Project Details

Human milk composition and infant neurodevelopment in rural Bangladesh

Krysten North, MD, MPH

Summary

BACKGROUND: 43% of children in low- and middle-income countries (LMICs) will not meet their neurodevelopmental potential, a trajectory partly determined by inadequate nutritional intake in infancy. Nearly 90% of infants in LMICs such as Bangladesh consume predominantly human milk (HM), which has variable composition based on maternal factors. GAP: The contribution of individual HM components to early child neurodevelopment has been inadequately studied, particularly in low- and middle-income countries (LMICs) such as Bangladesh, where rates of both breastfeeding and unmet neurodevelopmental potential are high. Certain HM macronutrients, growth factors, and HMOs have been linked to neurodevelopment, but nearly all of these studies have either been we or only among preterm populations. HYPOTHESIS: We hypothesize that: (1) HM protein content, (2) HMO 2’FL concentration, and (3) IGF-1 levels will be positively associated with cognitive scores on the Bayley Scales of Infant Development (BSID)-III at 24 months. METHODS: I will use HM samples collected at 1- and 4-months postpartum from a cohort of 99 mother-infant dyads in rural Bangladesh. I will use multiple linear regression methods to determine the relationship between 1- and 4-month HM composition (macronutrients, HMOs, and growth factors) and 24-month BSID-III scores. The primary outcome of this study will be the cognitive score on the BSID-III at 24 months. RESULTS: Pending. IMPACT: I will use the information generated by this observational study to inform future interventions targeting modifiable HM factors, such as fortification of HM among very high-risk infants or interventions to modify milk composition.