Docosahexaenoic acid (DHA) is a structural constituent of membranes specifically in the central nervous system. Its accumulation in the fetal brain takes place mainly during the last trimester of pregnancy and continues at very high rates up to the end of the second year of life. Since the endogenous formation of DHA seems to be relatively low, DHA intake may contribute to optimal conditions for brain development. We performed a narrative review on research on the associations between DHA levels and brain development and function throughout the lifespan. Data from cell and animal studies justify the indication of DHA in relation to brain function for neuronal cell growth and differentiation as well as in relation to neuronal signaling. Most data from human studies concern the contribution of DHA to optimal visual acuity development. Accumulating data indicate that DHA may have effects on the brain in infancy, and recent studies indicate that the effect of DHA may depend on gender and genotype of genes involved in the endogenous synthesis of DHA. While DHA levels may affect early development, potential effects are also increasingly recognized during childhood and adult life, suggesting a role of DHA in cognitive decline and in relation to major psychiatric disorders.

A direct influence of dietary long-chain polyunsaturated fatty acids (LC-PUFA) on the developmental quotient (DO) of the healthy term infant remains unexplored. To test this hypothesis, we designed a prospective study of three types of diet. 'I'wentynine infants received a LC-PUFA-supplemented formula, 31 received a standard infant formula. and 30 infants were breastfed exclusively. Neurodevelopmental response was measured by the Brunet-LCzine psychomotor development test at 4 mo. The fatty acid status was also assessed among three diet subgroups (59 subjects) at 4 mo. Formula-fed infants who received LC-PUFA supplementation scored significantly higher (p < 0.01) on the Brunet-IRzine scale than infants who received the standard formula. Breast-fed infants also performed better than those fed the standard formula. Arachidonic acid and docosahexaenoic acid levels in circulating lipids and erythrocyte phospholipids were higher among breast-fed infants and among the group fed the arachidonic-and docosahexaenoic acid-supplemented for-

Objectives:The objective of this study was to quantify human milk supply and intake of breastfed infants up to age 12 months. Additionally, human milk composition was quantified per energetic macronutrient and fatty acid composition in a subsample of lactating mothers. Methods:174 Italian breastfed children were followed using test-weighing and 3-day food protocols from birth to age twelve months. From a sub-sample of thirty mothers breast milk samples were collected at child ages one (T1), two (T2), three (T3), and six (T6) months, and were analyzed for the amount of protein, digestible carbohydrates, total lipids and fatty acid composition. Results:142 (82%) filled in at least one three-day food protocol within the first 12 months of life and complied with test-weighing of all milk feeds. The number of valid food protocols declined from 126 infants at one month to 77 at twelve months of age. Only galactose, non-protein nitrogen and protein decreased significantly from age one to age six months of lactation. Maternal BMI and age affected fatty acid levels in human milk. Median human milk intake decreased from 625ml at T1, over 724ml at T3 to 477ml/day at T6.Average energy and %energy from protein intake per day increased from 419 kcal (SD 99) and 8.4% (1.0) at T1, respectively, to 860 kcal (145) and 16.1% (2.6) at T12. Conclusion:These data provide a reference range of nutrient intakes in breastfed infants and may provide guidance for defining optimal nutrient intakes for infants that cannot be fully breastfed.4