No added cognitive benefit for nutrient-dense milk formula in preemies

A feeding formula enriched with macronutrients does not necessarily improve long-term cognitive outcome in preterm infants as compared with standard milk formula, a study has found. Meanwhile, infant growth over the first year of life is important and does wonder for later cognition.

A total of 92 preterm infants were randomized at 36 weeks corrected gestational age (CGA) to either preterm formula (PTF; energy density, 80 kcal/100 mL; protein, 2.2 g/100 mL; n=37) or term formula (TF; energy density, 67 kcal/100 mL; protein, 1.6 g/100 mL; n=37) until 6 months, or PTF until 40 weeks CGA then TF until 6 months (crossover group; n=18).

All children were followed for 10 years to assess childhood cognition. The assessment tool used was the short form Wechsler Intelligence Scale for Children III, with full computation of full-scale intelligence quotient (FSIQ) and four-factor index scores; verbal comprehension, freedom from distractibility (FDI), perceptual organization (POI), and processing speed (PSI).

Results showed no significant difference in FSIQ. However, compared with the crossover group, children in the PTF group had 10-point higher PSI (p=0.03).

Faster weight gain from term to 12 weeks CGA was strongly correlated with a 5-point increase in FSIQ (p=0.02) and four-point rise in POI (p=0.04). Infant head growth likewise showed a positive association with FSIQ (3.8-point increase; p=0.04) and FDI (6-point increase; p=0.003).

The findings suggest that nutritional exposures and growth in the first year of life are important and require closer attention. Nevertheless, more research is needed to establish optimal early diet in preterm infants.