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Sniffing or Tasting Breastmilk Reduces Preemies’ Risk of Developmental Delay

    A graphic depicting modern to late preterm infants sniffing or tasting breastmilk while being fed through a gastric tube

    Written by: Alla Katsnelson, Ph.D | Issue # 134 | 2026

    • Infants born at 32-37 weeks of gestation have a high risk of neurosensory impairments –– and there may be feeding strategies during their first weeks and months that ameliorate these effects. 
    • Preterm infants who sniffed or tasted a few drops of breastmilk while being fed through a gastric tube had a significantly lower risk of these impairments at age 2.
    •  Further research on this noninvasive intervention can reveal how best to put it into practice. 

    About one in every 10 babies worldwide is born before 40 weeks of gestation. Those born eight weeks early or fewer generally survive, but they have an increased risk of neurosensory issues such as blindness, deafness, cerebral palsy, and a range of developmental delays. 

    It turns out that sniffing or tasting breastmilk protects these infants from this risk, researchers from New Zealand and Australia report [1]. “This is very exciting because this is an easy, cheap intervention and it’s popular with parents because they can do it themselves,” Dame Jane Harding, a professor of neonatology at the University of Auckland, who led the work, said in a press release. 

    Many infants born preterm cannot coordinate suckling and swallowing. They may also be born before their mothers’ milk comes in. Despite these common issues, however, there is little evidence-based guidance for how to best feed these infants.

    The new study is part of a randomized trial called the Determinants of Feed Intolerance, Body Composition, and Development – or DIAMOND – study. The study began in 2017 with the aim of exploring which feeding interventions might best support the growth and development of so-called moderate-to-late preterm infants, born between 32 and 37 weeks of gestation. 

    The trial recruited 534 children  born during this period and randomly assigned them to receive one of three feeding interventions or its control condition. In the first group, the infants either received an intravenous solution of important amino acids or a solution of sugar water. In the second group, the infants received either donor breast milk or infant formula, or their own mothers’ breast milk when it became available. In the third group, infants sniffed or tasted a few drops of breastmilk before or while getting breastmilk or formula through a feeding tube, compared to tube feeding without sniffing or tasting breastmilk. 

    None of the interventions affected the infants’ body composition at 4 months of age or whether they were able to get all their needed calories through their stomachs by that time, as the researchers reported in 2024 [2]. In the new study, the researchers assessed the effect of these feeding interventions at age 2 in 425 of the children in the DIAMOND study.  

    More than a quarter of the cohort of children had some kind of neurosensory impairment – most commonly, mild developmental delay and language delay, but also cognitive and motor delay and cerebral palsy, the researchers found. Neither of the first two interventions had any effect on these outcomes. 

    But in the third group, neurosensory impairments were significantly less common –  21% versus 31% – in the children who had sniffed or tasted the breastmilk while feeding compared to those who had not. The effect was especially pronounced for language delay. What’s more, the effects seemed to be greater in children who got sniffs and tastes of breastmilk more frequently. 

    Some studies have shown that smell and taste increase blood flow and oxygen levels in the brain [3]. In infants, the smell of breastmilk and formula has been linked with brain activity, the researchers note. No previous studies have linked these findings to developmental issues, they write, but “an effect of early exposure to taste and smell is biologically plausible, and worthy of future study.”  

    The researchers also note that further studies are needed to pin down exactly how much exposure to breastmilk is most helpful for reducing the risk of neurodevelopmental impairments. 

    References

    1. Das S, Bloomfield FH, Alexander T, Jiang Y, Gamble G, Lin L, Harding JE. Two-Year Follow-Up of the Different Approaches to Feeding Infants Born Moderate-to-Late Preterm: Determinants of Feed Intolerance, Body Composition, and Development (DIAMOND) randomized trial. J Pediatr. 2026 May;292:114989. 
    2. Alexander T, Asadi S, Meyer M, Harding JE, Jiang Y, Alsweiler JM, Muelbert M, Bloomfield FH; DIAMOND Trial Group. Nutritional Support for Moderate-to-Late-Preterm Infants – A Randomized Trial. N Engl J Med. 2024 Apr 25;390(16):1493-1504. 
    3. Kringelbach, M.L. The human orbitofrontal cortex: linking reward to hedonic experience. Nat Rev Neurosci.2005;6:691-702
    4. Aoyama S, Toshima T, Saito Y, Konishi N, Motoshige K, Ishikawa N, Nakamura K, Kobayashi M. Maternal breast milk odour induces frontal lobe activation in neonates: a NIRS study. Early Hum Dev. 2010 Sep;86(9):541-5.