ArticleBMJ open2012
The apparent breastfeeding paradox in very preterm infants: relationship between breast feeding, early weight gain and neurodevelopment based on results from two cohorts, EPIPAGE and LIFT.
Article in BMJ open, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 83 papers, 5 of them syntheses that pooled it.
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Who cites it
83 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- A Systematic Review and Meta-Analysis of Human Milk Feeding and Short-Term Growth in Preterm and Very Low Birth Weight Infants.Nutrients · 2021Pooled it
- Breastfeeding education and support for women with twins or higher order multiples.The Cochrane database of systematic reviews · 2017Pooled it
- Working group reports: evaluation of the evidence to support practice guidelines for nutritional care of preterm infants-the Pre-B Project.The American journal of clinical nutrition · 2016Pooled it
- Executive summary: evaluation of the evidence to support practice guidelines for nutritional care of preterm infants-the Pre-B Project.The American journal of clinical nutrition · 2016Pooled it
- Human milk and neurodevelopment in children with very low birth weight: a systematic review.Nutrition journal · 2014Pooled it
- Preterm Infants on Early Solid Foods and Neurodevelopmental Outcome-A Secondary Outcome Analysis of a Randomized Controlled Trial.Nutrients · 2024Trial
- Narrative review of human milk fortifiers for preterm infants.Frontiers in pediatrics · 2026Review
- Evaluation of Mineral Content in Preterm Human Milk and Infant Formulas in Qatar: Assessing Compliance With Dietary Recommendations and Label Accuracy.Food science & nutrition · 2025Article
- Systemic inflammation during the neonatal period and BMI at 1 year in infants with gastroschisis: a retrospective cohort study.European journal of pediatrics · 2025Article
- Perinatal Neuroprotection in Preterm Birth.Geburtshilfe und Frauenheilkunde · 2025Article
- Does Breastfeeding Small for Gestational Age Neonates Promote a Healthier Growth Pattern? A Narrative Review.Children (Basel, Switzerland) · 2025Review
- Article
- Complex trajectories are associated with neurological impairment in infants with congenital gastrointestinal malformations aged two.Acta paediatrica (Oslo, Norway : 1992) · 2025Article
- Associations of maternal diet with nutritional and chemical exposure markers in human milk from the LACTACOL cohort of preterm infants.European journal of nutrition · 2025Article
- Comparison of INTERGROWTH- 21st and Fenton growth standards to assess size at birth and at discharge in preterm infants in the United Arab Emirates.BMC pediatrics · 2024Article
- Observational
- Role of the biological active components of human milk on long-term growth and neurodevelopmental outcome.Italian journal of pediatrics · 2024Review
- Breast milk feeding in premature infants with persistent ductus arteriosus.Pediatric research · 2024Article
- Supplementing human milk for preterm infants: a nutritional challenge?Pediatric research · 2024Article
- Fatty acid concentrations in preterm infants fed the exclusive human milk diet: a prospective cohort study.Journal of perinatology : official journal of the California Perinatal Association · 2024Article
23 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
contextSupplementation of breast milk is difficult once infants suckle the breast and is often discontinued at end of hospitalisation and after discharge. Thus, breastfed preterm infants are exposed to an increased risk of nutritional deficit with a possible consequence on neurodevelopmental outcome.
objectiveTo assess the relationship between breast feeding at time of discharge, weight gain during hospitalisation and neurodevelopmental outcome.
designObservational cohort study.
settingTwo large, independent population-based cohorts of very preterm infants: the Loire Infant Follow-up Team (LIFT) and the EPIPAGE cohorts. PATIENTS: 2925 very preterm infants alive at discharge.
main outcome measureSuboptimal neurodevelopmental outcome, defined as a score in the lower tercile, using Age and Stages Questionnaire at 2 years in LIFT and Kaufman Assessment Battery for Children Test at 5 years in EPIPAGE. Two propensity scores for breast feeding at discharge, one for each cohort, were used to reduce bias.
resultsBreast feeding at time of discharge concerned only 278/1733 (16%) infants in LIFT and 409/2163 (19%) infants in EPIPAGE cohort. Breast feeding is significantly associated with an increased risk of losing one weight Z-score during hospitalisation (LIFT: n=1463, adjusted odd ratio (aOR)=2.51 (95% CI 1.87 to 3.36); EPIPAGE: n=1417, aOR=1.55 (95% CI 1.14 to 2.12)) and with a decreased risk for a suboptimal neurodevelopmental assessment (LIFT: n=1463, aOR=0.63 (95% CI 0.45 to 0.87); EPIPAGE: n=1441, aOR=0.65 (95% CI 0.47 to 0.89) and an increased chance of having a head circumference Z-score higher than 0.5 at 2 years in LIFT cohort (n=1276, aOR=1.43 (95% CI 1.02 to 2.02)) and at 5 years in EPIPAGE cohort (n=1412, aOR=1.47 (95% CI 1.10 to 1.95)).
conclusionsThe observed better neurodevelopment in spite of suboptimal initial weight gain could be termed the 'apparent breastfeeding paradox' in very preterm infants. Regardless of the mechanisms involved, the current data provide encouragement for the use of breast feeding in preterm infants.
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