_______________________________________________________________________________________________________________________________ Open Access Maced J Med Sci. 2019 Jan 15; 7(1):77-81. 77 ID Design Press, Skopje, Republic of Macedonia Open Access Macedonian Journal of Medical Sciences. 2019 Jan 15; 7(1):77-81. https://doi.org/10.3889/oamjms.2019.035 eISSN: 1857-9655 Clinical Science Effect of Early Breast Milk Nutrition on Serum Insulin-Like Growth Factor-1 in Preterm Infants Fatma A. Alzaree 1* , Mones M. AbuShady 1 , Mohamed Abdel Atti 1 , Gihan A. Fathy 1 , Essam M. Galal 1 , Alaa Ali 1 , Tahany R. Elias 2 1 Department of Child Health, National Research Centre, Cairo, Egypt; 2 Department of Medical Biochemistry, Medical Research Division, National Research Centre, Cairo, Egypt Citation: Elzaree FA, AbuShady MM, Atti MA, Fathy GA, Galal EM, Ali A, Elias TR. Effect of Early Breast Milk Nutrition on Serum Insulin-Like Growth Factor-1 In Preterm Infants. Open Access Maced J Med Sci. 2019 Jan 15; 7(1):77-81. https://doi.org/10.3889/oamjms.2019.035 Keywords: Breastfeeding; Growth; IGF-1; Premature infants *Correspondence: Fatma A Alzaree. Department of Child Health, National Research Centre, Cairo, Egypt. E- mail: fatmaalzaree@yahoo.com Received: 05-Nov-2018; Revised: 04-Dec-2018; Accepted: 22-Dec-2018; Online first: 12-Jan-2019 Copyright: © 2019 Fatma A. Alzaree, Mones M. AbuShady, Mohamed Abdel Atti, Gihan A. Fathy, Essam M. Galal, Alaa Ali, Tahany R. Elias. This is an open- access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0) Funding: This research did not receive any financial support Competing Interests: The authors have declared that no competing interests exist Abstract BACKGROUND: Insulin-like growth factor 1 (IGF-1) is one of the essential intrauterine hormonal mediators of growth, and its serum values are often low after preterm delivery. AIM: To evaluate the influence of immediate breast milk feeding on serum IGF-1 in preterm newborns. SUBJECTS AND METHODS: This prospective, observational cohort study included 60 premature infants born < 32 weeks of gestation, divided into group A and B regarding breastfeeding or formula feeding. Growth measurements were taken at birth. The standard deviation of each measurement was calculated. Serum IGF-I was measured one day postnatal and at a time equivalent to 40 weeks of gestation. RESULTS: Significant higher level of mean serum IGF-1 was detected in group A than B at postnatal age equivalent to 40 weeks of gestation. In group A, the higher significant level was detected in mean serum IGF-1 at an age equivalent to 40 weeks of gestation than at birth (25.21 ± 6.69 and 20.13 ± 5.46 p < 0.05). Multiple linear regression analysis showed that high birth weight, increased age of gestation and breastfeeding were correlated to the elevated serum level of IGF-1 at a postnatal age corresponding to 40 weeks gestational age. CONCLUSION: Immediate breast milk feeding was accompanied by elevated IGF-1 in the serum of preterm infants. Introduction IGF-1 is an anabolic hormone with mitogenic, differentiating, antiapoptotic and metabolic effects [1]. A plethora of genetic and experimental researches suggest that IGF-1 is an essential factor of intrauterine growth of the fetus and after birth [2]. The placenta secretes IGF-1 throughout gestation which encourages the transmission of important nutrients from the mother to the fetus via the placenta [3]. During gestation, fetal circulating IGF-1 increases and at term birth, levels of cord serum IGF-1are positively related to the size of fetus and fat mass [4]. Fetal serum IGF-I constantly increases during last trimester, which coincides with the interval of the most rapid increase in fetal weight [5]. Late in gestation, circulating IGF-1 is mainly derived from the liver, although all fetal tissues express IGF-1 from an early stage of development [6]. The amniotic fluid contains higher IGF-1 concentrations than cord blood during gestation and at delivery and is swallowed by the fetus, and this source is missing after premature delivery [7]. Insulin is the main determinant of fetal and neonatal hepatic IGF-1 secretion, and via insulin, IGF-1 is magnified by the direct and indirect influences of nutrients like glucose and protein. Also, insulin reciprocally regulates hepatic production of insulin-like growth factor binding protein (IGFBP-1),