An excerpt from:
Pediatric Clinics of North America
Volume 48 . Number 1 . February 2001
The Role of Polyunsaturated Fatty Acids in Term and Preterm Infants and
Breastfeeding Mothers
William C. Heird MD
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Department of Pediatrics, Section of Nutrition, USDA/ARS Children's
Nutrition Research Center, Baylor College of Medicine, Houston, Texas
LONG-CHAIN POLYUNSATURATED FATTY ACID SUPPLEMENTATION OF LACTATING WOMEN
Supplementation of breastfeeding mothers with LC-PUFAs, theoretically,
should result in human milk with a higher LC-PUFA content without altering
the physical characteristics of the milk. DHA supplementation of
breastfeeding women increases the DHA content of maternal plasma lipids and
human milk with minimal effect on the content of other FAs in plasma lipids
or milk.[43] [53] Also, infants of DHA-supplemented mothers have higher
plasma and erythrocyte lipid contents of DHA. Thus, a comparison of
functional outcomes of breastfed infants whose mothers do or do not receive
DHA supplements may help to clarify the importance of the DHA content of
human milk in infant development; however, this approach presupposes that
the amount of DHA in human milk, not simply the presence, is important in
infant development.
To date, complete results of one such study have been published, [33] [53]
and partial results of an additional study still underway have been
published as abstracts.[43] [44] [45] In the completed study, breastfeeding
women were assigned to receive doses of supplemental DHA ranging from 0 to
1.3 g/d for the first 12 months of lactation. Maternal plasma and
erythrocyte phospholipid DHA and milk DHA content increased in a
dose-dependent manner. Breast milk DHA content ranged from 0.2% to 1.7% of
total FAs.[53] Infant plasma and erythrocyte phospholipid DHA also increased
but in a saturable curvilinear fashion; that is, breast-milk DHA contents of
more than 0.8% of total FAs had only a minimal effect on infant plasma or
erythrocyte phospholipid DHA content.[53] No detectable effects of milk DHA
content on infant visual function were found.[33] At 1 year of age, a modest
correlation was found between milk DHA content and Bayley MDI; however, at 2
years of age, this effect was not apparent.[33]
In the ongoing study, breastfeeding mothers were assigned randomly to
receive a DHA supplement ( 200 mg/d) or placebo for 4 months. Despite marked
differences in milk DHA content and the DHA content of infant plasma and
erythrocyte lipids, no significant difference in behavioral or
electrophysiologic assessments of visual acuity were observed at 4 or 8
months of age.[44] Also no significant difference was found between groups
in several tests of cognitive and behavioral development at 1 year of
age.[45] Assessments at 30 months, including the Bayley Scales of Infant
Development, have not been reported.
DHA supplementation of the breastfeeding mother seems to prevent the
decrease in maternal plasma lipid content of DHA that occurs in many women
with prolonged breastfeeding.[43] [53] This effect is probably advantageous;
on the other hand, the decrease in maternal plasma lipid DHA is minimal and
has not been related to adverse consequences. Moreover, although data to
support the practice are limited, maternal plasma lipid DHA content can be
maintained by occasional dietary servings of fish.
References
33. Gibson RA, Neumann MA, Makrides M: Effect of increasing breast milk
docosahexaenoic acid on plasma and erythrocyte phospholipid fatty acids and
neural indices of exclusively breast fed infants. Eur J Clin Nutr
51:578-584, 1997 Abstract
43. Jensen CL, Maude M, Anderson RE, et al: Effect of docosahexaenoic acid
supplementation of lactating women on the fatty acid composition of breast
milk lipids and maternal and infant plasma phospholipids. Am J Clin Nutr
71(suppl):292-299, 2000 Abstract
44. Jensen CL, Prager TC, Zou Y, et al: Effects of docosahexaenoic acid
supplementation on visual function and growth of breast-fed term infants.
Lipids 34(suppl):225, 1999
45. Jensen CL, Llorente AM, Voigt RG, et al: Effects of maternal
docosahexaenoic acid (DHA) supplementation on visual and neurodevelopmental
function of breast-fed infants and indices of maternal depression and
cognitive interference [abstract]. Pediatr Res 45:284, 1999
53. Makrides M, Neumann MA, Gibson RA: Effect of maternal docosahexaenoic
acid (DHA) supplementation on breast milk composition. Eur J Clin Nutr
50:352-357, 1996 Abstract
>>
If any one wants the full article I will email it to you:
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Sally Myer RN BSN ICCE (still working towards IBCLC)
McCook NE
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