Effect of increasing breast milk docosahexaenoic acid on plasma and erythrocyte phospholipid fatty acids and neural indices of exclusively breast fed infants

Abstract

Objectives: To determine the effect of increasing docosahexaenoic acid (DHA, 22 : 6 n-3) in breast milk on infant fatty acid pro®les. A secondary aim was to examine aspects of neural development. Design and Setting Double blind, placebo controlled study of infants recruited from postnatal wards at Flinders Medical Centre. Subjects: Fifty-two healthy term infants who were breast fed for at least 12 weeks and were from middle class families. Intervention: Breast milk with DHA concentrations that ranged from 0.1±1.7% of total fatty acids. This was achieved by supplementation of the maternal diet for the ®rst 12 weeks post partum. Results: Breast milk DHA was related to infant plasma (r 0.89, P`0.001) and erythrocyte (r 0.88, P`0.001) phospholipids in a saturable curvilinear manner so that breast milk DHA above 0.8% of total fatty acids resulted in little further increase in infant plasma or erythrocyte DHA levels. The rise in plasma and erythrocyte DHA was approximated by a fall in total n-6 polyunsaturated fatty acids. We could detect no relationship between visual evoked potential acuity (measured at 12 and 16 weeks) of infants by either the dietary grouping or the DHA status of individuals. A stepwise multiple regression showed that infant erythrocyte DHA at 12 weeks and home stimulation were the only independent factors associated with Bayley's MDI at 1 y (adjusted model r 2 0.18, P`0.005); while at 2 y gender and social score of the spouse were the only signi®cant predictors of Bayley's MDI (adjusted model r 2 0.22, P`0.005). Conclusions: Increasing breast milk DHA levels caused a dose dependent saturable increase in infant plasma and erythrocyte phospholipid DHA. There were no long-term effects of infant DHA status on indices of neurodevelopment.

Maternal fish oil supplementation in lactation: effect on developmental outcome in breast-fed infants

“…This had no apparent effect on the problem solving ability of the infants at nine month of age, although it seemed to have a positive effect in girls. A previous maternal-supplementation trial found that a similar increase in breast-milk DHA was associated with a positive effect on the Bayley mental development index score at one year of age, which was no longer evident at two years [25]. A recent Norwegian study has shown that supplementation with cod liver oil during pregnancy and lactation resulted in an increased mental processing score at four years of age [26].…”

“…Small cross sectional studies have observed relationship between the DHA-content of human milk, or levels of DHA in infant or maternal plasma, and the sleep pattern, visual acuity, cognitive abilities, speech perception and language development of breast-fed infants [14,15,[20][21][22][23][24]. Furthermore, studies supplementing lactating mothers with marine oils have shown that the DHA-intake of breast-fed infants may have beneficial effects on mental development [25][26][27]. The present maternal post-natal FO-supplementation trial was performed in Denmark where the population has a high intake of marine fatty acids compared to that in many other Western countries [35] and thus, higher levels of breast-milk DHA [1].…”

Human milk: maternal dietary lipids and infant development

“…Similar to LA, the levels of DHA in human milk also vary widely within and among populations (Innis, 1992(Innis, , 2004, which again results in differences in the plasma and cell membrane levels of DHA among breast-fed infants (Gibson et al 1997;Innis & King, 1999;Jensen et al 2000;Innis et al 2001). Milk fat from women following vegan diets, which lack DHA, contains < 0 .…”

Essential fatty acids in early life: structural and functional role

“…Supplementation of formula-fed preterm infants with graded levels of AA (0-1·1 g/100 g total fat) and DHA (0-0·76 g/100 g total fat) compared with breastfed babies demonstrated that plasma and erythrocyte LCPUFA levels can be mimicked by supplementing formula at similar levels to those present in breast milk. These levels translated into 0·54 g AA and 0·3 g DHA/100 g total fat for omnivorous women (Gibson et al 1997). Most LCPUFA-containing formulas presently used have 0·2-0·4 g DHA and 0·6-0·8 g AA/100 g total fat.…”