive
care unit specially designed to meet their basic needs of warmth, nutrition and protection.
The more premature the baby, the more complications he may face including various
combinations of respiratory, cardiovascular, neurological, visual and nutritional problems.

https://www.nuh.com.sg/news/media-articles_1648.html