{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T15:53:56Z","timestamp":1793116436711,"version":"4.5.0"},"reference-count":81,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,11,21]],"date-time":"2024-11-21T00:00:00Z","timestamp":1732147200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Prematurity significantly impacts neonatal health worldwide, necessitating effective interventions to improve outcomes for these vulnerable infants. While breastfeeding has emerged as a cornerstone of preterm care, its precise impact on neurodevelopment remains a subject of ongoing inquiry and debate. This systematic review aims to investigate the existing evidence in this area.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>On December 17, 2023, online databases including PubMed, The Cochrane Library, Embase, Web of Science, CNKI, VIP, CBM, and Wan Fang Data were searched. Comparisons were classified into several categories: never breastfeeding (Never-BF) versus exclusive breastfeeding, Never-BF versus any breastfeeding (Any-BF), predominant preterm formula (Pre-PTF) versus predominant breastfeeding (Pre-BF), and Pre-PTF versus predominant donor breast milk (Pre-DBM) groups. Randomized controlled trials and observational studies were analyzed separately through meta-analyses. Each study\u2019s risk of bias was assessed, and the GRADE system was utilized to evaluate the certainty of the findings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Sixteen studies met the inclusion criteria, comprising one RCT and 15 cohort studies. The key findings indicated that infants in the Any-BF groups demonstrated superior long-term cognitive scores compared to those in the Never-BF groups, particularly evident in infants assessed before 18\u2009months in the Pre-BF groups versus Pre-PTF groups. A reduced risk of neurodevelopmental impairment was also observed in preterm infants in the Any-BF groups. Evidence regarding the effect of breastfeeding on motor development was inconclusive, except for potential motor improvement in extremely low birth weight infants in the Any-BF groups. Neither exclusive breastfeeding nor pre-DBM exhibited clear superiority over Pre-PTF in terms of neurodevelopmental outcomes for preterm infants. Caution is warranted due to potential publication bias impacting the assessment of breastfeeding\u2019s impact on motor skills.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our systematic review supports current recommendations for breastfeeding in preterm infants, emphasizing its positive effects on cognitive abilities and reduced risk of neurodevelopmental disorders. Further studies are needed to clarify if DHM provides neurodevelopmental benefits comparable to maternal milk, as current evidence does not sufficiently address this question. Additionally, future investigations should prioritize refining our understanding of the influence of breastfeeding on motor development in this vulnerable population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration<\/jats:title>\n                    <jats:p>\n                      PROSPERO, identifier CRD42023492274, Available at:\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/prospero\/display_record.php?ID=CRD42023492274<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2024.1401250","type":"journal-article","created":{"date-parts":[[2024,11,21]],"date-time":"2024-11-21T00:10:31Z","timestamp":1732147831000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":33,"title":["A systematic review and meta-analysis of breastfeeding and neurodevelopmental outcomes in preterm infant"],"prefix":"10.3389","volume":"12","author":[{"given":"Ruolin","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erya","family":"Ying","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiujuan","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Han","family":"Qin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanping","family":"Guo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Guo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhangbin","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,11,21]]},"reference":[{"key":"ref1","volume-title":"Born too soon: decade of action on preterm birth","year":"2023"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1261","DOI":"10.1016\/S0140-6736(23)00878-4","article-title":"National, regional, and global estimates of preterm birth in 2020, with trends from 2010: a systematic analysis","volume":"402","author":"Ohuma","year":"2023","journal-title":"Lancet"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1016\/S2352-4642(21)00311-4","article-title":"Global, regional, and national causes of under-5 mortality in 2000\u201319: an updated systematic analysis with implications for the sustainable development goals","volume":"6","author":"Perin","year":"2022","journal-title":"Lancet Child Adolesc Health"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"101496","DOI":"10.1016\/j.eclinm.2022.101496","article-title":"Cost-effectiveness of antenatal corticosteroids and tocolytic agents in the management of preterm birth: a systematic review","volume":"49","author":"Sebastian","year":"2022","journal-title":"EClinicalMedicine"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"e2118904","DOI":"10.1001\/jamanetworkopen.2021.18904","article-title":"Assessment of neonatal intensive care unit practices, morbidity, and mortality among very preterm infants in China","volume":"4","author":"Cao","year":"2021","journal-title":"JAMA Netw Open"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"e0255352","DOI":"10.1371\/journal.pone.0255352","article-title":"ELBW and ELGAN outcomes in developing nations-systematic review and meta-analysis","volume":"16","author":"Ramaswamy","year":"2021","journal-title":"PLoS One"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1111\/ajo.13405","article-title":"The health and educational costs of preterm birth to 18 years of age in Australia","volume":"62","author":"Newnham","year":"2022","journal-title":"Aust N Z J Obstet Gynaecol"},{"key":"ref8","volume-title":"WHO recommendations for care of the preterm or low-birth-weight infant","year":"2022"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"295","DOI":"10.3389\/fped.2018.00295","article-title":"Human Milk: an ideal food for nutrition of preterm newborn","volume":"6","author":"Boquien","year":"2018","journal-title":"Front Pediatr"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"475","DOI":"10.1016\/S0140-6736(15)01024-7","article-title":"Lancet breastfeeding series G. 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