Exclusive Breastfeeding and Developmental Outcomes in Very Low Birth Weight Preterm Infants at 1 Year of Corrected Age: A Retrospective Cohort Study

Exclusive breastfeeding (EBF) is recommended for all infants, but its effect on the growth and neurodevelopment of very low birth weight (VLBW) preterm infants is still debated. This retrospective cohort study examined 82 VLBW infants (27-33 weeks’ gestational age or birth weight <1,500 g) enrolled in follow-up care at a tertiary hospital in Northeast Brazil to explore the impact of EBF during the first 6 months of life. The infants were classified into EBF or non-EBF (mixed or formula) feeding groups. Serial anthropometric measurements were converted into z-scores to evaluate growth trajectories, and developmental status was monitored up to 12 months of corrected age. Twenty-two infants were exclusively breastfed, and 60 received alternative feeding. Early advantages in head circumference and length were observed among EBF infants between 2 and 3 months, but these differences disappeared by midinfancy. At 1 year, neuropsychomotor outcomes and catch-up growth were similar across groups. These results are applicable specifically to infants born at 27-33 weeks’ gestational age or birth weight <1,500 g receiving structured postdischarge follow-up care. These findings suggest that, when infants receive structured postdischarge follow-up, EBF is sufficient to ensure appropriate growth and development in VLBW infants, while specialized formulas remain a valid alternative when EBF is not feasible. However, efforts should be prioritized to optimize EBF before considering formula supplementation. Further prospective research is needed to clarify how early nutrition interacts with socio-economic and environmental factors in shaping long-term outcomes.