Inadequate Content of Docosahexaenoic Acid (DHA) of Donor Human Milk for Feeding Preterm Infants: A Comparison with Mother’s Own Milk at Different Stages of Lactation

Abstract

A cross-sectional single-center study was designed to compare the fatty acids profile, particularly docosahexaenoic acid (DHA) levels, between milk banking samples of donor human milk and mother’s own milk (MOM) for feeding preterm infants born before 32 weeks’ gestation. MOM samples from 118 mothers included colostrum (1–7 days after delivery), transitional milk (9–14 days), and mature milk (15–28 days and ≥29 days). In the n-3 polyunsaturated fatty acids (PUFAs) group, the levels of α-linolenic acid (C18:3 n3) and DHA (C22:6 n3) showed opposite trends, whereas α-linolenic acid was higher in donor human milk as compared with MOM, with increasing levels as stages of lactation progressed, DHA levels were significantly lower in donor human milk than in MOM samples, which, in turn, showed decreasing levels along stages of lactation. DHA levels in donor human milk were 53% lower than in colostrum. Therefore, in preterm infants born before 32 weeks’ gestation, the use of pasteurized donor human milk as exclusive feeding or combined with breastfeeding provides an inadequate supply of DHA. Nursing mothers should increase DHA intake through fish consumption or nutritional supplements with high-dose DHA while breastfeeding. Milk banking fortified with DHA would guarantee adequate DHA levels in donor human milk.

Erythrocyte Membrane Docosahexaenoic Acid (DHA) and Lipid Profile in Preterm Infants at Birth and Over the First Month of Life: A Comparative Study with Infants at Term

“…Other studies have consistently demonstrated the need to add n-3 PUFAs for preterm infant formulas to obtain fatty acid profiles comparable to infants receiving human milk [ 39 , 40 ]. In a previous study of our group, donor human milk had an inadequate content of DHA for feeding preterm infants, so that milk banking fortified with DHA would ensure adequate DHA levels [ 22 ]. Also, DHA supply dose in preterm infants dependently increased plasma DHA levels [ 41 , 42 ].…”

“…Infants born preterm are especially dependent on an adequate postnatal nutritional supply of DHA, but this is difficult to achieve for different reasons. There is a deficient lipid profile based on analysis of fatty acid composition in food sources for premature infants, plasma or cord blood samples [ 22 , 23 , 24 ], a need to rely on parenteral nutrition particularly in neonates admitted to the neonatal intensive care unit (NICU), the difficulties of mothers in producing enough breast milk volume for exclusive enteral feeding, and the composition of milk banks based on pooled mature milk with deficient DHA levels. Moreover, the recommended minimal intake of 450 g/day of DHA for pregnant and lactating women is rarely achieved unless there is an increase in DHA intake through fish consumption or nutritional supplements with high-dose DHA while breastfeeding [ 22 ].…”

“…There is a deficient lipid profile based on analysis of fatty acid composition in food sources for premature infants, plasma or cord blood samples [ 22 , 23 , 24 ], a need to rely on parenteral nutrition particularly in neonates admitted to the neonatal intensive care unit (NICU), the difficulties of mothers in producing enough breast milk volume for exclusive enteral feeding, and the composition of milk banks based on pooled mature milk with deficient DHA levels. Moreover, the recommended minimal intake of 450 g/day of DHA for pregnant and lactating women is rarely achieved unless there is an increase in DHA intake through fish consumption or nutritional supplements with high-dose DHA while breastfeeding [ 22 ]. Interestingly, in a community-based cohort study from South Dakota USA, deficient DHA content in breast milk samples from 84 women who delivered neonates at term was improved by providing nursing mothers with their breast milk DHA level and education about DHA intake while breastfeeding [ 25 ].…”

“…In a previous study of our group [ 22 ], it was shown that the fatty acids profile in samples of donor human milk and mother’s own milk (MOM) at different stages of lactation collected from women who delivered preterm infants had an inadequate content of DHA. Lower levels of DHA in donor milk bank samples were particularly significant as compared with colostrum.…”

Docosahexaenoic Acid as the Bidirectional Biomarker of Dietary and Metabolic Risk Patterns in Chinese Children: A Comparison with Plasma and Erythrocyte

“…Fatty acids (FAs) play an important role in energy metabolism and compose fundamental structures through various types of lipids [ 1 ]. Important among these structures are n -3 (omega-3) polyunsaturated fatty acids (PUFAs), which are involved neurodevelopment, immune function, cellular signaling processes, angiogenesis, and inflammatory response [ 2 , 3 , 4 ], playing a crucial role in children’s growth, development, and function. Docosahexaenoic acid (DHA, C22:6 n -3) is the predominant n -3 PUFA, making up over 90% of the n -3 PUFAs in the brain and 10–20% of its total lipids [ 5 ].…”