Docosahexaenoic acid supplementation from mid‐pregnancy through parturition influenced breast milk fatty acid composition at 1 month post‐partum in a double‐blind randomized controlled trial in Mexico

Abstract

Omega‐3 polyunsaturated fatty acids (PUFAs), including docosahexaenoic acid (DHA), are essential for neural development and accumulate extensively in the fetal and infant brain. Studies have shown that DHA concentration in human milk (HM) increases with maternal supplementation with fish oil during pregnancy and/or lactation, but the benefits of prenatal supplementation with DHA alone are unknown. We investigated the effect of prenatal DHA supplementation on PUFA concentrations in HM at 1 mo post‐partum (PP). In a double‐blind RCT in Mexico, 1040 pregnant women received 400 mg DHA or placebo daily from 18‐22 weeks' gestation through parturition. Fatty acid (FA) concentrations (% of total FA) were determined using gas liquid chromatography in HM obtained from 174 women at 1 mo PP. Women receiving DHA had higher mean HM DHA and alpha‐linolenic acid (ALA) concentrations, expressed as % of total FAs, compared to placebo at 1 month PP. Mean HM DHA concentrations in DHA and placebo groups were 0.20 (SD=0.06) and 0.17 (SD=0.07), respectively (Δ=0.02, 95% CI=‐0.04, ‐0.004), and mean ALA concentrations were 1.38 (SD=0.47) and 1.24 (SD=0.46), respectively. Concentrations of other FAs such as eicosapentaenoic and arachidonic acid did not differ between groups (P>0.05). Prenatal DHA supplementation increased concentrations of DHA and ALA in HM 1 month PP, providing a mechanism through which breastfed infants might benefit.Grant Funding SourceNIH (HD043099)