ArticleBMJ (Clinical research ed.)2021
Effect of nutritionally modified infant formula on academic performance: linkage of seven dormant randomised controlled trials to national education data.
Article in BMJ (Clinical research ed.), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it, 22 citations in OpenAlex.
- Early Long-Chain Polyunsaturated Fatty Acids Supplementation on Long- and Short-Term Neurodevelopmental Outcomes in Preterm or Low Birth Weight Infants: A Meta-Analysis.Maternal & child nutrition · 2025Pooled it
- Essential and Potentially Toxic Elements in Commercial Milk Formulas: Health Risk Assessment Through a Systematic Review and Meta-analysis.Biological trace element research · 2026Review
- Commercial influences on infant and young child feeding.Future healthcare journal · 2025Article
- Research on commercial milk formulas for young children: A scoping review.Maternal & child nutrition · 2024Article
- Systematic comparison of Mendelian randomisation studies and randomised controlled trials using electronic databases.BMJ open · 2023Article
- Evidence for human milk as a biological system and recommendations for study design-a report from "Breastmilk Ecology: Genesis of Infant Nutrition (BEGIN)" Working Group 4.The American journal of clinical nutrition · 2023Article
- Health and nutrition claims for infant formula: international cross sectional survey.BMJ (Clinical research ed.) · 2023Article
- Gestational age at birth, chronic conditions and school outcomes: a population-based data linkage study of children born in England.International journal of epidemiology · 2023Article
- Data linkage in medical research.BMJ medicine · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo compare differences in academic performance between adolescents who were randomised in infancy to modified or standard infant formula.
designLinkage of seven dormant randomised controlled trials to national education data.
settingFive hospitals in England, 11 August 1993 to 29 October 2001, and schools in England, September 2002 to August 2016.
participants1763 adolescents (425 born preterm, 299 born at term and small for gestational age, 1039 born at term) who took part in one of seven randomised controlled trials of infant formula in infancy.
interventionsNutrient enriched versus standard term formula (two trials), long chain polyunsaturated fatty acid (LCPUFA) supplemented versus unsupplemented formula (two trials), high versus low iron follow-on formula (one trial), high versus low sn-2 palmitate formula (one trial), and nucleotide supplemented versus unsupplemented formula (one trial).
main outcome measuresThe primary outcome, determined by linkage of trial data to school data, was the mean difference in standard deviation scores for mandated examinations in mathematics at age 16 years. Secondary outcomes included differences in standard deviation scores in English (16 and 11 years) and mathematics (11 years). Analysis was by intention to treat with multiple imputation for participants missing the primary outcome.
results1607 (91.2%) participants were linked to school records. No benefit was found for performance in mathematics examinations at age 16 years for any modified formula: nutrient enriched in preterm infants after discharge from hospital, standard deviation score 0.02 (95% confidence interval -0.22 to 0.27), and nutrient enriched in small for gestational age term infants -0.11 (-0.33 to 0.12); LCPUFA supplemented in preterm infants -0.19 (-0.46 to 0.08) and in term infants -0.14 (-0.36 to 0.08); iron follow-on formula in term infants -0.12 (-0.31 to 0.07); and sn-2 palmitate supplemented formula in term infants -0.09 (-0.37 to 0.19). Participants from the nucleotide trial were too young to have sat their General Certificate of Secondary Education (GCSE) examinations at the time of linkage to school data. Secondary outcomes did not differ for nutrient enriched, high iron, sn-2 palmitate, or nucleotide supplemented formulas, but at 11 years, preterm and term participants randomised to LCPUFA supplemented formula scored lower in English and mathematics.
conclusionsEvidence from these randomised controlled trials indicated that the infant formula modifications did not promote long term cognitive benefit compared with standard infant formulas.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.