Brain scans of preterm babies could improve feeding strategies to boost brain development

TORONTO, ON – Preterm babies face many difficulties with feeding. It can take days before their mothers start producing enough breast milk, and up to weeks before the baby’s stomach is mature enough to tolerate the milk. For preterm babies born at 32 to 36 weeks, there is almost no evidence to guide doctors on how to best feed babies during this period, and practice varies widely. One common approach is to give babies a sugar solution intravenously while gradually increasing the amount of milk fed via a nasogastric tube down the nose into the stomach, finally shifting to breastfeeding when the baby is ready.

This world-first study is being co led by Professor Jane Harding at the University of Auckland-based Liggins Institute and Dr. Steven Miller, Division Head of Neurology at The Hospital for Sick Children (SickKids). On June 19, the researchers received $1.2 million in funding from the Health Research Council (HRC) to begin the study, which will involve 96 babies born at 32 to 36 weeks’ gestation.

Researchers will take MRI scans of preterm babies’ brains a few days after birth, and then again at their due date, to see how nutrition in the first days, while the babies are still learning how to breastfeed, affects brain growth and development.

The scan takes 30 to 40 minutes and is completely safe. MRI has been used for many years as a routine assessment of even the tiniest preterm babies. It is non-invasive, involves no radiation and has no known side effects.

Every year, around 5000 babies are born preterm in Aotearoa New Zealand. In Canada, an average of 7.8 per cent births are preterm births. The vast majority survive, but they carry a greater risk of problems with growth, learning, and adult diseases such as obesity and diabetes than babies born at term.

This new study builds on the Liggins Institute-led DIAMOND study, which is comparing different ways of providing nutritional support to preterm babies learning how to breastfeed. Researchers believe that optimizing how and what preterm babies are fed in those critical first days or weeks could prevent diseases later in life and help intellectual development.

The main DIAMOND study has been running for 18 months. Babies are randomly allocated to receive just sugar water or sugar water plus protein intravenously. They also either receive a specially formulated human milk substitute via the feeding tube while waiting for their mother’s breast milk supply to become available. On top of this, half of the babies smell and taste a few drops of milk before the tube-feed, as evidence from a pilot study suggests this may help them feed earlier.

Researchers in this new brain MRI study have proposed that giving babies protein-boosted sugar water intravenously may affect how the cerebral cortex matures. They also propose that breastmilk may support developing connections between nerve cells, and that exposure to the smell and taste of milk before a tube-feed may alter maturation of the thalamus – an important co-ordinating centre at the base of the brain.

“Improving early brain growth and maturation for preterm babies is associated with better overall development as the babies get older,” says Miller. “If we can pinpoint the feeding approach that best supports early brain development, it will improve their development and learning outcomes later in life.”

About The Hospital for Sick Children
The Hospital for Sick Children (SickKids) is recognized as one of the world’s foremost paediatric health-care institutions and is Canada’s leading centre dedicated to advancing children’s health through the integration of patient care, research and education. Founded in 1875 and affiliated with the University of Toronto, SickKids is one of Canada’s most research-intensive hospitals and has generated discoveries that have helped children globally.  Its mission is to provide the best in complex and specialized family-centred care; pioneer scientific and clinical advancements; share expertise; foster an academic environment that nurtures health-care professionals; and champion an accessible, comprehensive and sustainable child health system. SickKids is proud of its vision for Healthier Children. A Better World. For more information, please visit Follow us on Twitter (@SickKidsNews) and Instagram (@SickKidsToronto).



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