PMID- 33114672 OWN - NLM STAT- MEDLINE DCOM- 20210416 LR - 20210416 IS - 2072-6643 (Electronic) IS - 2072-6643 (Linking) VI - 12 IP - 11 DP - 2020 Oct 26 TI - 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. LID - 10.3390/nu12113278 [doi] LID - 3278 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. FAU - Hartel, Christoph AU - Hartel C AD - Department of Pediatrics, University Hospital of Wurzburg, 97080 Wurzburg, Germany. FAU - Spiegler, Juliane AU - Spiegler J AUID- ORCID: 0000-0002-1737-0628 AD - Department of Pediatrics, University Hospital Schleswig-Holstein Campus Lubeck, 23538 Lubeck, Germany. FAU - Fortmann, Ingmar AU - Fortmann I AUID- ORCID: 0000-0003-1676-8340 AD - Department of Pediatrics, University Hospital Schleswig-Holstein Campus Lubeck, 23538 Lubeck, Germany. FAU - Astiz, Mariana AU - Astiz M AD - Institute of Neurobiology, Center of Brain, Behavior and Metabolism, University of Lubeck, 23538 Lubeck, Germany. FAU - Oster, Henrik AU - Oster H AUID- ORCID: 0000-0002-1414-7068 AD - Institute of Neurobiology, Center of Brain, Behavior and Metabolism, University of Lubeck, 23538 Lubeck, Germany. FAU - Siller, Bastian AU - Siller B AD - Department of Pediatrics, University Hospital Schleswig-Holstein Campus Lubeck, 23538 Lubeck, Germany. FAU - Viemann, Dorothee AU - Viemann D AD - Department of Pediatric Pneumology, Allergy and Neonatology, Hannover Medical School, 30625 Hannover, Germany. FAU - Keil, Thomas AU - Keil T AD - Institute for Clinical Epidemiology and Biometry, University of Wurzburg, 97080 Wurzburg, Germany. AD - State Institute of Health, Bavarian Health and Food Safety Authority, 97688 Bad Kissingen, Germany. AD - Institute of Social Medicine, Epidemiology and Health Economics, Charite - Universitatsmedizin Berlin, 10117 Berlin, Germany. FAU - Banaschewski, Tobias AU - Banaschewski T AUID- ORCID: 0000-0003-4595-1144 AD - Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, 68159 Mannheim, Germany. FAU - Romanos, Marcel AU - Romanos M AUID- ORCID: 0000-0001-7628-8299 AD - Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital of Wurzburg, 97080 Wurzburg, Germany. FAU - Herting, Egbert AU - Herting E AD - Department of Pediatrics, University Hospital Schleswig-Holstein Campus Lubeck, 23538 Lubeck, Germany. FAU - Gopel, Wolfgang AU - Gopel W AD - Department of Pediatrics, University Hospital Schleswig-Holstein Campus Lubeck, 23538 Lubeck, Germany. LA - eng GR - 01ER0805 and 01ER1501/BMBF/ GR - 01GL1746A (PRIMAL)/BMBF/ PT - Evaluation Study PT - Journal Article DEP - 20201026 PL - Switzerland TA - Nutrients JT - Nutrients JID - 101521595 SB - IM MH - Attention Deficit Disorder with Hyperactivity/epidemiology/*etiology MH - Breast Feeding/*statistics & numerical data MH - Child MH - Child Development MH - Child, Preschool MH - Conduct Disorder/epidemiology/etiology MH - Female MH - Humans MH - Infant MH - Infant Nutritional Physiological Phenomena MH - Infant, Newborn MH - Infant, Very Low Birth Weight/*growth & development MH - Intelligence MH - Linear Models MH - Male MH - Mental Status and Dementia Tests MH - Probiotics/*therapeutic use MH - Risk Factors MH - *Time Factors PMC - PMC7693791 OTO - NOTNLM OT - breastfeeding OT - inattention/hyperactivity OT - intelligence OT - preterm children OT - probiotic prophylaxis OT - strength and difficulties COIS- The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses or interpretation of data; in the writing of the manuscript; or in the decision to publish the results. EDAT- 2020/10/30 06:00 MHDA- 2021/04/17 06:00 PMCR- 2020/11/01 CRDT- 2020/10/29 01:04 PHST- 2020/09/18 00:00 [received] PHST- 2020/10/20 00:00 [revised] PHST- 2020/10/23 00:00 [accepted] PHST- 2020/10/29 01:04 [entrez] PHST- 2020/10/30 06:00 [pubmed] PHST- 2021/04/17 06:00 [medline] PHST- 2020/11/01 00:00 [pmc-release] AID - nu12113278 [pii] AID - nutrients-12-03278 [pii] AID - 10.3390/nu12113278 [doi] PST - epublish SO - Nutrients. 2020 Oct 26;12(11):3278. doi: 10.3390/nu12113278.