Breast Milk Docosahexaenoic Acid Research Articles

Docosahexaenoic Acid Supplementation in Lactating Women Increases Breast Milk and Erythrocyte Membrane Docosahexaenoic Acid Concentrations and Alters Infant n–6:n–3 Fatty Acid Ratio

BackgroundLow concentrations of docosahexaenoic acid (DHA) or high n–6 (ω-6):n–3 ratio in pregnant women is associated with poor fetal growth velocity and suboptimal neurodevelopment. However, there is a lack of data on levels of important n–6 and n–3 fatty acids (FAs) at different time points during pregnancy and lactation from India. Data on how much DHA is transferred during actual supplementation are also scarce. ObjectivesWe report the concentrations of n–6 and n–3 FAs in maternal and infant blood and in breast milk following maternal supplementation with DHA or placebo. MethodsA total of 957 pregnant women (≤20 wk) from Belagavi, Karnataka, were randomly assigned to receive either 400 mg/d of algal DHA or placebo through 6 mo postpartum. Blood samples were collected from the mother at recruitment/baseline, delivery, and 6 mo postpartum and from the infant at birth (cord) and 12 mo (venous). Breast milk samples were collected from a subsample at delivery, 1 mo and 6 mo postpartum. The FA profile was analyzed using gas chromatography. ResultsThe concentration of DHA appeared to be higher in erythrocyte and breast milk samples of the DHA-supplemented group at all subsequent time points. The n–6:n–3 ratio was lower among women in the DHA group at delivery [DHA: 4.08 (1.79); placebo: 5.84 (3.57); P < 0.001] and at 6 mo postpartum [DHA: 5.34 (2.64); placebo: 7.69 (2.9); P < 0.001]. Infants of DHA-supplemented mothers also had a lower n–6:n–3 ratio at delivery and 12 mo. The n–6:n–3 ratio of breast milk increased from delivery through 1 to 6 mo but remained lower in the DHA-supplemented group than in the placebo. ConclusionsMaternal DHA supplementation with 400 mg/d from early pregnancy through 6 mo postpartum significantly increased circulating DHA in breast milk and infant erythrocyte, whereas decreased erythrocyte and breast milk n–6:n–3 ratio. However, maternal supplementation did not get the ratio to the recommended levels.

Impact of DHA from Algal Oil on the Breast Milk DHA Levels of Lactating Women: A Randomized Controlled Trial in China.

Population research on the intervention of docosahexaenoic acid (DHA) supplementation in lactating women is in its infancy in China. This study investigated the effect of DHA supplementation on DHA concentrations in the breast milk of lactating women, and the intervention effect, with respect to different dietary patterns. In this trial, 160 healthy lactating women in Nanjing (30–50 days postpartum) were recruited and randomly divided into control (one placebo capsule of similar appearance per day) and supplement (one capsule with 200 mg of DHA from algal oil per day) groups for 8 weeks. Before and after the intervention, all subjects were asked to maintain basic information, maternal anthropometric parameters, breast milk (10–15 mL) sample collection, and a dietary survey using a food frequency questionnaire. The concentrations of DHA and other fatty acids in breast milk were detected using capillary gas chromatography. This study was completed by 137 subjects, with 60 in the control group and 77 in the supplement group. Compared with the DHA concentrations in the breast milk at enrollment, the absolute concentrations of the control group showed a significant decrease at the end of the trial (p = 0.037). In addition, after intervention, the absolute and relative DHA concentrations in the supplement group (10.07 mg/100 mL and 0.40%, respectively) were higher than those in the control group (7.57 mg/100 mL and 0.28%, respectively), being statistically significant (p = 0.012 and p = 0.001). Furthermore, the maternal diet in the supplement group was divided into four dietary patterns. Pattern 1 mainly included fruits and livestock meat. Pattern 2 was dominated by milk and its products, eggs, fish, shrimp and shellfish, and soybeans and its products. Pattern 3 chiefly comprised cereal and beans other than soybeans, potatoes, and nuts. Pattern 4 was high in poultry meat and low in cooking oils. The change in the absolute concentration of DHA in Pattern 3 was lower than that in other patterns (p < 0.05). In conclusion, DHA supplementation in lactating mothers increased breast milk DHA concentrations. The dietary pattern mainly characterized by cereal and beans other than soybeans, potatoes, and nuts may contribute to the poor intervention effect.

Interaction between maternal dietary fat intake, breast milk omega-3 fatty acids and infant growth during the first year of life.

Long chain fatty acids (LCFA) of human milk (HM) might be associated with different patterns of weight gain in infancy. This study aims to examine the interaction between maternal dietary fat intake, breast milk content of docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) with infant growth during the first year of life. This longitudinal study was conducted among 215 Iranian mother-infant pairs. The infants were followed up from birth to 12 months of age. Trained healthcare providers measured infant anthropometrics including weight, length and head circumference at birth, 2, 4, 6 and 12 months of age. Breast hind milk samples were collected in the morning through hand expression between 6 and 12 weeks postpartum. Maternal dietary intake was assessed using a 3-day dietary record. Linear mixed effects models were performed to determine the interaction between maternal dietary fat intake, the breast milk content of EPA and DHA with infant growth. Further adjustments were applied for potential confounders. Mean and standard deviation (SD) of maternal age and body mass index were 29.70 (5.24) years and 24.47 (4.42)kg/m2 , respectively. Mean (SD) of infant birth weight was 3177.50 (413.20)g, and 50% were boys. An inverse interaction existed between maternal dietary fat intake and breast milk EPA with infant 4-month weight (β: -366.2, P-value: 0.01). We found a significant association of maternal dietary fat intake and infant 6-month weight (β: 22.5, P-value: 0.04). An inverse interaction was documented between maternal dietary fat intake and breast milk DHA with infant weight at 12-month of age (β: -95.3, P-value: 0.02). We found a significant association between maternal dietary fat intake and infant length at 12-month (β: 0.06, P-value: 0.02). We found an inverse interaction between maternal dietary fat intake and breast milk omega-3 fatty acids with infant weight at 4 and 12 months of age. Although longer follow-up of growth indices is recommended, these findings suggest functional relevance of HM composition to infant growth.

Breast Milk Docosahexaenoic Acid and Neonatal Outcome in Preterm Infants: A Cross-sectional Study

Background: The usual intake of fish products is not common in Iranian mothers. Objectives: Regarding the significant effect of this nutrient material on neonatal outcomes, we aimed to evaluate the breast milk docosahexaenoic acid (DHA) level in mothers with preterm delivery. Methods: This cross-sectional study was done in 67 mothers with gestational age lower than 36 weeks during 2018 - 2019. Breast milk samples of 5 - 10 milliliters were evaluated by gas chromatography for DHA level. Then, the correlation between the breast milk DHA levels and neonatal outcomes was assessed. Results: A total of 67 mothers were eligible in the study. The mean gestational age and birth weights were 31.54 ± 4.44 weeks and 1707.85 ± 595.83 g, respectively. The mean DHA, as a percentage of total breast milk fatty acids, was 0.29 ± 0.0127%. Statistical analysis showed no significant relationship between the breast milk DHA level and gestational age, birth weight, maternal age, delivery mode, neonatal growth index, and neonatal complications. The relationship between the intake of food materials rich in DHA and breast milk level was not statistically significant. Conclusions: We concluded that the breast milk DHA level of mothers with preterm delivery was acceptable, although it revealed no significant correlation with maternal factors and neonatal outcomes.

Polyunsaturated Fatty Acid Composition in Breast Milk Plasma of HIV-infected and Uninfected Mothers in Relation to Infant Clinical Outcomes.

Background:The increased coverage of prevention of mother to child transmission (PMTCT) services has significantly reduced paediatric HIV infection incidence. The aim of the study was to compare breast milk omega-6 and omega-3 polyunsaturated fatty acid profiles of HIV infected and uninfected mothers and determine the association between fatty acid profiles and postnatal transmission of HIV, morbidity/mortality of HIV exposed and unexposed infants.Methods:A prospective cohort study of 57 HIV infected and 57 HIV uninfected lactating mothers was conducted in Gweru, Zimbabwe from July 2019 to March 2020. The women’s 114 babies (term and preterm) were also enrolled and stratified by HIV exposure and infection status. The mother-infant pairs were followed up at 6 weeks, 16 weeks and 6 months postpartum to determine, HIV transmission rate, breast milk polyunsaturated fatty acid profiles as well as infant clinical outcomes.Results:The mean breast milk docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) levels in HIV uninfected mothers (0.82 ± 0.92; 0.47 ± 0.75 μg/ml respectively) at 6 weeks postpartum were significantly higher compared to those of HIV infected mothers (0.33 ± 0.32; 0.08 ± 0.14 μg/ml) respectively. The same pattern was observed at 16 weeks postpartum in terms of DHA and EPA mean concentration. However, the arachidonic acid (AA) levels and AA/DHA ratio measured at 6 weeks postpartum were significantly higher in HIV infected mothers (2.31 ± 2.01; 17.18 ± 52.47 respectively) compared to HIV uninfected mothers (0.82 ± 0.54; 9.71 ± 21.80; P < .001). A higher morbidity rate was observed amongst HIV exposed infants than HIV unexposed infants (3.26 ± 0.13; 2.49 ± 0.09; P < .001) respectively. A significant positive correlation was observed between AA and infant morbidity (r = .388; P < .001).Conclusion:Deficiencies in breast milk omega-3 fatty acids were observed in HIV infected women. Maintaining a healthy balance between omega-6 and omega-3 fatty acid diets is critical for breast feeding mothers regardless of their HIV status. The adverse clinical outcomes observed amongst HIV exposed infants emphasise their vulnerability under conditions of maternal universal antiretroviral therapy.

Differences in Sensorimotor Development Among U.S. Infants Receiving Breastmilk and/or Formula in the First 6-Months From the PediaTrac™ Project

ObjectivesAchieving sensorimotor (SEM) milestones is one measure of early infant brain development promoted through higher docosahexaenoic acid (DHA) levels. Both breastmilk and formula contain DHA, with a global level of 0.32% in breastmilk and many formula brands. However, a 2017 study of Midwestern U.S. mothers found significantly lower breastmilk DHA levels. It was thus hypothesized that infants fed formula would have higher SEM scores. The objective of this study was to measure differences in SEM development between infants fed breastmilk, formula, or a combination in participants of the PediaTrac™ Project. PediaTrac is a web-based measure providing longitudinal, real time, multidomain data on infant and toddler growth and development at time periods corresponding to well child visits. MethodsUsing PediaTrac, data were collected from 548 caregiver-infant dyads across multiple Midwestern sites. Caregivers reported the primary nutrition source as breastfeeding, formula or combination. Their responses to gross and fine motor function questions were used to create a SEM composite, Percent of Maximum Possible (POMP) score at newborn (NB), 2-, 4- and 6-months. Data were analyzed via ANOVA and Tukey test using SPSS. ResultsInfants fed formula had statistically higher mean SEM scores at NB (M = 0.618Formula, M = 0.590Breast, p = 0.017), 2- (M = 0.706Formula, M = 0.680Breast, p = 0.006) and 6-months (M = 0.727Formula, M = 0.696Breast, p = 0.014) compared to breastfed infants. Mean SEM scores of combination fed infants were higher than breastfed infants at 2- (M = 0.701Combination, M = 0.680Breast, p = 0.184), 4- (M = 0.684Combination, M = 0.673Breast, p = 0.573) and 6-months (M = 0.704Combination, M = 0.696Breast, p = 0.895), despite no significant differences between scores. ConclusionsFormula fed infants showed consistently higher SEM scores than breastfed infants in the first 6-months. These findings contradict previous research, indicating a need for further investigation into variables contributing to these discrepancies such as maternal breastmilk DHA concentrations, socioeconomic factors, site specific confounds, accuracy of parent reports of motor development, etc. Funding SourcesEunice Kennedy Shriver National Institute of Child Health & Human Development of the National Institutes of Health. EMU College of Health & Human Services Research Support Award.

Baseline red blood cell and breast milk DHA levels affect responses to standard dose of DHA in lactating women on a controlled feeding diet

BackgroundThe importance of providing the newborn infant with docosahexaenoic acid (DHA) from breast milk is well established. However, women in the United States, on average, have breast milk DHA levels of 0.20%, which is below the worldwide average (and proposed target) of >0.32%. Additionally, the relationship between maternal red blood cell (RBC) and breast milk DHA levels may provide insight into the sufficiency of DHA recommendations during lactation. Whether the standard recommendation of at least 200 mg/day of supplemental DHA during lactation is sufficient for most women to achieve a desirable RBC and breast milk DHA status is unknown. MethodsLactating women (n = 27) at about 5 weeks postpartum were enrolled in a 10–12 week controlled feeding study that included randomization to 480 or 930 mg choline/d (diet plus supplementation). As part of the intervention, all participants were required to consume a 200 mg/d of microalgal DHA. RBC and breast milk DHA levels were measured by capillary gas chromatography in an exploratory analysis. ResultsMedian RBC DHA was 5.0% (95% CI: 4.3, 5.5) at baseline and 5.1% (4.6, 5.4) after 10 weeks of supplementation (P = 0.6). DHA as a percent of breast milk fatty acids increased from 0.19% (0.18, 0.33) to 0.34% (0.27, 0.38) after supplementation (P<0.05). The proportion of women meeting the target RBC DHA level of >5% was unchanged (52% at baseline and week 10). The proportion of women achieving a breast milk DHA level of >0.32% approximately doubled from 30% to 56% (p = 0.06). Baseline RBC and breast milk DHA levels affected their responses to supplementation. Those with baseline RBC and breast milk DHA levels above the median (5% and 0.19%, respectively) experienced no change or a slight decrease in levels, while those below the median had a significant increase. Choline supplementation did not significantly influence final RBC or breast milk DHA levels. ConclusionsOn average, the standard prenatal DHA dose of 200 mg/d did not increase RBC DHA but did increase breastmilk DHA over 10 weeks in a cohort of lactating women in a controlled-feeding study. Baseline DHA levels in RBC and breast milk affected the response to DHA supplementation, with lower levels being associated with a greater increase and higher levels with no change or a slight decrease. Additional larger, dose-response DHA trials accounting for usual intakes and baseline DHA status are needed to determine how to best achieve target breast milk DHA levels and to identify additional modifiers of the variable breast milk DHA response to maternal DHA supplementation.

Effect of omega-3 supplementation during pregnancy and lactation on the fatty acid composition of breast milk in the first months of life: a narrative review

Omega-3 long-chain, polyunsaturated fatty acids are essential, so they must be provided through the diet, as their biological synthesis is limited, making it essential to meet their requirements during physiological stages such as pregnancy and lactation. A narrative review was conducted on the effects of omega-3 supplementation during pregnancy and lactation on the fatty acid composition of breast milk in the first months of life. Eight randomized clinical studies were analyzed, showing a significant increase in docosahexaenoic acid (DHA) concentration in breast milk (BM) post-supplementation, compared to control groups. One study evaluated the dose needed to achieve 8 % DHA in erythrocytes and 1 % DHA in BM, reaching these levels with a supplementation close to 1 g of docosahexaenoic acid + eicosapentaenoic acid (EPA). Finally, a trial was found that used supplementation with small lipid contributions (0,59 g α-linolenic acid (ALA)), without generating significant changes in the DHA composition of LM, but in the ALA content. Therefore, it is inferred that omega-3 supplementation beneficially modifies DHA and EPA levels in the composition of BM in pregnant women and during the lactation stage, although further studies are needed to identify doses, times, beneficial effects on development, and more efficient forms of delivery of omega-3 supplementation.

Breast milk n-3 long-chain polyunsaturated fatty acids and blood pressure: an individual participant meta-analysis

PurposeIt is controversial whether a higher intake of n-3 long-chain polyunsaturated fatty acids (n-3 LC PUFA) through breastfeeding is associated or not to a lower blood pressure (BP) during childhood. We aimed to clarify this point by undertaking a meta-analysis involving the data from seven European birth cohorts.MethodsWe searched https://www.birthcohort.net for studies that had collected breast milk samples, and had at least one BP measurement in childhood. Principal investigators were contacted, and all agreed to share data. One additional study was identified by contacts with the principal investigators. For each cohort, we analyzed the association of breast milk n-3 LC PUFAs with systolic and diastolic BP with linear mixed effects models or linear regression, and pooled the estimates with a random effects model. We also investigated age-specific and sex-specific associations.ResultsA total of 2188 participants from 7 cohorts were included. Overall, no associations between breast milk n-3 LC PUFAs and BP were observed. In the pooled analysis, each 0.1 wt% increment in breast milk docosahexaenoic acid (DHA) was associated with a 1.19 (95% CI − 3.31, 0.94) mmHg lower systolic BP. Associations were similar for boys and girls and at different ages.ConclusionIn this individual participant meta-analysis, we found no evidence for an association between breast milk n-3 LC PUFAs and BP.

Quantification of breast milk trans fatty acids and trans fat intake by Hong Kong lactating women.

Diet westernization in Hong Kong may increase trans fat intake, whereas it may decrease intake of polyunsaturated fatty acids. The present study was to determine the current breast milk fatty acid composition and trans fat intake by Hong Kong lactating mothers. Sixty lactating women were recruited for the study. Each participant donated 15 ml of milk at week 4 and 6 after delivery. Dietary data were collected using a 3-day food record method, covering 2 weekdays and 1 weekend day. Milk fatty acids were analyzed using a gas chromatography method. Trans fat consumption was assessed using the Nutrition Data System for Research or calculating the intake based on percentage of trans fatty acids in the breast milk. Linoleic acid, α-linolenic acid, arachidonic acid, and docosahexaenoic acid in breast milk were 16.23%, 1.52%, 0.59%, and 0.66% total milk lipids, respectively. Mean daily intakes of total fat, saturated fatty acids, monounsaturated fatty acids, were 79, 24, 29, and 18 g, respectively. Total trans fat intake was estimated to be 1.15-1.20 g daily and accounted for 0.50-0.52% total energy. Breast milk of Hong Kong Chinese lactating women contained relatively higher contents of arachidonic and docosahexaenoic acids compared with those of Western countries. Compared with the previous study conducted in 1995, breast milk total trans fatty acids in 2018 still remained low. Total trans fat intake by Hong Kong lactating women in 2018 was a half of WHO's recommendation that total trans fat intake should be <1% total energy.

The effect of holothuria scabra on the level of docosahexaenoic acid in breast milk with preterm birth

The objective of the research was to determine the giving of Holothuria scabra on the level of Docoxahexaenoic Acid (DHA) of breast milk with preterm chilbirth. The research was a quasi experimental study with control group design. The samples were postpartum mothers with preterm childbirth consisted of 40 people divided into two groups. Postpartum mothers given Holothuria scabra capsule were intervention group and the postpartum mothers not given Holothuria scabra were control group. The sample of mother's milk of pretest of each group was taken in the seventh day and seven day later the sample was taken 3cc. Intervention was done for 7 days per sample with 3 times dosage consisted of 2 capsules per day. The sample of breast milk was examined with Human DHA ELISA kit. The data were analyzed using Mann-Whitney test and Wilcoxon test. The results of the research indicated the difference of DHA level between intervention group and control group with a value of p=value 0.006. After the intervention, the average increase was 187.02μg/mL for intervention group and 7.05μg/mL for control group with a value of 1151.04μg/mL.

Correlation Between Docosahexaenoic Acid Intake and It’s Content in Breast Milk of Lactating Mothers in Jakarta

Objective: Docosahexaenoic acid (DHA) is the predominant structural fatty acid in the brain and crucial for cognitive development in early life. Newborn DHA intake completely depends on preformed DHA in mother’s breast milk. In advancing years, globalization has been declining the fish intake of Asian countries. This study aims to determine DHA intake among lactating mothers in Jakarta and its association with breast milk’s DHA.Method: This cross-sectional study was conducted in Grogol Petamburan and Cilincing Public Health Centers, Jakarta. Eighty healthy lactating mothers aged 20–35 years old in 1–6 months postpartum were taken using consecutive sampling method. Characteristics data were taken by interviews and DHA intake was assessed with the semiquantitative food frequency questionnaire. Breast milk specimens were collected in the morning and its DHA content was analyzed using Gas Chromatography with Mass Spectrometry. Descriptive analyses and Spearman rho test were used with a 95% confidence level.Result: This study showed the median of subjects’ DHA intake was 158.5(13.9–719.7) mg/day, i.e., 67.5% of the subjects was below Food and Agriculture Organization (FAO) recommendation. The median of breast milk DHA was 51.7(19–184.7) mg/day, only 42.5 % of the subjects had breast milk DHA to meet the minimal requirement of their infant. A moderate positive correlation was found between maternal DHA intake with breast milk DHA (r = 0.478, p &lt; 0.001). Conclusion: Maternal DHA intake has moderate positive correlation with breast milk DHA, more than half of the subject had DHA intake below FAO recommendation.

The Effect of Maternal Obesity on Breast Milk Fatty Acids and Its Association with Infant Growth and Cognition—The PREOBE Follow-Up

This study analyzed how maternal obesity affected fatty acids (FAs) in breast milk and their association with infant growth and cognition to raise awareness about the programming effect of maternal health and to promote a healthy prenatal weight. Mother–child pairs (n = 78) were grouped per maternal pre-pregnancy body mass index (BMI): normal-weight (BMI = 18.5–24.99), overweight (BMI = 25–29.99) and obese (BMI > 30). Colostrum and mature milk FAs were determined. Infant anthropometry at 6, 18 and 36 months of age and cognition at 18 were analyzed. Mature milk exhibited lower arachidonic acid (AA) and docosahexaenoic acid (DHA), among others, than colostrum. Breast milk of non-normal weight mothers presented increased saturated FAs and n6:n3 ratio and decreased α-linolenic acid (ALA), DHA and monounsaturated FAs. Infant BMI-for-age at 6 months of age was inversely associated with colostrum n6 (e.g., AA) and n3 (e.g., DHA) FAs and positively associated with n6:n3 ratio. Depending on the maternal weight, infant cognition was positively influenced by breast milk linoleic acid, n6 PUFAs, ALA, DHA and n3 LC-PUFAs, and negatively affected by n6:n3 ratio. In conclusion, this study shows that maternal pre-pregnancy BMI can influence breast milk FAs and infant growth and cognition, endorsing the importance of a healthy weight in future generations.

Correlation Between Docosahexaenoic Acid Intake and It’s Content in Breast Milk of Lactating Mothers in Jakarta

Objective: Docosahexaenoic acid (DHA) is the predominant structural fatty acid in the brain and one of the most important nutrient for cognitive development in early life. During early life, there is very limited metabolic capability to convert omega-3 fatty acids to DHA. Therefore, newborn intake of DHA completely depends on preformed DHA in mother’s breast milk. This study aims to determine DHA intake among lactating mothers and their association with breast milk’s DHA.Method: This cross-sectional study was conducted in Grogol Petamburan and Cilincing Public Health Centre in Jakarta. Eighty healthy lactating mothers aged 20–35 years old in 1–6 months postpartum was taken using consecutive sampling method. Mother’s DHA intake was assessed with a semiquantitative food frequency questionnaire. Post-feed breast milk specimens were collected in the morning, transported with cool boxes, and stored in the laboratory at -70° C before the analyses. Breast milk DHA content was analysed using Gas Chromatography with Mass Spectrometry. Descriptive analyses and Spearman rho test was used with a 95% confidence level.Result: This study showed the median of subjects’ DHA intake was 158.5(13.9–719.7) mg/day, i.e. 67.5% of the subjects was below Food and Agriculture Organization (FAO) recommendation (200 mg/day). The median of breast milk DHA was 51.7(19–184.7) mg/day, only 42.5 % of the subjects had breast milk DHA to meet the minimal requirement of their infant based on FAO recommendation (0.1% of total energy requirement). There was a moderate correlation between subject DHA intake with breast milk’s DHA content (r = 0.478, p &lt; 0.001). Conclusion: More than half of the subjects had DHA intake below FAO recommendation. Our finding showed a positive moderate correlation between DHA intake and breast milk DHA among lactating mothers.

Docosahexaenoic Acid in Mature Breast Milk of Low-income Mothers.

Docosahexaenoic acid (DHA) is among the main components of synaptosomal membranes and myelin sheaths. Because DHA is essential for child neurodevelopment, breast milk DHA levels should be improved by optimizing maternal nutrition. We determined DHA percentage levels in breast milk of low-income mothers receiving care at the public healthcare sector. We performed a descriptive, cross-sectional study in breast milk samples from 39 exclusively breast-feeding adult mothers with normal fetal and neonatal history. Samples were collected 90 ± 7 days after delivery. Breast milk fatty acid composition was determined by gas chromatography. The cut-off value of DHA was 0.3% of total fatty acids in milk according to recommendations. Median DHA in milk was 0.14% (0.12-0.21). Breast milk DHA levels were lower than the minimum recommended in 92% of samples. The analysis of breast milk samples from low-income exclusively breast-feeding mothers showed that they did not reach the minimum recommended DHA percentage.

Association between Breastmilk LC PUFA, Carotenoids and Psychomotor Development of Exclusively Breastfed Infants.

The first months of infant life are crucial for proper neurodevelopment, which may be influenced by several factors, including nutrition and nutrients (e.g., long-chain polyunsaturated fatty acids (LC PUFA) and carotenoids) of which the concentration in breastmilk is diet-dependent. This study analysed the relationship between the average concentrations of selected LC PUFA and carotenoids in breastmilk samples from the first and third months of lactation and the psychomotor development of exclusively breastfed infants at the sixth month of life. Infant psychomotor development was assessed using the Children Development Scale (DSR). The average age of infants during the assessment was 6.6 ± 0.2 months and 30.9 ± 3.8 years for mothers (n = 39 mother–infant pairs). The average concentration of docosahexaenoic acid (DHA) was 0.50% of fatty acids. The average concentration of carotenoids was 33.3 nmol/L for β-carotene, 121 nmol/L for lycopene and 33.3 nmol/L for lutein + zeaxanthin. The total results of the Performance scale and Motor subscale were 39 centiles and 4.1 points, respectively. Adjusted multivariate regression models revealed associations between breastmilk DHA and motor development (β = 0.275; p ≤ 0.05), α-linolenic acid (ALA; β = 0.432; p ≤ 0.05), n-3 LC PUFA (β = 0.423; p ≤ 0.05) and β-carotene (β = 0.359; p ≤ 0.05). In addition, an association between the Perception subscale and DHA was observed (β = 0.316; p ≤ 0.05; model 2). There were no significant associations between the overall Performance scale scores. Due to the positive association between concentrations of n-3 LC PUFA (ALA and DHA) and β-carotene in breastmilk and infant motor development, it is important to provide these nutrients with breastmilk. According to the diet-dependent concentration of these compounds in breastmilk, breastfeeding mothers should have a diet abundant in dietary sources of these nutrients, e.g., fish, nuts, seeds, vegetable oils, vegetables and fruits.

N-docosahexaenoylethanolamine detected in human breast milk

Purpose: Measure concentrations of the neurogenic, pro-neurogenic, pro-synaptogenic and anti-inflammatory mediator N-docosahexaenoylethanolamine (synaptamide) in relation to its precursor docosahexaenoic acid (DHA) in breast milk. Design and methods: Postpartum women were recruited prior to discharge. We supplemented half the subjects with omega-3 fatty acids. Breast milk samples were collected at 1, 4 and 8 weeks. Synaptamide and DHA concentrations were determined by liquidchromatography/tandem mass spectrometry (LC-MS/MS) and gas chromatography, respectively. Results: Synaptamide was detected in all breast milk samples. The concentration ranged from 44 to 257 fmol/mL. Omega-3 fatty acid supplementation did not affect DHA or synaptamide concentration in breast milk due to a high-DHA-containing diet self-selected by control mothers. Nevertheless, synaptamide levels significantly correlated with DHA concentration in breast milk (r = 0.624, P < 0.001). Conclusion: This is the first demonstration of detectable concentrations of synaptamide in human breast milk. Although the attempt to raise the milk DHA content by omega-3 fatty acid supplementation was not successful in the current study, the positive correlation observed between synaptamide and DHA concentration suggests that synaptamide levels in human milk can be raised by proper omega-3 fatty acid supplementation that is known to increase DHA.

Associations of maternal nutrition during pregnancy and post-partum with maternal cognition and caregiving.

Pregnant and post‐partum women require increased nutrient intake and optimal cognition, which depends on adequate nutrition, to enable reasoning and learning for caregiving. We aimed to assess (a) differences in maternal cognition and caregiving between women in Malawi who received different nutritional supplements, (b) 14 effect modifiers, and (c) associations of cognition and caregiving with biomarkers of iron, Vitamin A, B‐vitamin, and fatty acid status. In a randomized controlled trial (n = 869), pregnant women daily received either multiple micronutrients (MMN), 20 g/day lipid‐based nutrient supplements (LNS), or a control iron/folic acid (IFA) tablet. After delivery, supplementation continued in the MMN and LNS arms, and the IFA control group received placebo until 6 months post‐partum, when cognition (n = 712), caregiving behaviour (n = 669), and biomarkers of nutritional status (n = 283) were assessed. In the full group, only one difference was significant: the IFA arm scored 0.22 SD (95% CI [0.01, 0.39], p = .03) higher than the LNS arm in mental rotation. Among subgroups of women with baseline low hemoglobin, poor iron status, or malaria, those who received LNS scored 0.4 to 0.7 SD higher than the IFA arm in verbal fluency. Breastmilk docosahexaenoic acid and Vitamin B12 concentrations were positively associated with verbal fluency and digit span forward (adjusting for covariates ps < .05). In this population in Malawi, maternal supplementation with MMN or LNS did not positively affect maternal cognition or caregiving. Maternal docosahexaenoic acid and B12 status may be important for post‐partum attention and executive function.

Prenatal Docosahexaenoic Acid Supplementation Does Not Affect Nonfasting Serum Lipid and Glucose Concentrations of Offspring at 4 Years of Age in a Follow-Up of a Randomized Controlled Clinical Trial in Mexico

Docosahexaenoic acid (DHA) has regulatory effects on lipid and glucose metabolism. Differences in DHA availability during specific developmental windows may program metabolic changes. We investigated the effects of maternal DHA supplementation during pregnancy on the nonfasting serum lipid and glucose concentrations of offspring at 4 y of age. We used data from the Prenatal Omega-3 Fatty Acid Supplementation, Growth, and Development trial, a double-blind randomized controlled trial conducted in Mexico. Pregnant women were supplemented daily with 400 mg DHA or placebo from 18-22 wk of gestation to delivery. The primary outcomes of the trial were offspring growth and neurological development. Nonfasting blood samples were obtained from the offspring at 4 y of age. We analyzed serum total, HDL, non-HDL, and LDL cholesterol; the total-to-HDL cholesterol ratio; apolipoprotein B (apoB); triglycerides; glucose; and insulin as secondary outcomes and compared their concentrations between treatment groups. Data from 524 offspring were available. The women were compliant with the intervention based on pill counts and changes in cord blood and breast milk DHA concentrations. None of the between-group differences (DHA compared with placebo), adjusted for maternal height and time since last food intake, were significant (P range 0.27-0.83). Means (95% CIs) were as follows: total cholesterol (TC), 1.73 mg/dL (-2.63, 6.09 mg/dL); HDL cholesterol, 0.66 mg/dL (-1.07, 2.39 mg/dL); non-HDL cholesterol, 1.77 mg/dL (-1.83, 5.37 mg/dL); LDL cholesterol, 1.62 mg/dL (-2.21, 5.45 mg/dL); TC:HDL ratio, 0.01 (-0.09, 0.11); apoB, -0.15 mg/dL (-2.78, 2.48 mg/dL); triglycerides, 0.21 mg/dL (-10.93, 10.52 mg/dL); glucose, -0.67 mg/dL (-2.46, 1.11 mg/dL); and insulin, 0.62 μU/mL (-0.88, 2.11 μU/mL). Prenatal DHA supplementation does not affect nonfasting serum lipid and glucose concentrations of offspring at 4 y of age. This trial was registered at clinicaltrials.gov as NCT00646360.

Breast milk DHA levels may increase after informing women: a community-based cohort study from South Dakota USA.

BackgroundDocosahexaenoic acid (DHA), an omega-3 fatty acid found in breast milk, has many health benefits for both mother and baby. A 2007 meta-analysis found U.S. women had breast milk DHA levels (0.20% of total fatty acids) below the worldwide mean (0.32%). In 2008, international dietary recommendations were made for pregnant and lactating women to consume 200 mg of DHA per day. This community-based study aimed to define current milk DHA levels from upper Midwest USA lactating mothers and to determine if providing information about their own level along with dietary recommendations would incite changes to increase breast milk DHA content.MethodsNew mothers attending lactation classes or using hospital pumping rooms in Sioux Falls, South Dakota, USA participated by providing one drop of breast milk on a card for fatty acid analysis at baseline and 1 month after initial reporting. DHA levels were analyzed by gas chromatography. Mothers received a report of their own breast milk level along with dietary recommendations on DHA intake for lactating women. Median baseline and follow-up DHA levels were determined and differences were compared by Wilcoxon signed-rank test.ResultsAt baseline, breast milk DHA content (n = 84) was highly variable (range 0.05 to 0.73%) with a median of 0.18% (IQR, 0.13, 0.28; mean ± SD, 0.22 ± 0.13%), well below the worldwide average (0.32%). Women who reported taking DHA supplements (n = 43) had higher levels than those who did not (0.23% vs. 0.15%, P < 0.0001). In a subset of 60 mothers who submitted a second sample, median breast milk DHA content increased from 0.19 to 0.22% (P < 0.01).ConclusionsFindings suggest that providing nursing mothers with their breast milk DHA level and education about DHA intake while breastfeeding motivates change to increase DHA levels.Electronic supplementary materialThe online version of this article (doi:10.1186/s13006-016-0099-0) contains supplementary material, which is available to authorized users.