Advanced Baby Imaging Lab, Memorial Hospital of Rhode Island, Pawtucket, RI, United States.
University of Wisconsin-Madison, Waisman Centre, Madison, WI, United States.
Neuroimage. 2018 Sep;178:649-659. doi: 10.1016/j.neuroimage.2017.12.056. Epub 2017 Dec 20.
Throughout early neurodevelopment, myelination helps provide the foundation for brain connectivity and supports the emergence of cognitive and behavioral functioning. Early life nutrition is an important and modifiable factor that can shape myelination and, consequently, cognitive outcomes. Differences in the nutritional composition between human breast and formula milk may help explain the functional and cognitive disparity often observed between exclusively breast versus formula-fed children. However, past cognitive and brain imaging studies comparing breast and formula feeding are often: cross-sectional; performed in older children and adolescents relying on parental recall of infant feeding; and generally treat formula-fed children as a single group despite the variability between formula compositions. Here we address some of these weakness by examining longitudinal trajectories of brain and neurocognitive development in children who were exclusively breastfed versus formula-fed for at least 3 months. We further examine development between children who received different formula compositions. Results reveal significantly improved overall myelination in breastfed children accompanied by increased general, verbal, and non-verbal cognitive abilities compared to children who were exclusively formula-fed. These differences were found to persist into childhood even with groups matched for important socioeconomic and demographic factors. We also find significant developmental differences depending on formula composition received and that, in particular, long-chain fatty acids, iron, choline, sphingomyelin and folic acid are significantly associated with early myelination trajectories. These results add to the consensus that prolonged and exclusive breastfeeding plays an important role in early neurodevelopment and childhood cognitive outcomes.
在早期神经发育过程中，髓鞘形成有助于为大脑连接提供基础，并支持认知和行为功能的出现。生命早期的营养是一个重要的、可改变的因素，它可以影响髓鞘形成，进而影响认知结果。人乳和配方奶的营养成分差异可能有助于解释纯母乳喂养与配方奶喂养的儿童之间经常观察到的功能和认知差异。然而，过去比较母乳喂养和配方奶喂养的认知和脑成像研究通常存在以下局限性：横断面研究；在年龄较大的儿童和青少年中进行，依赖于父母对婴儿喂养的回忆；并且通常将配方奶喂养的儿童视为一个单一的群体，尽管配方奶的组成存在差异。在这里，我们通过检查至少 3 个月纯母乳喂养和配方奶喂养的儿童的大脑和神经认知发育的纵向轨迹来解决其中的一些局限性。我们进一步研究了接受不同配方组成的儿童之间的发育情况。结果显示，与纯配方奶喂养的儿童相比，母乳喂养的儿童的整体髓鞘形成明显改善，并且一般、言语和非言语认知能力也有所提高。即使在匹配了重要的社会经济和人口统计学因素的情况下，这些差异在儿童期仍然存在。我们还发现了与配方组成有关的显著的发育差异，特别是长链脂肪酸、铁、胆碱、鞘磷脂和叶酸与早期髓鞘形成轨迹显著相关。这些结果进一步证明，长期、纯母乳喂养在早期神经发育和儿童认知结果中起着重要作用。
