Human milk polyunsaturated fatty acids are related to neurodevelopmental, anthropometric, and allergic outcomes in early life: a systematic review

Abstract

Polyunsaturated fatty acids are critically important for newborn nutrition and in the trajectory of growth and developmental processes throughout early life. This systematic review (PROSPERO ID: CRD42023400059) critically analyzes literature pertaining to how omega-3 and omega-6 fatty acids in human milk are related to health outcomes in early life. Literature selected for the review were published between 2005 and 2020 and included assessments in healthy term children between 0 and 5 years of age. The studies reported the relation between human milk fatty acids docosahexaenoic acid (C22:6n-3, DHA), eicosapentaenoic acid (C20:5n-3, EPA), alpha-linolenic acid (C18:3n-3, ALA), arachidonic acid (C20:4n-6, AA), and linoleic acid (C18:2n-6, LA) with three domains of health outcomes: neurodevelopment, body composition, and allergy, skin & eczema. Results from the 21 studies consistently suggested better health outcomes across the three domains for infants consuming milk with higher concentrations of total n-3, DHA, EPA, and ALA. Negative health outcomes across the three domains were associated with higher levels of total n-6, AA, and LA in milk. N-3 and n-6 content of milk were related to neurodevelopmental, body composition, and allergy, skin & eczema outcomes with moderate certainty. Maternal diet impacting milk fatty acid content and fatty acid desaturase genotype modifying physiologic responses to fatty acid intake were prominent gaps identified in the review using the NIH Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies and GRADE approach. This research study can inform baby nutrition product development, and fatty acid intake recommendations or dietary interventions for mothers and children.

Nutritional Strategies for Preterm Neonates and Preterm Neonates Undergoing Surgery: New Insights for Practice and Wrong Beliefs to Uproot

“…The advantages of human milk for preterm newborns have been shown by several research studies, even for those who underwent major surgery [ 44 , 45 ]. Human milk plays a crucial role in neurodevelopment through crucial nutrients, such as polyunsaturated fatty acids, that support brain development [ 46 , 47 ]. In recent years, attention has focused on the early introduction of human milk so that the newborn is no longer exposed to a long period of PN [ 48 ].…”

Effect of Holder Pasteurization, Mode of Delivery, and Infant’s Gender on Fatty Acid Composition of Donor Breast Milk

“…Human milk is a remarkable and complex fluid that has evolved over time to meet the nutritional and developmental needs of infants [ 1 , 2 ]. Fatty acids are crucial components of human milk and play a vital role in the growth and well-being of the child [ 3 , 4 ]; on average, breast milk is composed of about 3–5% fat [ 5 ]. However, it is important to note that individual variations are common.…”

“…Fatty acids, including essential ones like LA and ALA, are transferred across the placenta to support fetal development. In the case of preterm birth, this transfer is disrupted, therefore the only postnatal source is the BM of FAs for the developing infant [ 3 , 4 , 19 ].…”

“…Fatty acids play a crucial role in intrauterine development, contributing to the formation and growth of various tissues and organs in the developing fetus. The availability of essential fatty acids during pregnancy is critical to developing the nervous and immune systems and other physiological processes [ 3 , 4 ]. Fatty acids are structural components of cell membranes, influencing membrane fluidity and stability [ 25 ].…”

“…Fatty acids are structural components of cell membranes, influencing membrane fluidity and stability [ 25 ]. This is particularly important during rapid cell division and differentiation in the developing fetus [ 3 , 4 ]. A cohort study suggests that higher mean daily serum levels of DHA during the early postnatal period are associated with less severe retinopathy of prematurity (ROP), but only in infants with elevated arachidonic acid values [ 27 ].…”