Breastfeeding boosts metabolites important for brain growth

April 27, 2019

Science Daily/Children's National Health System

Micro-preemies who primarily consume breast milk have significantly higher levels of metabolites important for brain growth and development, according to sophisticated imaging conducted by an interdisciplinary research team at Children's National.

"Our previous research established that vulnerable preterm infants who are fed breast milk early in life have improved brain growth and neurodevelopmental outcomes. It was unclear what makes breastfeeding so beneficial for newborns' developing brains," says Catherine Limperopoulos, Ph.D., director of MRI Research of the Developing Brain at Children's National. "Proton magnetic resonance spectroscopy, a non-invasive imaging technique that describes the chemical composition of specific brain structures, enables us to measure metabolites essential for growth and answer that lingering question."

According to the Centers for Disease Control and Prevention, about 1 in 10 U.S. infants is born preterm. The Children's research team presented their findings during the Pediatric Academic Societies 2019 Annual Meeting.

The research-clinicians enrolled babies who were very low birthweight (less than 1,500 grams) and 32 weeks gestational age or younger at birth when they were admitted to Children's neonatal intensive care unit in the first week of life. The team gathered data from the right frontal white matter and the cerebellum -- a brain region that enables people to maintain balance and proper muscle coordination and that supports high-order cognitive functions.

Each chemical has its own a unique spectral fingerprint. The team generated light signatures for key metabolites and calculated the quantity of each metabolite. Of note:

·     Cerebral white matter spectra showed significantly greater levels of inositol (a molecule similar to glucose) for babies fed breast milk, compared with babies fed formula.

·     Cerebellar spectra had significantly greater creatine levels for breastfed babies compared with infants fed formula.

·     And the percentage of days infants were fed breast milk was associated with significantly greater levels of both creatine and choline, a water soluble nutrient.

"Key metabolite levels ramp up during the times babies' brains experience exponential growth," says Katherine M. Ottolini, the study's lead author. "Creatine facilitates recycling of ATP, the cell's energy currency. Seeing greater quantities of this metabolite denotes more rapid changes and higher cellular maturation. Choline is a marker of cell membrane turnover; when new cells are generated, we see choline levels rise."

Already, Children's National leverages an array of imaging options that describe normal brain growth, which makes it easier to spot when fetal or neonatal brain development goes awry, enabling earlier intervention and more effective treatment. "Proton magnetic resonance spectroscopy may serve as an important additional tool to advance our understanding of how breastfeeding boosts neurodevelopment for preterm infants," Limperopoulos adds.

https://www.sciencedaily.com/releases/2019/04/190427104808.htm

New evidence links exclusive breastfeeding, early play/stimulation to children's later success

Enriched play/stimulation to age two creates brighter four-year-olds, say investigators

June 21, 2016

Science Daily/Grand Challenges Canada

A pair of new studies further strengthen scientific understanding of the links between what a child experiences in the first years of life and later childhood behavior and abilities. Researchers working in South Africa and Pakistan report their findings in a new paper.

Funded by the Government of Canada through Grand Challenges Canada, researchers working in South Africa and Pakistan report their findings in papers launched today.

In the first study, an international team led by Dr Ruth M. Bland of the Royal Hospital for Sick Children and Institute of Health and Wellbeing, University of Glasgow, assessed over 1,500 children in South Africa, 900 of whom had been involved in an early infant feeding study.

They found longer durations of exclusive breastfeeding strongly associated with fewer conduct disorders at ages 7 to 11 years. Children exclusively breastfed for the recommended six months, compared with those exclusively breastfed for less than one month, were approximately half (56 percent) as likely to have conduct disorders at primary school age.

Other highlighted findings, published in PLOS Medicine, included:

• ·      Important determinants of a child's cognitive development: attending creche (preschool) and mother's IQ
• ·      Children who attended creche for at least one year were 74 percent more likely to have higher executive function (which enables us to plan, focus attention, remember instructions, and juggle multiple tasks successfully. The brain needs this skill set to filter distractions, prioritize tasks, set and achieve goals, and control impulses. Executive function, therefore, influences educational and social success.)
• ·      Children stimulated at home, such as through play, were one third (36 percent) more likely to have higher executive function scores
• ·      There was weaker evidence that, for boys, exclusive breastfeeding for more than one month improved cognitive development.

The study also examined a number of current life factors that might influence children's development, finding that children were two-and-a-half times more likely to exhibit emotional-behavioural problems if their mothers had a current mental health problem or severe parenting stress.

"The duration of exclusive breastfeeding of an infant has greater importance than previously realized in several areas of development," said lead author Dr Tamsen J. Rochat of the Human Science Research Council, Durban, South Africa.

"For example, childhood onset conduct disorders can lead to aggressive or disruptive behaviours, which interfere with learning and peer relationships, in turn leading to low self-esteem and further behavioural problems. Conduct disorders that start in childhood and persist into the teen years are associated with an increase in antisocial (and potentially violent or criminal) behaviours, poor long-term mental health and low academic achievement in later life."

"Evidence from studies in high-income countries suggests that the economic cost of conduct disorders is enormous," added Dr Bland. For example, a publication from the United Kingdom cited in the paper estimates the annual cost of crime attributable to people who had a conduct disorder in childhood at US$117 billion.

The study was also one of the first to assess the impact of HIV exposure on the development of primary school-age children in Africa. Previous studies suggested that children, although themselves HIV-negative, were disadvantaged if they were born to HIV-positive mothers, particularly in the areas of emotional and behavioural development. This study found that HIV-negative children born to HIV-positive mothers performed as well as those born to HIV-negative mothers.

Play and communication -- "responsive stimulation" -- pays dividends for impoverished rural children in Pakistan

The second paper, published by The Lancet Global Health and led by Dr Aisha K. Yousafzai of Aga Khan University, Karachi, followed up a cohort of impoverished children in rural Pakistan whose parents had been guided on strengthening nutritional care and "responsive stimulation" used to the end of age 2.

In the responsive stimulation intervention, caregivers were coached to observe and respond to their child's cues during play and communication activities, improving the quality of interactions.

The intervention, adapted from the UNICEF and the World Health Organization's 'Care for Child Development' approach (which is readily available online), included using everyday household items or homemade toys to stimulate children's cognitive, language, motor and affective (emotional/feeling) skills.

At age 4, children who received the responsive stimulation intervention were, to varying degrees, more likely to have:

·      Higher IQ

·      Better pre-academic skills (in sizes and comparisons, and shapes)

·      Better executive functioning

·      More pro-social behaviour.

The follow-up study also found parents were better caregivers.

The research involved 1,302 four-year-olds and their mothers from the original study, which had likewise shown that responsive stimulation "significantly benefitted children's cognitive, language and motor development at two years." The investigators intend to follow this cohort throughout their schooling.

"The abilities fostered by stimulation are important for readiness and a successful transition to preschool," said Dr Yousafzai. "The competencies assessed in this study have been shown to predict school engagement and longer-term academic attainment."

"Other studies have shown that the early success of children clearly links to their productivity and income potential later in life and, at a large scale, impacts the economic well-being of societies."

The inclusion of stimulation intervention in health programs is important to support healthy development. It is hoped more research will follow that will provide insights on how to optimize integrated packages of health, growth and development.

The newly published research from South Africa and Pakistan closely follows the release of another Grand Challenges Canada study, conducted by Harvard University, showing that one-third of 3- or 4-year-olds in low- and middle-income countries don't reach expected developmental milestones.

Grand Challenges Canada funded the studies as part of its contribution to the growing international "Saving Brains" partnership, which convenes for a conference in Toronto June 21-22, focused on the results from 11 follow-up studies, including the two publications launched today.

"One in three children in 'developing' countries are in fact failing to develop to their full potential. These studies show how parents can help develop smart, social kids who make good decisions: breastfeed babies and play with children," said Dr Peter A. Singer, Chief Executive Officer of Grand Challenges Canada.

https://www.sciencedaily.com/releases/2016/06/160621193106.htm

Longer duration of breastfeeding linked with higher adult IQ and earning ability

March 17, 2015

Science Daily/The Lancet

Longer duration of breastfeeding is linked with increased intelligence in adulthood, longer schooling, and higher adult earnings, a study following a group of almost 3,500 newborns for 30 years.

"The effect of breastfeeding on brain development and child intelligence is well established, but whether these effects persist into adulthood is less clear," explains lead author Dr Bernardo Lessa Horta from the Federal University of Pelotas in Brazil.

"Our study provides the first evidence that prolonged breastfeeding not only increases intelligence until at least the age of 30 years but also has an impact both at an individual and societal level by improving educational attainment and earning ability. What is unique about this study is the fact that, in the population we studied, breastfeeding was not more common among highly educated, high-income women, but was evenly distributed by social class. Previous studies from developed countries have been criticized for failing to disentangle the effect of breastfeeding from that of socioeconomic advantage, but our work addresses this issue for the first time."

Horta and colleagues analysed data from a prospective study of nearly 6000 infants born in Pelotas, Brazil in 1982. Information on breastfeeding was collected in early childhood. Participants were given an IQ test (Wechsler Adult Intelligence Scale, 3rd version) at the average age of 30 years old and information on educational achievement and income was also collected.

Information on IQ and breastfeeding was available for just over half (3493) participants. The researchers divided these subjects into five groups based on the length of time they were breastfed as infants, controlling for 10 social and biological variables that might contribute to the IQ increase including family income at birth, parental schooling, genomic ancestry, maternal smoking during pregnancy, maternal age, birthweight, and delivery type.

While the study showed increased adult intelligence, longer schooling, and higher adult earnings at all duration levels of breastfeeding, the longer a child was breastfed for (up to 12 months), the greater the magnitude of the benefits. For example, an infant who had been breastfed for at least a year gained a full four IQ points (about a third of a standard deviation above the average), had 0.9 years more schooling (about a quarter of a standard deviation above the average), and a higher income of 341 reais per month (equivalent to about one third of the average income level) at the age of 30 years, compared to those breastfed for less than one month.

According to Dr Horta, "The likely mechanism underlying the beneficial effects of breast milk on intelligence is the presence of long-chain saturated fatty acids (DHAs) found in breast milk, which are essential for brain development. Our finding that predominant breastfeeding is positively related to IQ in adulthood also suggests that the amount of milk consumed plays a role."

Writing in a linked Comment, Dr Erik Mortensen from the University of Copenhagen in Denmark says, "With age, the effects of early developmental factors might either be diluted, because of the effects of later environmental factors, or be enhanced, because cognitive ability affects educational attainment and occupational achievements...By contrast, Victora and colleagues' study suggests that the effects of breastfeeding on cognitive development persist into adulthood, and this has important public health implications...However, these findings need to be corroborated by future studies designed to focus on long-term effects and important life outcomes associated with breastfeeding."

http://www.sciencedaily.com/releases/2015/03/150317195937.htm