This summary is adapted from ‘Improved Neurodevelopmental Outcomes at 5.5 Years of Age in Children Who Received Bovine Milk Fat Globule Membrane and Lactoferrin in Infant Formula Through 12 Months: A Randomized Controlled Trial’ by Colombo et al. 2023
Published in 2023, this study delves into the developmental benefits of supplementing infant formula with milk fat globule membrane (MFGM). Understanding the intricacies of infant nutrition is crucial as it lays the foundation for a child’s health trajectory. The study presented a comprehensive analysis of the prolonged cognitive effects attributed to MFGM-enriched formula.
Infant formula development aims to discover key nutrients which impact short and long term outcomes as the child grows. Infancy is a critical period for development, and intake of certain nutrients has been seen to have lasting effects throughout childhood. This includes for the development of the brain and nervous system, know as neurodevelopment. Human milk composition is the standard to support neurodevelopment in infants. One component of human milk which has been of interest in the development of infant formula is milk fat globule membrane (MFGM), the substance which surrounds fat droplets present in human breast milk. MFGM is present in cow’s milk and therefore cow’s milk-based infant formula at low concentrations, but there have been efforts to supplement formula with additional MFGM. Multiple studies have suggested that this benefits neurodevelopment in infancy1,2,3. The study summarised here is a follow-up study of one of these earlier trials of MFGM supplementation in infant formula. A beneficial effect of MFGM on neurodevelopment was previously seen at 18 months, and this study aimed to investigate a potential effect at 5.5 years of age.
This study was carried out across three clinical sites in the Anhui Province in China. Infants were randomised to receive cow milk-based study formula (Mead Johnson Nutrition), either standard formulation or added bovine MFGM and lactoferrin. Infants received these formulas for 1 year. At 5.5 years old, scales were used which measure intellectual ability including verbal comprehension, working memory and processing speed. There were 116 participants in this follow-on study, from 292 infants that completed the original study.
There were improved scores on intelligence and mental performance scales among children who received infant formula enriched with MFGM and lactoferrin compared to those who received standard infant formula at 5.5 years of age. There were improved visual spatial scores, which represent improved attention to visual detail and ability to process visual input among these children. Other domains in the intelligence scales such as verbal comprehension and working memory. The improvement seen in children who had received the study formula was mainly driven by the differences in processing speed and visual processing. There were no significant differences in child behavior scores, which represents the child’s emotional and interaction behaviour. The stroop task test, known to reflect a person’s selective attention capacity and skills, was again higher in children who had received the formula enriched with MFGM and lactoferrin.
This study indicated that there may be positive cognitive effects of MFGM supplementation in infant formula which persist through early childhood. This suggests that exposure to the components in the formula during infancy may influence brain development at a particularly important time in development. The first two years of life are thought to be a critical period for neurodevelopment4, therefore the effects of infant formula should be carefully considered.
Despite the positive result seen in this study, there were some potential limitations. Other studies of supplementation in infancy have seen positive cognitive effects at 4 years of age which did not remain at 7 years of age5. As this study was at 5.5 years of age, MFGM may or may not have an effect in later childhood. It is also difficult to attribute the cognitive benefit seen here to MFGM, as lactoferrin, DHA, and sialic acid were also added to the study formula and may also be having an effect. There was a low rate of follow up in this study, as less than 40% of the infants enrolled in the original trial participated at 5.5 years, which may have introduced bias.
In conclusion, this study indicated a potential benefit of infant formula MFGM supplementation on cognitive function remained into early childhood. MFGM components may aid in infant neurodevelopment and therefore appears to be a worthwhile component to supplement in infant formula.
- Gurnida D.A., Rowan A.M., Idjradinata P., Muchtadi D., Sekarwana N. Association of complex lipids containing gangliosides with cognitive development of 6-month-old infants. Early Hum Dev. 2012; 88: 595-601
- Timby N., Domellof E., Hernell O., Lonnerdal B., Domellof M. Neurodevelopment, nutrition, and growth until 12 mo of age in infants fed a low-energy, low-protein formula supplemented with bovine milk fat globule membranes: a randomized controlled trial. Am J Clin Nutr. 2014; 99: 860-868
- Li F., Wu S.S., Berseth C.L., Harris C.L., Richards J.D., Wampler J.L. et al. Improved neurodevelopmental outcomes associated with bovine milk fat globule membrane and lactoferrin in infant formula: a randomized, controlled trial. J Pediatr. 2019; 215: 24-31.e8
- Colombo J., Gustafson K.M., Carlson S.E. Critical and sensitive periods in development and nutrition. Ann Nutr Metab. 2019; 75: 34-42
- Helland I.B., Smith L., Blomén B., Saarem K., Saugstad O.D., Drevon C.A. Effect of supplementing pregnant and lactating mothers with n-3 very-long-chain fatty acids on children’s IQ and body mass index at 7 years of age. Pediatrics. 2008; 122: e472-e479