Mama’s milk sugars to protect the vulnerable preterm brain

In a public private partnership between the departments of Neonatology and Developmental Origins of Disease of the UMC Utrecht and Danone Nutricia Research, this project aims to identify human milk sugars (HMS) in breast milk that protect preterm infants from developing brain injury. Additionally, it will be tested in experimental models whether supplementation with HMS can be used as a therapeutic approach.

Approximately 10% of all babies are born preterm. Of the extremely preterm born infants, 40% will develop some kind of brain injury, leading to life-long motor, cognitive and psychological impairments. Currently, there are no effective therapies for brain injury in preterm infants. Early life infections are an important risk factor for the development of brain injury and breast milk is known to reduce the risk of infections in the vulnerable preterm infant. The content of human milk sugars (HMS) in breast milk varies widely between mothers and it has been demonstrated that absence of specific HMS increases the risk of infections in preterm infants.

Whether HMS also provide protection against the development of preterm brain injury is not known and will be investigated in this research project. At the Wilhelmina Children’s Hospital, breast milk of 80 extremely preterm-born infants in the first 4 weeks of life will be collected weekly. The profiles of HMS will be correlated to brain injury as assessed by routine MRI at term-equivalent age. Additionally, in experimental models of preterm brain injury it will be assessed whether early life HMS supplementation can be used a therapy to protect the injured brain.

If HMS indeed protect the preterm brain from injury, future characterization of breast milk can contribute to the identification of those preterm infants at (higher) risk for impaired neurodevelopment. In addition, breast milk supplemented with specific HMS in early life may be used as a preventative therapy to reduce the risk of brain injury in these vulnerable preterm infants.