Breastfeeding for 3 months or longer but not probiotics is associated with reduced risk for inattention/hyperactivity and conduct problems in very-low-birth-weight children at early primary school age

Christoph Härtel; Juliane Spiegler; Ingmar Fortmann; Mariana Astiz; Henrik Oster; Bastian Siller; Dorothee Viemann; Thomas Keil; Tobias Banaschewski; Marcel Romanos; Egbert Herting; Wolfgang Göpel

doi:10.3390/nu12113278

Breastfeeding for 3 months or longer but not probiotics is associated with reduced risk for inattention/hyperactivity and conduct problems in very-low-birth-weight children at early primary school age

Christoph Härtel^*, Juliane Spiegler, Ingmar Fortmann, Mariana Astiz, Henrik Oster, Bastian Siller, Dorothee Viemann, Thomas Keil, Tobias Banaschewski, Marcel Romanos, Egbert Herting, Wolfgang Göpel

^*Korrespondierende/r Autor/-in für diese Arbeit

19 Zitate (Scopus)

Abstract

(1) Background: We aimed to evaluate the effect of proposed “microbiome-stabilising interventions”, i.e., breastfeeding for 3 months and prophylactic use of Lactobacillus acidophilus/ Bifidobacterium infantis probiotics on neurocognitive and behavioral outcomes of very-low-birthweight (VLBW) children aged 5–6 years. (2) Methods: We performed a 5-year-follow-up assessment including a strength and difficulties questionnaire (SDQ) and an intelligence quotient (IQ) assessment using the Wechsler Preschool and Primary Scale of Intelligence (WPPSI)-III test in preterm children previously enrolled in the German Neonatal Network (GNN). The analysis was restricted to children exposed to antenatal corticosteroids and postnatal antibiotics. (3) Results: 2467 primary school-aged children fulfilled the inclusion criteria. In multivariable linear regression models breastfeeding 3 months was associated with lower conduct disorders (B (95% confidence intervals (CI)): 0.25 (0.47 to 0.03)) and inattention/hyperactivity (0.46 (0.81 to 0.10)) as measured by SDQ. Probiotic treatment during the neonatal period had no effect on SDQ scores or intelligence. (4) Conclusions: Prolonged breastfeeding of highly vulnerable infants may promote their mental health later in childhood, particularly by reducing risk for inattention/hyperactivity and conduct disorders. Future studies need to disentangle the underlying mechanisms during a critical time frame of development.

Originalsprache	Englisch
Aufsatznummer	3278
Zeitschrift	Nutrients
Jahrgang	12
Ausgabenummer	11
Seiten (von - bis)	1-14
Seitenumfang	14
DOIs	https://doi.org/10.3390/nu12113278
Publikationsstatus	Veröffentlicht - 11.2020

Fördermittel

Author Contributions: Conceptualization, C.H., J.S., I.F., H.O., M.A. and W.G.; methodology, C.H., J.S., T.K., T.B., M.R., E.H. and W.G.; software, C.H. and J.S.; validation, C.H., J.S., M.R. and W.G.; formal analysis, C.H. and J.S.; investigation, C.H., J.S., I.F., B.S., D.V. and T.K.; data curation, C.H., J.S., E.H. and W.G.; writing—original draft preparation, C.H. and J.S.; writing—review and editing: C.H., J.S., I.F., D.V., H.O., M.A., T.K., T.B., M.R., E.H., WNutr.G.ie;nprtsoject2020, administration,12, x FOR PEER RE.H.,EVIEWW.G. and C.H.; funding acquisition, W.G. and C.H. All authors have read10 ofand14 agreed to the published version of the manuscript. Funding: The study was performed by members of the German Neonatal Network (GNN) and the Priming Funding: The study was performed by members of the German Neonatal Network (GNN) and the Priming immunity at the beginning of life (PRIMAL) Consortium. GNN and PRIMAL are funded by the German Ministry for Education and Research. There has been no involvement in study design, collection of analysis, interpretation ooff ddaattaa,, wwrriittiinngg ooff tthhee rreeppoorrtt oorr ddeecciissiioonn ttoo ssuubbmmiitt tthhee mmaannuussccrriipptt ffoorr ppuubblliiccaattiioonn bbyy tthhee GGeerrmmaann MMiinniissttrryy ffoorr Education and Research.

UN SDGs

Dieser Output leistet einen Beitrag zu folgendem(n) Ziel(en) für nachhaltige Entwicklung

SDG 3 – Gesundheit und Wohlergehen
SDG 5 – Gender Equality
SDG 8 – Angemessene Arbeitsbedingungen und wirtschaftliches Wachstum
SDG 10 – Weniger Ungleichheiten

Strategische Forschungsbereiche und Zentren

Forschungsschwerpunkt: Gehirn, Hormone, Verhalten - Center for Brain, Behavior and Metabolism (CBBM)

Dokumente

10.3390/nu12113278

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Härtel, C., Spiegler, J., Fortmann, I., Astiz, M., Oster, H., Siller, B., Viemann, D., Keil, T., Banaschewski, T., Romanos, M., Herting, E., & Göpel, W. (2020). Breastfeeding for 3 months or longer but not probiotics is associated with reduced risk for inattention/hyperactivity and conduct problems in very-low-birth-weight children at early primary school age. Nutrients, 12(11), 1-14. Artikel 3278. https://doi.org/10.3390/nu12113278

@article{f48949910373419397ce822c7d804419,

title = "Breastfeeding for 3 months or longer but not probiotics is associated with reduced risk for inattention/hyperactivity and conduct problems in very-low-birth-weight children at early primary school age",

abstract = "(1) Background: We aimed to evaluate the effect of proposed “microbiome-stabilising interventions”, i.e., breastfeeding for 3 months and prophylactic use of Lactobacillus acidophilus/ Bifidobacterium infantis probiotics on neurocognitive and behavioral outcomes of very-low-birthweight (VLBW) children aged 5–6 years. (2) Methods: We performed a 5-year-follow-up assessment including a strength and difficulties questionnaire (SDQ) and an intelligence quotient (IQ) assessment using the Wechsler Preschool and Primary Scale of Intelligence (WPPSI)-III test in preterm children previously enrolled in the German Neonatal Network (GNN). The analysis was restricted to children exposed to antenatal corticosteroids and postnatal antibiotics. (3) Results: 2467 primary school-aged children fulfilled the inclusion criteria. In multivariable linear regression models breastfeeding 3 months was associated with lower conduct disorders (B (95\% confidence intervals (CI)): 0.25 (0.47 to 0.03)) and inattention/hyperactivity (0.46 (0.81 to 0.10)) as measured by SDQ. Probiotic treatment during the neonatal period had no effect on SDQ scores or intelligence. (4) Conclusions: Prolonged breastfeeding of highly vulnerable infants may promote their mental health later in childhood, particularly by reducing risk for inattention/hyperactivity and conduct disorders. Future studies need to disentangle the underlying mechanisms during a critical time frame of development.",

author = "Christoph H{\"a}rtel and Juliane Spiegler and Ingmar Fortmann and Mariana Astiz and Henrik Oster and Bastian Siller and Dorothee Viemann and Thomas Keil and Tobias Banaschewski and Marcel Romanos and Egbert Herting and Wolfgang G{\"o}pel",

note = "Funding Information: Author Contributions: Conceptualization, C.H., J.S., I.F., H.O., M.A. and W.G.; methodology, C.H., J.S., T.K., T.B., M.R., E.H. and W.G.; software, C.H. and J.S.; validation, C.H., J.S., M.R. and W.G.; formal analysis, C.H. and J.S.; investigation, C.H., J.S., I.F., B.S., D.V. and T.K.; data curation, C.H., J.S., E.H. and W.G.; writing—original draft preparation, C.H. and J.S.; writing—review and editing: C.H., J.S., I.F., D.V., H.O., M.A., T.K., T.B., M.R., E.H., WNutr.G.ie;nprtsoject2020, administration,12, x FOR PEER RE.H.,EVIEWW.G. and C.H.; funding acquisition, W.G. and C.H. All authors have read10 ofand14 agreed to the published version of the manuscript. Funding: The study was performed by members of the German Neonatal Network (GNN) and the Priming Funding: The study was performed by members of the German Neonatal Network (GNN) and the Priming immunity at the beginning of life (PRIMAL) Consortium. GNN and PRIMAL are funded by the German Ministry for Education and Research. There has been no involvement in study design, collection of analysis, interpretation ooff ddaattaa,, wwrriittiinngg ooff tthhee rreeppoorrtt oorr ddeecciissiioonn ttoo ssuubbmmiitt tthhee mmaannuussccrriipptt ffoorr ppuubblliiccaattiioonn bbyy tthhee GGeerrmmaann MMiinniissttrryy ffoorr Education and Research. Publisher Copyright: {\textcopyright} 2020 by the authors. Licensee MDPI, Basel, Switzerland. Copyright: Copyright 2020 Elsevier B.V., All rights reserved.",

year = "2020",

month = nov,

doi = "10.3390/nu12113278",

language = "English",

volume = "12",

pages = "1--14",

journal = "Nutrients",

issn = "2072-6643",

publisher = "Multidisciplinary Digital Publishing Institute (MDPI)",

number = "11",

}

Härtel, C, Spiegler, J, Fortmann, I, Astiz, M, Oster, H, Siller, B, Viemann, D, Keil, T, Banaschewski, T, Romanos, M, Herting, E & Göpel, W 2020, 'Breastfeeding for 3 months or longer but not probiotics is associated with reduced risk for inattention/hyperactivity and conduct problems in very-low-birth-weight children at early primary school age', Nutrients, Jg. 12, Nr. 11, 3278, S. 1-14. https://doi.org/10.3390/nu12113278

Breastfeeding for 3 months or longer but not probiotics is associated with reduced risk for inattention/hyperactivity and conduct problems in very-low-birth-weight children at early primary school age. / Härtel, Christoph; Spiegler, Juliane; Fortmann, Ingmar et al.
in: Nutrients, Jahrgang 12, Nr. 11, 3278, 11.2020, S. 1-14.

Publikation: Beiträge in Fachzeitschriften › Zeitschriftenaufsätze › Forschung › Begutachtung

TY - JOUR

T1 - Breastfeeding for 3 months or longer but not probiotics is associated with reduced risk for inattention/hyperactivity and conduct problems in very-low-birth-weight children at early primary school age

AU - Härtel, Christoph

AU - Spiegler, Juliane

AU - Fortmann, Ingmar

AU - Astiz, Mariana

AU - Oster, Henrik

AU - Siller, Bastian

AU - Viemann, Dorothee

AU - Keil, Thomas

AU - Banaschewski, Tobias

AU - Romanos, Marcel

AU - Herting, Egbert

AU - Göpel, Wolfgang

N1 - Funding Information: Author Contributions: Conceptualization, C.H., J.S., I.F., H.O., M.A. and W.G.; methodology, C.H., J.S., T.K., T.B., M.R., E.H. and W.G.; software, C.H. and J.S.; validation, C.H., J.S., M.R. and W.G.; formal analysis, C.H. and J.S.; investigation, C.H., J.S., I.F., B.S., D.V. and T.K.; data curation, C.H., J.S., E.H. and W.G.; writing—original draft preparation, C.H. and J.S.; writing—review and editing: C.H., J.S., I.F., D.V., H.O., M.A., T.K., T.B., M.R., E.H., WNutr.G.ie;nprtsoject2020, administration,12, x FOR PEER RE.H.,EVIEWW.G. and C.H.; funding acquisition, W.G. and C.H. All authors have read10 ofand14 agreed to the published version of the manuscript. Funding: The study was performed by members of the German Neonatal Network (GNN) and the Priming Funding: The study was performed by members of the German Neonatal Network (GNN) and the Priming immunity at the beginning of life (PRIMAL) Consortium. GNN and PRIMAL are funded by the German Ministry for Education and Research. There has been no involvement in study design, collection of analysis, interpretation ooff ddaattaa,, wwrriittiinngg ooff tthhee rreeppoorrtt oorr ddeecciissiioonn ttoo ssuubbmmiitt tthhee mmaannuussccrriipptt ffoorr ppuubblliiccaattiioonn bbyy tthhee GGeerrmmaann MMiinniissttrryy ffoorr Education and Research. Publisher Copyright: © 2020 by the authors. Licensee MDPI, Basel, Switzerland. Copyright: Copyright 2020 Elsevier B.V., All rights reserved.

PY - 2020/11

Y1 - 2020/11

N2 - (1) Background: We aimed to evaluate the effect of proposed “microbiome-stabilising interventions”, i.e., breastfeeding for 3 months and prophylactic use of Lactobacillus acidophilus/ Bifidobacterium infantis probiotics on neurocognitive and behavioral outcomes of very-low-birthweight (VLBW) children aged 5–6 years. (2) Methods: We performed a 5-year-follow-up assessment including a strength and difficulties questionnaire (SDQ) and an intelligence quotient (IQ) assessment using the Wechsler Preschool and Primary Scale of Intelligence (WPPSI)-III test in preterm children previously enrolled in the German Neonatal Network (GNN). The analysis was restricted to children exposed to antenatal corticosteroids and postnatal antibiotics. (3) Results: 2467 primary school-aged children fulfilled the inclusion criteria. In multivariable linear regression models breastfeeding 3 months was associated with lower conduct disorders (B (95% confidence intervals (CI)): 0.25 (0.47 to 0.03)) and inattention/hyperactivity (0.46 (0.81 to 0.10)) as measured by SDQ. Probiotic treatment during the neonatal period had no effect on SDQ scores or intelligence. (4) Conclusions: Prolonged breastfeeding of highly vulnerable infants may promote their mental health later in childhood, particularly by reducing risk for inattention/hyperactivity and conduct disorders. Future studies need to disentangle the underlying mechanisms during a critical time frame of development.

AB - (1) Background: We aimed to evaluate the effect of proposed “microbiome-stabilising interventions”, i.e., breastfeeding for 3 months and prophylactic use of Lactobacillus acidophilus/ Bifidobacterium infantis probiotics on neurocognitive and behavioral outcomes of very-low-birthweight (VLBW) children aged 5–6 years. (2) Methods: We performed a 5-year-follow-up assessment including a strength and difficulties questionnaire (SDQ) and an intelligence quotient (IQ) assessment using the Wechsler Preschool and Primary Scale of Intelligence (WPPSI)-III test in preterm children previously enrolled in the German Neonatal Network (GNN). The analysis was restricted to children exposed to antenatal corticosteroids and postnatal antibiotics. (3) Results: 2467 primary school-aged children fulfilled the inclusion criteria. In multivariable linear regression models breastfeeding 3 months was associated with lower conduct disorders (B (95% confidence intervals (CI)): 0.25 (0.47 to 0.03)) and inattention/hyperactivity (0.46 (0.81 to 0.10)) as measured by SDQ. Probiotic treatment during the neonatal period had no effect on SDQ scores or intelligence. (4) Conclusions: Prolonged breastfeeding of highly vulnerable infants may promote their mental health later in childhood, particularly by reducing risk for inattention/hyperactivity and conduct disorders. Future studies need to disentangle the underlying mechanisms during a critical time frame of development.

UR - https://www.scopus.com/pages/publications/85094829497

U2 - 10.3390/nu12113278

DO - 10.3390/nu12113278

M3 - Journal articles

C2 - 33114672

AN - SCOPUS:85094829497

SN - 2072-6643

VL - 12

SP - 1

EP - 14

JO - Nutrients

JF - Nutrients

IS - 11

M1 - 3278

ER -