Peer-reviewed article
Human Milk Oligosaccharides in Breast Milk at Two Weeks of Age in Relation to Neurodevelopment in 2-Year-Old Children Born Extremely Preterm: An Explorative Trial.
Erik Wejryd, Erik Freiholtz Jern, Giovanna Marchini, Ulrika Åden, Eva Landberg et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined whether specific components in breast milk called human milk oligosaccharides (HMOs) are linked to brain development in extremely preterm infants. Researchers analyzed milk from 76 mothers at two weeks after birth and measured their babies' development at two years old. The study found that certain HMOs appeared associated with better or worse neurodevelopmental outcomes, but the authors emphasize these are preliminary findings requiring further research.
Key points
- The HMO called 3FL was associated with less neurodevelopmental impairment
- The HMO called LSTa was associated with worse neurodevelopmental impairment, lower language and motor scores
- The HMO called LSTb was associated with better cognitive and language scores
- No significant associations were found for overall HMO diversity, total sialic acid content, or secretor/Lewis patterns
- The authors note these are exploratory findings and do not constitute evidence of causation
Limitations
This is an explorative, hypothesis-generating study with a small sample of 76 infants and no comparison or control group, so causation cannot be established. The findings are preliminary and require validation through larger, prospective studies before they can guide clinical practice.
Abstract
Background: Preventing neurodevelopmental impairment after extremely preterm birth remains challenging. While breast milk feeding is linked to better neurodevelopment, the underlying mechanisms are unclear. This study explored the association between individual human milk oligosaccharides (HMO) and neurodevelopment at two years of age in extremely preterm children. Methods: Milk samples from mothers of 76 extremely preterm infants collected at two weeks after birth were analyzed for 15 dominant HMOs. Register data from examination and Bayley-III neurodevelopmental assessment at two years' corrected age was retrieved and categorized into levels of impairment. An exploratory analysis examined associations between the HMO composition and neurodevelopment. Results: Bioinformatic volcano plots revealed associations between specific HMOs and outcomes: 3FL with less neurodevelopmental impairment, LSTb with higher Bayley-III cognitive scores, and LSTa with worse neurodevelopmental impairment outcomes. Spearman correlations indicated LSTa was linked to more neurodevelopmental impairment (p = 0.018), lower language (p = 0.009), and motor (p = 0.02) scores, whereas 3FL correlated with less neurodevelopmental impairment (p = 0.02). Dichotomized analysis showed LSTa was associated with more neurodevelopmental impairment and lower language scores (p < 0.05), 3FL with milder neurodevelopmental impairment (p < 0.05), and LSTb with better cognitive (p < 0.01) and language (p < 0.05) scores. No significant associations were found for HMO diversity, total sialic acid content, or secretor/Lewis patterns. Conclusions: In this explorative hypothesis-generating study, certain HMOs appeared to be associated with both potentially beneficial and adverse neurodevelopmental outcomes in extremely preterm infants. However, these findings should be interpreted with caution, as they do not constitute evidence but rather serve as a preliminary foundation for future hypothesis-driven research.