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.

Félix Castillo,Joan Carles Domingo,Félix-Joel Castillo-Ferrer,Begoña Cordobilla

doi:10.3390/nu13041300

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.

Highlights

Polyunsaturated fatty acids (PUFAs), omega-3 (α-linolenic acid [ALA], eicosapentaenoic acid [EPA] and docosahexaenoic [docosahexaenoic acid (DHA)] acid) and omega-6 are essential nutrients for growth, development and function [1]
Premature infants are deficient in DHA for several reasons, including loss of fetal accretion of DHA that typically occurs during the third trimester and immature enzymatic systems of chain elongation and desaturation of ALA to form DHA [11,12]
The DHA content in breast milk varies in direct correlation with maternal DHA intake [14,15,16], and mothers consuming a Western diet have lower levels of DHA in their milk as commonly DHA intake is below the recommended minimal intake of 450 mg/day for pregnant and lactating women [17,18]

Summary

Introduction

Polyunsaturated fatty acids (PUFAs), omega-3 (α-linolenic acid [ALA], eicosapentaenoic acid [EPA] and docosahexaenoic [DHA] acid) and omega-6 (arachidonic acid [AA] and linoleic acid [LA]) are essential nutrients for growth, development and function [1]. Premature infants are deficient in DHA for several reasons, including loss of fetal accretion of DHA that typically occurs during the third trimester and immature enzymatic systems of chain elongation and desaturation of ALA to form DHA [11,12]. These premature infants are reliant on enteral sources of DHA, most commonly through breast milk [13]. The DHA content in breast milk varies in direct correlation with maternal DHA intake [14,15,16], and mothers consuming a Western diet have lower levels of DHA in their milk as commonly DHA intake is below the recommended minimal intake of 450 mg/day for pregnant and lactating women [17,18]

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