Susan asked about side effects of Expecta Lipil, Mead Johnson's DHA  
supplement for pregnant and breastfeeding mothers. There has been at least one  report 
of mothers who take this experiencing a dose dependent amount  of excess gas 
and belching:
 
Innis SM, Hansen JW. Plasma fatty acid responses, metabolic effects, and  
safety of microalgal and fungal oils rich in arachidonic and docosahexaenoic  
acids in healthy adults. Am J Clin Nutr 1996; 64:159-167
 
Babies who receive DHA/ARA supplemented formulas have certainly experienced  
side effects from it including explosive diarrhea, diaper rash, and abdominal  
cramping (similar to a subgroup of adults who experience the same thing from  
ingesting olean/olestra in potato chips). 
 
Supplementation of mothers has not shown any long term effects on the IQ of  
their breastfed infants. Supplementing the mother is a saturable curve. Once a 
 certain level is reached, adding more will not drive DHA levels higher. In  
talking with Leon Mitoulas at the ILCA conference he mentioned that he has 
some  preliminary research on how the milk of supplemented mothers may be altered 
in  unintended and undesirable ways. 
 
Maternal  supplements with large concentrations of LCPUFAs can offset the 
production of  naturally made medium chain fatty acids, disrupting the natural 
concentration of  all fatty acids in the breast milk. The possibility exists of 
unnaturally high  levels of LCFUFAs and unnaturally low levels of medium chain 
fatty acids being  present in the milk of mothers who consume supplements. 
Supplementation of  LCPUFAs during pregnancy could have a long term effect due 
to the fatty acids  being stored in maternal fat and released postpartum into 
the breast milk,  further disrupting the natural fatty acid balance.
 
We need to be  very careful as "it is not nice to upset mother nature." Nine 
months of prenatal  DHA supplements and 12 months of them after the baby is 
born simply adds over  $200 per mother to the bank account of formula companies. 
 
Marsha Walker,  RN, IBCLC
Weston,  MA
 
 

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