Higher in-hospital proportion of breast milk intake improves brain functional connectivity and neurological assessment in preterm infants.

OBJECTIVE

Preterm infants may face neurodevelopmental challenges linked to altered brain maturation processes. This study aimed to investigate the impact of in-hospital breast milk intake on brain resting-state functional connectivity (rs-FC) and neurological assessment at discharge in preterm infants.

METHODS

We collected data on breast milk intake from 97 preterm infants, evaluated neurological outcomes using the Amiel-Tison Neurological Assessment (ATNAT), and assessed rs-FC via functional near-infrared spectroscopy (fNIRS). Groups were stratified by breast milk intake proportion (cutoffs of >70% vs. ≤70%; cutoffs of >90% vs. ≤90%), and conducted logistic regression analysis to explore the relationship between rs-FC and neurological assessment.

RESULTS

Preterm infants with >70% breast milk intake exhibited significantly higher ATNAT levels ( χ 2 = 8.306 , p = 0.004) and stronger rs-FC (p = 0.001) between the right precentral gyrus (PCG) and inferior parietal lobe (IPL). The >90% intake group also showed higher ATNAT levels ( χ 2 = 7.090 , p = 0.008) and further rs-FC enhancements (PCG-PFL: p = 0.016; PCG-IPL: p = 0.008). Logistic regression confirmed rs-FC as a predictor of optimal neurological assessment [p = 0.011, Exp (B) = 0.206, 95% CI: 0.062- 0.682].

CONCLUSION

Higher in-hospital breast milk intake (>70% of total enteral nutrition) improves rs-FC and neurological outcomes in preterm infants, with dose-dependent effects.