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Review
. 2019 Aug 30;11(9):2029.
doi: 10.3390/nu11092029.

The Influence of Early Nutrition on Brain Growth and Neurodevelopment in Extremely Preterm Babies: A Narrative Review

Barbara E Cormack  1   2 , Jane E Harding  2 , Steven P Miller  3   4 , Frank H Bloomfield  5   6
Affiliations
Review

The Influence of Early Nutrition on Brain Growth and Neurodevelopment in Extremely Preterm Babies: A Narrative Review

Barbara E Cormack et al. Nutrients. .

Abstract

Extremely preterm babies are at increased risk of less than optimal neurodevelopment compared with their term-born counterparts. Optimising nutrition is a promising avenue to mitigate the adverse neurodevelopmental consequences of preterm birth. In this narrative review, we summarize current knowledge on how nutrition, and in particular, protein intake, affects neurodevelopment in extremely preterm babies. Observational studies consistently report that higher intravenous and enteral protein intakes are associated with improved growth and possibly neurodevelopment, but differences in methodologies and combinations of intravenous and enteral nutrition strategies make it difficult to determine the effects of each intervention. Unfortunately, there are few randomized controlled trials of nutrition in this population conducted to determine neurodevelopmental outcomes. Substantial variation in reporting of trials, both of nutritional intakes and of outcomes, limits conclusions from meta-analyses. Future studies to determine the effects of nutritional intakes in extremely preterm babies need to be adequately powered to assess neurodevelopmental outcomes separately in boys and girls, and designed to address the many potential confounders which may have clouded research findings to date. The development of minimal reporting sets and core outcome sets for nutrition research will aid future meta-analyses.

Keywords: amino acid; brain; extremely low birthweight; follow up; gestational age; growth; infant; newborn; nutrition; nutrition disorders/etiology; parenteral nutrition; premature; preterm.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Changes in neurodevelopmental outcomes for extremely preterm babies in 2008–2018.
Figure 2
Figure 2
Nutrients needed for normal brain development.
Figure 3
Figure 3
Effects of nutrient deficiency during brain development.
See this image and copyright information in PMC

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