Effect of increasing breast milk docosahexaenoic acid on plasma and erythrocyte phospholipid fatty acids and neural indices of exclusively breast fed infants.
OBJECTIVE
To determine the effect of increasing docosahexaenoic acid (DHA, 22:6 n-3) in breast milk on infant fatty acid profiles. A secondary aim was to examine aspects of neural development.


METHODS
Double blind, placebo controlled study of infants recruited from postnatal wards at Flinders Medical Centre.


METHODS
Fifty-two healthy term infants who were breast fed for at least 12 weeks and were from middle class families.


METHODS
Breast milk with DHA concentrations that ranged from 0.1-1.7% of total fatty acids. This was achieved by supplementation of the maternal diet for the first 12 weeks post partum.


RESULTS
Breast milk with DHA was related to infant plasma (r = 0.89, P < 0.001) and erythrocyte (r = 88, P < 0.001) phospholipids in a saturable curvilinear manner so that breast milk DHA above 0.8% of total fatty acids resulted in little further increase in infant plasma or erythrocyte DHA levels. The rise in plasma and erythrocyte DHA was approximated by a fall in total n-6 polyunsaturated fatty acids. We could detect no relationship between visual evoked potential acuity (measured at 12 and 16 weeks) of infants by either the dietary grouping or the DHA status of individuals. A stepwise multiple regression showed that infant erythrocyte DHA at 12 weeks and home stimulation were the only independent factors associated with Bayley's MDI at 1 y (adjusted model r2 = 0.18, P < 0.005); while at 2 y gender and social score of the spouse were the only significant predictors of Bayley's MDI (adjusted model r2 = 0.22, P < 0.005).


CONCLUSIONS
Increasing breast milk DHA levels caused a dose dependent saturable increase in infant plasma and erythrocyte phospholipid DHA. There were no long-term effects of infant DHA status on indices of neurodevelopment.
Gibson
R A
RA
Department of Paediatrics & Child Health, Flinders Medical Centre, Adelaide, SA, Australia.
Neumann
M A
MA
Makrides
M
M
D001942:Breast Feeding; D004032:Diet; D004281:Docosahexaenoic Acids / Q000008:administration & dosage* / Q000032:analysis; D004912:Erythrocytes / Q000378:metabolism*; D005074:Evoked Potentials, Visual; D005227:Fatty Acids / Q000097:blood*; D043371:Fatty Acids, Omega-6; D005231:Fatty Acids, Unsaturated / Q000097:blood; D005260:Female; D006801:Humans; D007223:Infant; D008606:Mental Processes; D008895:Milk, Human / Q000737:chemistry*; D009420:Nervous System / Q000254:growth & development*; D010743:Phospholipids / Q000097:blood*; D011597:Psychomotor Performance; D012044:Regression Analysis
D005227:Fatty Acids; D043371:Fatty Acids, Omega-6; D005231:Fatty Acids, Unsaturated; D010743:Phospholipids; D004281:Docosahexaenoic Acids