Polyunsaturated fatty acid content of breast milk from women with and without gestational diabetes mellitus

Abstract

Reduced insulin sensitivity and abnormal nutrient metabolism in gestational diabetes mellitus (GDM) may compromise polyunsaturated fatty acid (PUFA) content of breast milk. The purpose of the present study was to evaluate and compare PUFA milk composition of women with and without GDM. Breast milk collections were performed in GDM (n=6) and controls (n=12) at weeks 2, 6, 10 and 12 postpartum using a hospital grade breast pump. Estimated dietary intake of PUFA and use of prenatal supplements containing DHA (PS/DHA) was determined by 24-hour dietary recalls conducted after each milk collection. Based on these preliminary data, milk docosahexaenoic acid (DHA; C22:6n-3) concentration in milk of women with GDM not consuming PS/DHA had a tendency to be lower compared to controls at all weeks, and the n-3 to n-6 long chain fatty acid ratio was lower at 6 and 10 weeks. There were no differences between groups for other milk PUFAs. Further, women with GDM and controls who consumed PS/DHA during lactation had higher milk DHA compared to women not consuming PS/DHA at weeks 2 and 6 for GDM and week 12 for controls. Milk eicosapentaenoic acid (EPA; C20:5n-3) was higher at weeks 2, 6, and 10 in women with GDM consuming PS/DHA and weeks 10 and 12 for controls. Dietary + supplement linoleic acid (LA; C18:2n-6), linolenic acid (ALA; C18:3n-3), DHA, EPA, and n-3/n-6 were correlated with breast milk content of these fatty acids. Dietary ALA and LA did not correlate with milk DHA and arachidonic acid (ARA; C20:4n-6). Interestingly, there was an inverse association between 1 hour postpandrial glycemia during pregnancy and average milk DHA over the four time points. The current investigation points to lower milk DHA concentration in women with GDM who did not consume PS/DHA compared to controls not consumig PS/DHA. Based on these findings, and an earlier report of low DHA concentration in infants born to women with GDM, the importance of DHA supplementation during breast feeding for women with GDM is underscored.