Effect of dietary intervention to reduce the n-6/n-3 fatty acid ratio on maternal and fetal fatty acid profile and its relation to offspring growth and body composition at 1 year of age Effect of two doses of docosahexaenoic acid (DHA) in the diet of preterm infants on infant fatty acid status: results from the DINO trial. Maternal supplementation with very-long-chain n-3 fatty acids during pregnancy and lactation augments children's IQ at 4 years of age. Effect of maternal docosahexaenoic acid (DHA) supplementation on breast milk composition. Fatty acid composition in maternal milk and plasma during supplementation with cod liver oil Impact of early dietary gamma-linolenic acid supplementation on atopic eczema in infancy. Effects of margarine and butter consumption on distribution of trans-18∶1 fatty acid isomers and conjugated linoleic acid in major serum lipid classes in lactating women Allergic disease in infants up to 2 years of age in relation to plasma omega-3 fatty acids and maternal fish oil supplementation in pregnancy and lactation. Effects of maternal docosahexaenoic acid intake on visual function and neurodevelopment in breastfed term infants. The Effects of Fish Oil Supplementation in Pregnancy on Breast Milk Fatty Acid Composition Over the Course of Lactation: A Randomized Controlled Trial Dietary fat intakes for pregnant and lactating women. Maternal fish oil supplementation in lactation: Effect on visual acuity and n−3 fatty acid content of infant erythrocytes Fish oil supplementation of lactating mothers affects cytokine production in 2 1/2-year-old children Supplemental Conjugated Linoleic Acid Consumption Does Not Influence Milk Macronutrient Contents in all Healthy Lactating Women Maternal dietary alpine butter intake affects human milk: Fatty acids and conjugated linoleic acid isomers Maternal supplementation with CLA decreases milk fat in humans A randomized controlled trial of the effect of fish oil supplementation in late pregnancy and early lactation on the n−3 fatty acid content in human breast milk Fish Oil Supplementation During Lactation: Effects on Cognition and Behavior at 7 Years of Age High-fat dairy product consumption increases Δ9c’ 11t−18∶2 (rumenic acid) and total lipid concentrations of human milk Higher dose of docosahexaenoic acid in the neonatal period improves visual acuity of preterm infants: results of a randomized controlled trial. A randomized trial of supplementation with docosahexaenoic acid-rich tuna oil and its effects on the human milk cytokines interleukin 1 beta, interleukin 6, and tumor necrosis factor alpha. Effects of varying maternal dietary cholesterol and phytosterol in lactating women and their infants. The effect of hydrogenated fat in the diet of nursing mothers on lipid composition and prostaglandin content of human milk. Diet and blood pressure in 2.5-y-old Danish children. Nutritional effect of including egg yolk in the weaning diet of breast-fed and formula-fed infants: a randomized controlled trial. Maternal fish oil supplementation during lactation does not affect blood pressure, pulse wave velocity, or heart rate variability in 2.5-y-old children. Dietary fat type influences total milk fat content in lean women. The effects of dietary fatty acids and cholesterol on the milk lipids of lactating women and the plasma cholesterol of breast-fed infants. Similar effects on infants of n-3 and n-6 fatty acids supplementation to pregnant and lactating women. Maternal Fish Oil Supplementation in Lactation and Growth during the First 2.5 Years of Life Maternal fish oil supplementation in lactation: effect on developmental outcome in breast-fed infants. DHA Supplementation during Pregnancy and Lactation Affects Infants' Cellular but Not Humoral Immune Response The effect of maternal supplementation with linoleic and gamma-linolenic acids on the fat composition and content of human milk: a placebo-controlled trial. Maternal supplementation with docosahexaenoic acid during pregnancy does not affect early visual development in the infant: a randomized controlled trial. Infant feeding and childhood cognition at ages 3 and 7 years: Effects of breastfeeding duration and exclusivity. Effect of reducing the n-6:n-3 long-chain PUFA ratio during pregnancy and lactation on infant adipose tissue growth within the first year of life: an open-label randomized controlled trial. Dietary arachidonic acid dose-dependently increases the arachidonic acid concentration in human milk. Maternal fish oil supplementation during lactation may adversely affect long-term blood pressure, energy intake, and physical activity of 7-year-old boys. Supplementation of DHA but not DHA with arachidonic acid during pregnancy and lactation influences general movement quality in 12-week-old term infants. Docosahexaenoic acid transfer into human milk after dietary supplementation: a randomized clinical trial. Breast milk fatty acid profile in relation to infant growth and body composition: results from the INFAT study Th1 and Th2 Chemokines, Vaccine-Induced Immunity, and Allergic Disease in Infants After Maternal ω-3 Fatty Acid Supplementation During Pregnancy and Lactation Effect of maternal docosahexaenoic acid supplementation on postpartum depression and information processing. Does docosahexaenoic acid (DHA) status in pregnancy have any impact on postnatal growth? Six-year follow-up of a prospective randomized double-blind monocenter study on low-dose DHA supplements Oxidation of an Oil Rich in Docosahexaenoic Acid Compared to Linoleic Acid in Lactating Women Effect of docosahexaenoic acid supplementation of lactating women on the fatty acid composition of breast milk lipids and maternal and infant plasma phospholipids. Supplementation with 200 mg/Day Docosahexaenoic Acid from Mid-Pregnancy through Lactation Improves the Docosahexaenoic Acid Status of Mothers with a Habitually Low Fish Intake and of Their Infants Human milk fatty acids from lactating mothers of preterm infants: a study revealing wide intra- and inter-individual variation. Effect of increasing breast milk docosahexaenoic acid on plasma and erythrocyte phospholipid fatty acids and neural indices of exclusively breast fed infants Randomized, controlled trial to examine the impact of providing yogurt to women enrolled in WIC. The Impact of Nutritional Fatty Acids during Pregnancy and Lactation on Early Human Adipose Tissue Development Randomized controlled trial of docosahexaenoic acid supplementation in midwestern U.S. human milk donors. Effect of Supplementing Pregnant and Lactating Mothers With n-3 Very-Long-Chain Fatty Acids on Children's IQ and Body Mass Index at 7 Years of Age Effect of cooked and raw egg consumption on ovalbumin content of human milk: a randomized, double‐blind, cross‐over trial Does maternal docosahexaenoic acid supplementation during pregnancy and lactation lower BMI in late infancy? Neurodevelopmental outcomes of preterm infants fed high-dose docosahexaenoic acid: a randomized controlled trial. Improved Cognitive Development Among Preterm Infants Attributable to Early Supplementation of Human Milk With Docosahexaenoic Acid and Arachidonic Acid
Background / Objective : Evidence is accumulating that the long-chain PUFA ( LCPUFA ) are associated with offspring growth and body composition . We investigated the relationship between LCPUFAs in red blood cells ( RBCs ) of pregnant women/breastfeeding mothers and umbilical cord RBCs of their neonates with infant growth and body composition ⩽1 year of age . Subjects/ Methods : In an open-label r and omized , controlled trial , 208 healthy pregnant women received a dietary intervention ( daily supplementation with 1200 mg n-3 LCPUFAs and dietary counseling to reduce arachidonic acid ( AA ) intake ) from the 15th week of gestation until 4 months of lactation or followed their habitual diet . Fatty acids of plasma phospholipids ( PLs ) and RBCs from maternal and cord blood were determined and associated with infant body weight , body mass index ( BMI ) , lean body mass and fat mass assessed by skinfold thickness measurements and ultrasonography . Results : Dietary intervention significantly reduced the n-6/n-3 LCPUFA ratio in maternal and cord-blood plasma PLs and RBCs . Maternal RBCs docosahexaenoic acid ( DHA ) , n-3 LCPUFAs and n-6 LCPUFAs at the 32nd week of gestation were positively related to birth weight . Maternal n-3 LCPUFAs , n-6 LCPUFAs and AA were positively associated with birth length . Maternal RBCs AA and n-6 LCPUFAs were significantly negatively related to BMI and Ponderal Index at 1 year postpartum , but not to fat mass . Conclusion : Maternal DHA , AA , total n-3 LCPUFAs and n-6 LCPUFAs might serve as prenatal growth factors , while n-6 LCPUFAs also seems to regulate postnatal growth . The maternal n-6/n-3 LCPUFA ratio does not appear to have a role in adipose tissue development during early postnatal life Formula supplemented with docosahexaenoic acid ( DHA ) improves retinal function of preterm infants but the optimal dose is unknown . In a r and omized controlled trial we examined the effect of increasing the DHA concentration of human milk and formula on circulating fatty acids of preterm infants . Infants born <33 weeks gestation were fed high-DHA milk ( 1 % total fat as DHA ) or st and ard-DHA milk ( 0.2 - 0.3 % DHA ) until reaching their estimated due date ( EDD ) . Milk arachidonic acid ( AA ) concentration was approximately 0.5 % for both groups . At EDD , erythrocyte membrane phospholipid DHA was elevated in the high-DHA group compared with st and ard-DHA ( mean+/-SD , high-DHA 6.8+/-1.2 , st and ard-DHA 5.2+/-0.7 , p<0.0005 ) but AA was lower ( high-DHA 14.9+/-1.3 , st and ard-DHA 16.0+/-1.2 , p<0.0005 ) . Feeding preterm infants human milk and formula with 1 % DHA raises but does not saturate erythrocyte phospholipids with DHA . Milk exceeding 1 % DHA may be required to increase DHA status to levels seen in term infants OBJECTIVES Docosahexaenoic acid ( DHA ; 22:6 n-3 ) and arachidonic acid ( AA ; 20:4 n-6 ) are important for development of the central nervous system in mammals . There is a growth spurt in the human brain during the last trimester of pregnancy and the first postnatal months , with a large increase in the cerebral content of AA and DHA .  The fetus and the newborn infant depend on maternal supply of DHA and AA . Our hypothesis was that maternal intake of DHA during pregnancy and lactation is marginal and that high intake of this fatty acid would benefit the child . We examined the effect of supplementing pregnant and lactating women with very-long-chain n-3 polyunsaturated fatty acids ( PUFAs ; cod liver oil ) on mental development of the children , compared with maternal supplementation with long-chain n-6 PUFAs ( corn oil ) . METHODS The study was r and omized and double-blinded . Pregnant women were recruited in week 18 of pregnancy to take 10 mL of cod liver oil or corn oil until 3 months after delivery . The cod liver oil contained 1183 mg/10 mL DHA , 803 mg/10 mL eicosapentaenoic acid ( 20:5 n-3 ) , and a total of 2494 mg/10 mL summation operator n-3 PUFAs . The corn oil contained 4747 mg/10 mL linoleic acid ( 18:2 n-6 ) and 92 mg/10 mL alpha-linolenic acid ( 18:3 n-3 ) . The amount of fat-soluble vitamins was identical in the 2 oils ( 117 micro g/mL vitamin A , 1 micro g/mL vitamin D , and 1.4 mg/mL dl-alpha-tocopherol ) . A total of 590 pregnant women were recruited to the study , and 341 mothers took part in the study until giving birth . All infants of these women were scheduled for assessment of cognitive function at 6 and 9 months of age , and 262 complied with the request . As part of the protocol , 135 subjects from this population were invited for intelligence testing  with the Kaufman Assessment Battery for Children ( K-ABC ) at 4 years of age . Of the 135 invited children , 90 came for assessment . Six children did not complete the examination . The K-ABC is a measure of intelligence and achievement design ed for children aged 2.5 years through 12.5 years . This multisubtest battery comprises 4 scales : Sequential Processing , Simultaneous Processing , Achievement ( not used in the present study ) , and Nonverbal Abilities . The Sequential Processing and Simultaneous Processing scales are hypothesized to reflect the child 's style of problem solving and information processing . Scores from these 2 scales are combined to form a Mental Processing Composite , which serves as the measure of intelligence in the K-ABC . RESULTS We received dietary information from 76 infants ( 41 in the cod liver oil group and 35 in the corn oil group ) , documenting that all of them were breastfed at 3 months of age . Children who were born to mothers who had taken cod liver oil ( n = 48 ) during pregnancy and lactation scored higher on the Mental Processing Composite of the K-ABC at 4 years of age as compared with children whose mothers had taken  corn oil  ( n = 36 ; 106.4 [ 7.4 ] vs 102.3 [ 11.3 ] ) . The Mental Processing Composite score correlated significantly with head circumference at birth ( r = 0.23 ) , but no relation was found with birth weight or gestational length . The children 's mental processing scores at 4 years of age correlated significantly with maternal intake of DHA and eicosapentaenoic acid during pregnancy . In a multiple regression model , maternal intake of DHA during pregnancy was the only variable of statistical significance for the children 's mental processing scores at 4 years of age . CONCLUSION Maternal intake of very-long-chain n-3 PUFAs during pregnancy and lactation may be favorable for later mental development of children OBJECTIVE To assess the effect of varying maternal intake of docosahexaenoic acid ( DHA , 22 : 6n-3 ) , in the absence of other dietary polyunsaturates , on breast milk fatty acids . DESIGN AND INTERVENTION Lactating mothers were r and omised on day 5 post-partum to groups consuming equal numbers of capsules but containing either placebo or an oil containing DHA ( 43 % ) as its only polyunsaturate to receive 0 , 0.2 , 0.4 , 0.9 , 1.3 g DHA/day . Breast milk fatty acids as well as maternal plasma and erythrocyte phospholipids were assessed at 12 weeks post partum by capillary gas chromatography . RESULTS Breast milk DHA levels ranged from 0.2 to 1.7 % of total fatty acids and increased in a dose dependent manner ( r2 = 0.89 , P < 0.01 ) . Maternal plasma ( r2 = 0.71 , P < 0.01 ) and erythrocyte ( r2 = 0.77 , P < 0.01 ) phospholipid DHA levels increased and were also strongly associated with dietary dose of DHA . Increasing maternal dietary doses of DHA did not affect breast milk arachidonic acid ( AA , 20 : 4n-6 ) levels or antioxidant status as measured by plasma vitamin A or E levels . CONCLUSIONS Our results have demonstrated that DHA in the diet has a strong , specific and dose-dependent effect on breast milk DHA Objective : We investigated how cod liver oil influences the amount of essential fatty acids in mothers ’ breast milk . Design and Intervention : Lactating mothers ( n=22 ) were r and omized into four groups 3–8 weeks after parturition . They were supplemented for 14 days with 0 , 2.5 , 5 and 10 ml cod liver oil ( 7.7 g eicosapentaenoic acid ( EPA , 20:5n-3 ) , 10.2 g docosahexaenoic acid ( DHA , 22:6n-3 ) and 22.9 g n-3 fatty acids in total per 100 ml ) . Results : In maternal plasma phospholipids there was an increase in the content of EPA and DHA in the group supplemented with 10 ml cod liver oil daily ( P≤0.05 ) . DHA concentrations in breast milk pre-supplementation ranged from 0.15 to 1.56 wt% and increased in all supplemented groups ( P≤0.05 ) . The concentration of EPA in breast milk increased in the groups supplemented with 5 or 10 ml cod liver oil ( P≤0.05 ) , whereas the concentration of arachidonic acid ( AA , 20:4n-6 ) did not change in any of the supplemented groups . Total intake of DHA adjusted to body mass index ( BMI ) , correlated to DHA concentrations in plasma ( r=0.49 , P=0.02 ) and breast milk ( r=0.45 , P=0.04 ) . The concentration of tocopherol did not change during the supplementation period , neither in plasma nor in breast milk . Conclusion : Dietary intake of DHA is reflected in the concentration of DHA in breast milk , without affecting the concentration of AA or tocopherol . Sponsorship : Supported by Peter Möller avd . av Orkla Polyunsaturated fatty acids ( PUFAs ) are components of cell membranes and may play an immunomodulating role in the pathogenesis of atopic dermatitis ( AD ) . The goal was to determine the impact of PUFAs on AD by dietary supplementation of infants . Based on the parents ' decision on their babies ' primary feeding , mothers and newborns were r and omized to the supplementation with gamma-linolenic acid ( GLA ) or placebo for up to 6 months . Breastfed infants received GLA by supplementing their mothers . Formula diet was commercial whey hydrolysate unsupplemented with PUFAs .  Of 131 eligible infants , 24 developed AD within the first year of life . Of these , nine belonged to the exclusively breastfed group ( n = 58 ) , 14 to the combined-fed group ( n = 53 ) , and one to the never breastfed group ( n = 20 ) . We could not find an influence of GLA on the development of AD . In subjects with AD , at 1 yr of age the serum-immunoglobulin E ( IgE ) was the lowest in the GLA-supplemented group A-subjects . In the GLA-supplemented group , GLA-levels in breast milk were similar in atopic and non-atopic infants . In the non-supplemented group the GLA-content of breast milk was 0.07 % of total fatty acids in atopic infants vs. 0.17 % in non-atopic infants ( p < 0.01 ) . Dietary GLA-supplementation could not prevent AD . Interestingly , the number of infants developing AD was the lowest in never breastfed children . In infants suffering from AD , GLA-supplementation seemed to reduce total IgE in the first year of life Trans FA ( TFA ) have at least one trans double bond and comprise several isomers and types , including many of the CLA ( e.g. , c9 , t11–18∶2 CLA ) . Some TFA may have adverse effects ( e.g. , cardiovascular disease ) , whereas some are though to have beneficial effects ( e.g. , anticarcinogenicity ) . The presence of TFA in human tissues and fluids is related to dietary intake , although this relationship is not completely understood — especially in regard to serum lipid fractions . This study was conducted as part of an investigation design ed to test the influence of butter ( B ) , “ low TFA ” margarine ( LT ) , and regular margarine ( RM ) on milk fat content . Here we tested the secondary hypothesis that consumption of B , LT , and RM by lactating women would result in differential distribution of TFA and CLA in major serum lipid classes . Breastfeeding women ( n=11 ) participated in this r and omized Latinsquare study consisting of five periods : intervention I ( 5 d ) , washout I ( 7 d ) , intervention II ( 5 d ) , washout II ( 7 d ) , and intervention III ( 5 d ) . Extracted serum lipid was separated into cholesterol ester ( CE ) , TAG , and phospholipid ( PL ) fractions and analyzed for total and isomeric TFA and CLA concentrations . Data indicate that TAG consistently contained the highest concentration of total t-18∶1 . No interaction between treatment and fraction was found for any of the t-18∶1 isomers identified . Absolute concentration of each t-18∶1 isomer was greatest during the RM period , regardless of fraction . On a relative basis , concentrations of t10–18∶1 and t12–18∶1 were most responsive to treatment in the CE fraction . The concentration of c9 , t11–18∶2 CLA was highest in the TAG fraction and lowest in the PL fraction , regardless of treatment . In summary , these results indicate ( i ) that there is a differential distribution of some isomeric TFA and CLA among human serum lipid fractions and ( ii ) that dietary TFA intake influences absolute and relative concentrations of some of the isomers in selected fractions We have previously reported a protective effect of maternal omega-3 long-chain polyunsaturated fatty acids ( ω-3 LCPUFA ) supplementation in pregnancy and lactation on IgE-associated eczema and food allergy in the infant during the first year of life . Here we investigate whether the effects of the LCPUFA supplementation on IgE-associated diseases last up to 2 yr of age and assess the relationship between plasma proportions of ω-3 PUFAs and the frequency and severity of infant allergic disease . 145 pregnant women , at risk of having an allergic infant , were r and omized to daily supplementation with 1.6 g eicosapentaenoic acid ( EPA ) and 1.1 g docosahexaenoic acid ( DHA ) or placebo starting in the 25th gestational week and continuing through 3.5 months of breastfeeding . Clinical examinations , skin prick tests and analysis of maternal and infant plasma phospholipid fatty acids and infant specific IgE were performed . No difference in the prevalence of allergic symptoms was found between the intervention groups . The cumulative incidence of IgE-associated disease was lower in the ω-3-supplemented group ( 6/54 , 13 % ) compared with the placebo group ( 19/62 , 30 % , p=0.01 ) . Higher maternal and infant proportions of DHA and EPA were associated with lower prevalence of IgE associated disease ( p=0.01 - 0.05 ) in a dose-dependent manner . Higher maternal and infant proportions of DHA and EPA were found if the infants presented none , when compared with multiple allergic symptoms , ( p<0.05 ) regardless of sensitization . In summary , the ω-3 supplementation offered no obvious preventive effect on the prevalence of clinical symptoms of allergic disease , but the decrease in cumulative incidence of IgE-associated disease seen during the first year still remained until 2 yr of age . Furthermore , high proportions of DHA and EPA in maternal and infant plasma phospholipids were associated with less IgE-associated disease and a reduced severity of the allergic phenotype BACKGROUND Normal brain and visual development is thought to require exogenous docosahexaenoic acid ( DHA ; 22:6n-3 ) intake , but the amount needed is debatable . Because the supplementation of breastfeeding mothers with DHA increases the DHA content of their infants ' plasma lipids , we hypothesized that it might also improve brain or visual function in the infants . OBJECTIVE The objective was to determine the effect of DHA supplementation of breastfeeding mothers on neurodevelopmental status and visual function in the recipient infant . DESIGN Breastfeeding women received capsules containing either a high-DHA algal oil ( approximately 200 mg DHA/d ) or a vegetable oil ( no DHA ) for 4 mo after delivery . Outcome variables included the fatty acid pattern of maternal plasma phospholipid and milk lipids 4 mo postpartum , the fatty acid pattern of plasma phospholipids and visual function in infants at 4 and 8 mo of age , and neurodevelopmental indexes of the infants at 12 and 30 mo of age . RESULTS Milk lipid and infant plasma phospholipid DHA contents of the supplemented and control groups were approximately 75 % and approximately 35 % higher , respectively , at 4 mo postpartum . However , neither the neurodevelopmental indexes of the infants at 12 mo of age nor the visual function at 4 or 8 mo of age differed significantly between groups . In contrast , the Bayley Psychomotor Development Index , but not the Mental Development Index , of the supplemented group was higher ( P < 0.01 ) at 30 mo of age . CONCLUSION DHA supplementation  of breastfeeding mothers results in higher infant plasma phospholipid DHA contents during supplementation and a higher Bayley Psychomotor Development Index at 30 mo of age but results in no other advantages either at or before this age This study evaluated the longitudinal effect of fish oil in pregnancy on breast milk fatty acid composition and infant outcomes . In a r and omized , controlled trial , 98 women received 2.2 g docosahexaenoic acid ( DHA ) and 1.1 g eicosapentaenoic acid ( EPA ) or olive oil from 20 wk of gestation until delivery .  Fatty acid composition in breast milk ( at 3 d , 6 wk , and 6 mo ) and infant erythrocyte membranes ( at 1 y ) were determined by gas liquid chromatography . Breast milk fatty acids were examined in relationship to growth and development . Compared with control group , breast milk from women who received fish oil had proportionally higher DHA and EPA levels at 3 d and 6 wk after delivery , but this difference was no longer apparent by 6 mo . Infant DHA status at 1 y of age was directly related to DHA levels at 3 d , 6 wk , and 6 mo postpartum ( but not to antenatal supplementation ) . Both EPA and DHA in breast milk were positively correlated with Griffith 's developmental scores including h and and eye coordination . Thus , supplementation in pregnancy was associated with increased n-3 long-chain polyunsaturated fatty acids ( LCPUFAs ) in breast milk , particularly in early lactation , and this was positively associated with infant DHA status at 1 Dietary fat intake in pregnancy and lactation affects  pregnancy outcomes  and child growth , development and health . The European Commission charged the research project PERILIP , jointly with the Early Nutrition Programming Project , to develop recommendations on dietary fat intake in pregnancy and lactation . Literature review s were performed and a consensus conference held with international experts in the field , including representatives of international scientific associations . The adopted conclusions include : dietary fat intake in pregnancy and lactation ( energy% ) should be as recommended for the general population ; pregnant and lactating women should aim to achieve an average dietary intake of at least 200 mg DHA/d ; intakes of up to 1 g/d DHA or 2.7 g/d n-3 long-chain PUFA have been used in r and omized clinical trials without significant adverse effects ; women of childbearing age should aim to consume one to two portions of sea fish per week , including oily fish ; intake of the DHA precursor , alpha-linolenic acid , is far less effective with regard to DHA deposition in fetal brain than preformed DHA ; intake of fish or other sources of long-chain n-3 fatty acids results in a slightly longer pregnancy duration ; dietary inadequacies should be screened for during pregnancy and individual counselling be offered if needed Studies on formula-fed infants indicate a beneficial effect of dietary DHA on visual acuity . Cross-sectional studies have shown an association between breast-milk DHA levels and visual acuity in breast-fed infants . The objective in this study was to evaluate the biochemical and functional effects of fish oil ( FO ) supplements in lactating mothers . In this double-blinded r and omized trial , Danish mothers with habitual fish intake below the 50th percentile of the Danish National Birth Cohort were r and omized to microencapsulated FO [ 1.3 g/d long-chain n−3 FA ( n−3 LCPUFA ) ] or olive oil ( OO ) . The intervention started within a week after delivery and lasted 4 mon . Mothers with habitual high fish intake and their infants were included as a reference group . Ninety-seven infants completed the trial ( 44 OO-group , 53 FO-group ) and 47 reference infants were followed up . The primary outcome measures were : DHA content of milk sample s ( 0 , 2 , and 4 mon postnatal ) and of infant red blood cell ( RBC ) membranes ( 4 mon postnatal ) , and infant visual acuity ( measured by swept visual evoked potential at 2 and 4 mon of age ) . FO supplementation gave rise to a threefold increase in the DHA content of the 4-mon milk sample s ( P<0.001 ) . DHA in infant RBC reflected milk contents ( r=0.564 , P<0.001 ) and was increased by almost 50 % ( P<0.001 ) . Infant visual acuity was not significantly different in the r and omized groups but was positively associated at 4 mon with infant RBC-DHA ( P=0.004 , multiple regression ) . We concluded that maternal FO supplementation during lactation did not enhance visual acuity of the infants who completed the intervention . However , the results showed that infants with higher RBC levels of n−3 LCPUFA had a better visual acuity at 4 mon of age , suggesting that n−3 LCPUFA may influence visual maturation Abstract n−3 PUFA influence immune functioning and may affect the cytokine phenotype during development . To examine whether maternal fish oil supplementation during lactation could modify later  immune responses in children , 122 lactating Danish mothers with a fish intake below the population median were r and omized to groups supplemented for the first 4 mon of lactation with 4.5 g/d of fish oil ( equivalent to 1.5 g/d of n−3 long-chain PUFA ) or olive oil .  Fifty-three mothers with a fish intake in the highest quartile of the population were also included . The FA composition of erythrocyte membranes was measured at 4 mon and at 2 1/2 yr . Plasma immunoglobulin E ( IgE ) levels and cytokine production in lipopolysaccharide-stimulated whole-blood cultures were determined at 2 1/2 yr . Erythrocyte n−3 PUFA at 4 mon were higher in infants from the fish oil group compared with the olive oil group ( P<0.001 ) but were no longer different at 2 1/2 yr . The median production of lipopolysaccharide-induced interferon γ(IFN-γ ) in the fish oil group was fourfold higher than that in the olive oil group ( P=0.034 ) , whereas interleukin-10 ( IL-10 ) production was similar . The IFN-γ/IL-10 ratio was twofold higher in the fish oil group ( P=0.019 ) and was positively correlated with 20∶5n−3/20∶4n−6 in erythrocytes at 4 mon ( P=0.050 ) . The percentages of atopic children and plasma IgE were not different in the two groups , but the study was not design ed to look at atopy . Cytokine responses and erythrocyte FA composition in children of mothers with a high fish intake were intermediate in comparison with those in the r and omized groups . Fish oil supplementation during lactation result ed in increased in vitro IFN-γ production in the children 2 yr after the supplementation was given , which may reflect a faster maturation of the immune system The term “ conjugated linoleic acid ” ( CLA ) refers to a group of positional and geometric isomers that are derived from linoleic acid and are found primarily in meat and milk products from ruminant animals . Due to the array of putative benefits associated with various forms of CLA , there has been recent interest in supplementing human diets with these fatty acids especially when weight loss is desired . However , in many animal models , CLA has been shown to decrease milk fat production . There is some concern , therefore , that maternal CLA supplementation during lactation might inadvertently decrease nutrient supply to the nursing infant . However , there is only limited research on the effect of CLA consumption on milk fat content in women . Based on previously published work from our laboratory , we hypothesized that CLA supplementation would reduce the milk fat percentage in lactating women in a dose-dependent manner . Breastfeeding women ( n = 12 ) were assigned r and omly to treatments of 4 g/day safflower oil ( SFO ) , 2 g/day CLA plus 2 g/day SFO , or 4 g/day CLA in a double blind , 3 × 3 Latin square design . Conjugated linoleic acid supplements contained approximately equal amounts of cis9,trans11–18:2 and trans10,cis12–18:2 ; the two most common isoforms of CLA . Milk was collected by complete breast expression on the last day ( day 5 ) of each intervention period and analyzed for macronutrient and fatty acid composition . On day 4 of each intervention period , infant milk consumption was estimated by 24 h weighing of the infant . Washout periods were 9 days in length . We observed a dose-dependent increase in the concentrations of cis9,trans11–18:2 and trans10,cis12–18:2 in the milk fat . However , we detected neither a change in overall macronutrient composition nor infant milk consumption . These data do not support those obtained from animal models or our previous human work suggesting that consumption of CLA mixtures necessarily reduces milk fat . It is possible that either ( 1 ) the interpretation of our previously published data should be reevaluated , and /or ( 2 ) there are important intra- and inter-species differences in this regard Consumption of CLA by lactating women affects the composition of their milk , but the pattern of the different CLA isomers is still unknown . We determined the effects of short  maternal supplementation with CLA-rich Alpine butter  on the occurrence of FA and CLA isomers in human milk . In an open r and omized controlled study with a two-period cross-over design , milk FA and CLA isomer concentrations were measured on postpartum days > -20 in two parallel groups of lactating women before , during , and after consumption of defined quantities of Alpine butter or margarine with comparable fat content ( 10 d of butter followed by 10 d of margarine for one group , and vice versa in the other ) . In the 16 women who completed the study ( 8/group )  , Alpine butter supplementation , increased the C16 and C18 FA , the sum of saturated FA , the 18∶1 trans FA , and the trans FA with CLA . The CLA isomer 18∶2 c9 , t11 increased by 19.7 % . Significant increases were also found for the isomers t9,t111 , t7,c9,t11,c13 , and t8,c10 18∶2 . The remaining nine of the total 14 detectable isomers showed no changes , and concentrations were < 5 mg/100 g fat . A breastfeeding mother can therefore modulate the FA/CLA supply of her child by consuming Alpine butter . Further studies will show whether human milk containing this FA and CLA isomer pattern acts as a functional food for newborns CLA refers to isomers of octadecadienoic acid with conjugated double bonds . The most abundant form of CLA ( rumenic acid ( RA ) : c9,t11 - 18∶2 ) is found in milk and beef fat . Further , CLA supplements containing RA and t10,c12−18∶2 are now available . Consumption of commercially produced CLA has been shown to decrease adipose accretion in growing laboratory and production animals and cause milk fat depression in cows . We tested the hypothesis that CLA supplementation would increase milk CLA concentration and decrease milk fat content in humans . Breastfeeding women ( n=9 ) participated in this double-blind , placebo-controlled , crossover study divided into three periods : intervention l ( 5 d ) , washout ( 7 d ) , and intervention II ( 5 d ) . Women were r and omized to treatment order . During each intervention period , women consumed 1.5 g of CLA supplement or placebo ( olive oil ) daily ; during the washout period , no supplements were consumed . Milk was collected by complete breast expression on the final day of each period ; milk output was estimated by 24-h weighing on the penultimate day of each intervention period . Milk RA and t10,c12−18∶2 concentrations were greater ( P<0.05 ) during the CLA treatment period as compared to the placebo period . Milk fat content was significantly lower during the CLA treatment , as compared to the placebo treatment ( P<0.05 ) . Data indicate no effect of treatment on milk output . Therefore , it would be prudent that lactating women not consume commercially available CLA supplements at this time The aim of this research was to investigate the effect of fish oil supplementation , in the third trimester of pregnancy and early lactation period of healthy pregnant Danish women . Forty-four pregnant women were r and omly allocated to fish oil supplementation ( 1.3 g EPA and 0.9 g DHA per day ) from week 30 of gestation ( FO-group ) or to a control regimen ( olive oil or no oil ; controls ) . The FO-group was r and omly subdivided into women stopping fish oil supplementation at delivery [ FO(pregn ) ] , and women continuing supplementation for an , additional 30 d [ FO(pregn/lact ) ] . Thirty-six women agreed to collect milk sample s at days 4 , 16 , and 30 postpartum . The FA composition of the milk sample s was determined by GLC . At days 4 , 16 , and 30 in lactation , FO(pregn/lact ) women ( n=12 ) had , respectively 2.3 ( P=0.001 ) , 4.1 ( P=0.001 ) , and 3.3 ( P=0.001 ) times higher mean contents of LCPUFA(n−3 ) in their breast milk compared with controls ( n=13 ) , and 1.7 ( P=0.005 ) , 2.8 ( P=0.001 ) , and 2.8 ( P=0.001 ) , times higher LCPUFA(n−3 ) contents , respectively , at these days compared with FO(pregn ) women ( n=11 ) . The latter group did not differ significantly from controls with regard to LCPUFA(n−3 ) content in the breast milk . Similar results were obtained when analyzing separately for effects on the milk content of DHA . Dietary supplementation with 2.7 g LCPUFA(n−3 ) per day from week 30 of gestation and onward more than tripled the LCPUFA(n−3 ) content in early breast milk ; supplementation limited to pregnancy only was much less effective Early accumulation of n-3 long-chain PUFA ( LCPUFA ) in the brain may contribute to differences in later cognitive abilities . In this study , our objective was to examine whether fish oil ( FO ) supplementation during lactation affects processing speed , working memory , inhibitory control , and socioemotional development at 7 years . Danish mothers ( n = 122 ) were r and omized to FO [ 1.5 g/d n-3 LCPUFA ] or olive oil ( OO ) supplementation during the first 4 months of lactation . The trial also included a high-fish intake ( HFI ) reference group ( n = 53 ) . Ninety-eight children were followed-up with an assessment of processing speed , an age-appropriate Stroop task , and the Strength and Difficulties Question naire  at 7 year . A group effect of the intervention ( FO vs. OO ) was found in prosocial behavior scores ; this negative effect was carried by the boys . Exploratory analyses including all participants revealed the speed of processing scores were predicted by maternal n-3 LCPUFA intake during the intervention period ( negative relation ) and maternal education ( positive relation ) . Stroop scores indicative of working memory and inhibitory control were predicted by infant erythrocyte DHA status at 4 months of age ( negative relation ) . Early fish oil supplementation may have a negative effect on later cognitive abilities . Speed of processing and inhibitory control/working memory are differentially affected , with speed of processing showing effects of fish oil intake as a whole , whereas inhibitory control/working memory was related more specifically to DHA status Conjugated octadecadienoic acids ( 18∶2 ’ conjugated linoleic acids ) have been shown to be anticarcinogenic and may influence growth and nutrient partitioning . The Δ9c ’ 11t−18∶2 isomer ( rumenic acid ’ RA ) is most common in both food sources and human tissues . To determine if maternal diet can influence milk RA concentration ’ breastfeeding women ( n=16 ) were enrolled in a 3-wk crossover study . Women initially consumed minimal amounts of food containing RA during week 1 ’ then were assigned r and omly to consume diets rich in high-fat dairy foods ( and thus RA ) during week 2 or 3 . Milk was collected by complete breast expression twice during each experimental week . Current and chronic RA intakes were estimated by 3-d dietary records and food frequency question -naires ’ respectively . Estimated chronic RA intakes ranged from 49 to 659 mg/d . Dietary RA intake was greater during the high compared to the low dairy period ( 291±75 vs. 15±24 mg/d ’ respectively ; P<0.0001 ) . Milk contained more RA during the high than the low dairy period ( 13.5±0.1 vs. 8.2±0.4 μmol/g lipid ’ respectively ; P<0.0001 ) . Milk lipid concentration was influenced by diet ’ such that lipid concentration was greater during the high than the low dairy period ( 46.6±5.0 vs. 38.3±1.6 mg/g milk ’ respectively ; P<0.05 ) . Additionally ’ multiple regression analyses suggested that body mass index was the primary predictor of milk RA and lipid concentrations . In summary ’ these data indicate that both lipid and RA concentrations of human milk can be influenced by diet BACKGROUND Preterm infants have improved visual outcomes when fed a formula containing 0.2 - 0.4 % docosahexaenoic acid ( DHA ) compared with infants fed no DHA , but the optimal DHA dose is unknown . OBJECTIVE We assessed visual responses of preterm infants fed human milk ( HM ) and formula with a DHA concentration estimated to match the intrauterine accretion rate ( high-DHA group ) compared with infants fed HM and formula containing DHA at current concentrations . DESIGN A double-blind r and omized controlled trial studied preterm infants born at <33 wk gestation and fed HM or formula containing 1 % DHA ( high-DHA group ) or approximately 0.3 % DHA ( current practice ; control group ) until reaching their estimated due date ( EDD ) . Both groups received the same concentration of arachidonic acid . Sweep visual evoked potential ( VEP ) acuity and latency were assessed at 2 and 4 mo corrected age ( CA ) . Weight , length , and head circumference were assessed at EDD and at 2 and 4 mo CA . RESULTS At 2 mo CA , acuity of the high-DHA group did not differ from the control group [ high-DHA group ( x + /- SD ) : 5.6 + /- 2.4 cycles per degree ( cpd ) , n = 54 ; control group : 5.6 + /- 2.4 cpd , n = 61 ; P = 0.96 ] . By 4 mo CA , the high-DHA group exhibited an acuity that was 1.4 cpd higher than the control group ( high-DHA : 9.6 + /- 3.7 cpd , n = 44 ; control : 8.2 + /- 1.8 cpd ; n = 51 ; P = 0.025 ) . VEP latencies and anthropometric measurements were not different between the high-DHA and control groups . CONCLUSION The DHA requirement of preterm infants may be higher than currently provided by preterm formula or HM of Australian women BACKGROUND Increased consumption of n-3 long-chain polyunsaturated fatty acids ( PUFAs ) has been recommended during pregnancy and lactation . The production of proinflammatory cytokines by human peripheral blood mononuclear cells ( P BMC s ) can be modified by dietary n-3 PUFAs . OBJECTIVE We sought to determine whether dietary supplementation of lactating women with docosahexaenoic acid ( DHA ) can modulate the concentration of cytokines in the aqueous phase of human milk and the production of cytokines by human milk cells ( HMCs ) and P BMC s. DESIGN In this double-blind , prospect i ve , r and omized trial , mothers of healthy full-term infants were asked to consume daily a nutritional supplement of 2000 mg oil containing either placebo ( n = 40 ) , 300 mg DHA + 70 mg eicosapentaenoic acid ( EPA ; n = 40 ) , or 600 mg DHA + 140 mg EPA ( n = 40 ) . The fatty acid composition of plasma , P BMC s , milk , and HMCs from lactating mothers at 4 wk postpartum was measured by gas chromatography . The concentration of interleukin 6 and tumor necrosis factor alpha in milk and the production of interleukin 1beta , tumor necrosis factor alpha , and interleukin 6 by P BMC s and HMCs after stimulation with lipopolysaccharide was measured by enzyme-linked immunosorbent assay . RESULTS At 4 wk postpartum , 82 mothers were still breast-feeding their infants .  DHA increases in maternal plasma , P BMC s , milk , and HMCs were proportional to dietary DHA . There was no relation between tissue DHA status and cytokine concentrations . CONCLUSIONS Consumption of < or = 600 mg DHA and 140 mg EPA/d for 4 wk increased n-3 PUFA concentrations in relevant tissues but did not cause perturbations in cytokine concentrations in human milk Relationships between maternal cholesterol and phytosterol intake , and concen- trations of cholesterol and phytosterol in maternal plasma , breast milk , and infant plasma were evaluated in 14 lactating mothers and their infants . The mothers took an ad libitum diet for 30 days after delivery and then were r and omized to one oftwo diets : one containing 190 mg cholesterol and 1200 mg phytosterol per day , and a polyunsaturated/saturated fat ratio of 1.8 ; the second , a high cholesterol diet calculated to contain 520 mg cholesterol and 50 mg phytosterol/day , with a polyunsaturated/saturated fat ratio of 0 . 12 . After 4 weeks on either diet , the mothers then crossed over to the other for a second 4 week period . Breast milk constituted the infants ' sole intake during the two periods . During the ad libitum , low cholesterol-phytosterol enriched , and high cholesterol- low phytosterol diet periods , mean ± SE breast milk cholesterol ( milligrams per grams total milk fat ) was unchanged ( 2.4 ± 0.4 , 2.4 ± 0.1 , and 2.5 ± 0.2 , respectively ) , despite a significant reduction of maternal plasma cholesterol from 220 ± 14 mg/dl ( ad libitum ) to 166 ± 7 ( low cholesterol diet ) , and 186 ± 6 ( high cholesterol diet ) . Infant plasma cholesterol , 143 ± 8 mg/dl on maternal ad libitum diet , was not significantly changed during maternal low cholesterol diet ( 140 ± 7 ) , or during maternal high cholesterol diet ( 150 ± 8) . Maternal milk phytosterol ( 0.17 ± 0.03 mg/g ) on ad libitum diet , rose to 2.2 ± 0.3 on low cholesterol-phytosterol enriched diet , and fell to 0.7 ± 0.1 on the high cholesterol-low phytosterol diet , P < 0.0001 . Maternal plasma phytosterol levels changed similarly , being 2.3 ± 0.9 mg/dl on ad libitum , 11.7 ± 0.9 on low cholesterol , and 4.9 ± 1.3 on high cholesterol intakes , P < 0.0001 . Infant plasma phytosterol levels , 0.37 ± 0.04 mg/dl on both maternal ad libitum and high cholesterol intakes , rose to 0.54 ± 0.05 on maternal low cholesterol , phytosterol enriched diet ( P < 0.01 ) . Maternal dietary and plasma phytosterol levels were closely correlated ( r = 0.62 , P = 0.0001 ) , as were plasma and milk phytosterol levels ( r = 0.39 , P = 0.02 ) . Milk phytosterol and infant plasma phytosterol levels were also closely related ( r = 0.43 , P = 0.008 ) . Conversely for cholesterol , the only significant maternal correlation was between dietary and plasma levels , r = 0.43 , P = 0.004 . No significant correlations were observed between maternal plasma and milk cholesterol levels , or between maternal milk and infant plasma cholesterol levels . On the polyunsaturate enriched as compared to a saturate enriched diet , milk content of linoleic acid was more than doubled , while oleic , palmitoleic , stearic , palmitic , and myristic acid levels were reduced . Am . J. Clin . Nut , . 31 : 1347 - 1354 , 1978 To study the effects of hydrogenated fat in the maternal diet on lipid composition and prostagl and in content of human milk  , eight nursing mothers , 2 months postpartum , were provided with two 5-day diets in a cross-over design with an intervening 2-day period . Diets for the two periods were identical except that sources of hydrogenated fat were used in the meals for one period and nonhydrogenated fat in the other . Trans-isomers of octadecenoic acid ( 18:lt ) comprised 11.8 % of the total fatty acids in the hydrogenated fat diet compared with 1.0 % in the nonhydrogenated fat diet . The 18:lt content of milk collected daily during hydrogenated fat consumption was 6.5 % of the total fatty acids and was significantly higher ( p less than 0.01 ) than the 18:lt content ( 1.8 % of the total fatty acids ) of milk collected during nonhydrogenated fat consumption . The amount of 18:lt in the milk was positively correlated ( r = 0.909 ) with the 18:lt content in the previous day 's diet . Although detectable concentrations of prostagl and ins PGF2 alpha and PGE were found in human milk , their concentrations were not affected by hydrogenated fat in the maternal diet BACKGROUND Blood pressure tracks from childhood into adulthood , and early diet may have long-term effects on hypertension . OBJECTIVE The study 's aim was to investigate whether intakes of n-3 long-chain polyunsaturated fatty acids ( n-3 LC-PUFAs ) during lactation and current intakes of macronutrients affect blood pressure in 2.5-y-old Danish children . DESIGN Mothers ( n = 122 ) with low fish intakes were r and omly assigned to receive supplementation with 4.5 g fish oil or olive oil/d during the first 4 mo of lactation . The trial also included 53 mothers with high fish intakes . One hundred five of these women 's children attended a 2.5-y follow-up examination at which anthropometric data and blood pressure were obtained . Mothers then kept a 7-d dietary record of food consumed by their children . A full set of data from 73 children was analyzed for effects of fish oil supplementation and cross-sectional correlations with current diet . RESULTS We found no significant effect of the mothers ' fish oil intakes during the first 4 mo of lactation on the blood pressure of the children 2.5 y later . Greater protein intakes measured as a percentage of energy were associated cross-sectionally with significantly lower diastolic and systolic blood pressures in the children at age 2.5 y after control for outdoor temperature , age , sex , weight , and height ( P = 0.028 and 0.035 , respectively ) . Greater protein intakes measured as g/d were also associated with significantly lower systolic blood pressures ( P = 0.008 ) . A 1-SD increase in protein intake corresponded with a decrease of approximately 3 mm Hg in systolic blood pressure . CONCLUSION The blood pressure of young Danish children was not significantly affected by intakes of n-3 LC-PUFAs via breast milk , but greater protein intakes at 2.5 y were associated with lower blood pressure BACKGROUND Egg yolks can be a source of docosahexaenoic acid ( DHA ) and iron but are often associated with adverse consequences on plasma cholesterol . OBJECTIVE Our goal was to investigate the effect of consumption of 4 egg yolks/wk on infant DHA status and hemoglobin , ferritin , and plasma cholesterol concentrations . Secondary outcomes included plasma iron , transferrin , and transferrin saturation . DESIGN This was a r and omized controlled trial comparing no dietary intervention , consumption of 4 regular egg yolks/wk , and consumption of 4 n-3 fatty acid-enriched egg yolks/wk in breast-fed and formula-fed infants from 6 to 12 mo of age .  Erythrocyte DHA concentrations , cholesterol , and iron status were assessed at 6 and 12 mo of age . RESULTS Of the 82 breast-fed infants recruited , 23 of 28 ( no intervention ) , 23 of 27 ( regular eggs ) , and 24 of 27 ( n-3 eggs ) completed the trial . Of the 79 formula-fed infants enrolled , 23 of 27 ( no intervention ) , 24 of 26 ( regular eggs ) , and 20 of 26 ( n-3 eggs ) completed the trial .  Erythrocyte DHA concentrations were 30 - 40 % higher after the n-3 egg intervention than after treatment with regular eggs or no eggs in both breast-fed and formula-fed infants . Egg treatment had no significant effect on plasma cholesterol , hemoglobin , ferritin , and transferrin but did result in improvements in plasma iron and transferrin saturation compared with no egg treatment . CONCLUSIONS n-3 Fatty acid-enriched eggs may provide a means of increasing dietary DHA during the second 6 mo of life . Egg yolks may also be a useful source of iron during the weaning period and can be safely included in the weaning diet with no perturbations in plasma cholesterol Maternal ( n-3 ) PUFA deficiency is associated with higher  blood pressure ( BP ) later in life in rat offspring , and early intake of ( n-3 ) PUFA in formula-fed infants was shown to modify later BP . BP , heart rate ( HR ) , and heart rate variability ( HRV ) are affected by dietary ( n-3 ) PUFA in adults . In this study , we investigated whether fish oil ( FO ) supplementation of lactating mothers could modify BP , pulse wave velocity ( PWV ) , and HRV in their children after 2 y. Mothers with low fish intake were r and omly assigned to FO or olive oil ( OO ) supplementation for the first 4 mo after delivery . A reference group of mothers with a high habitual fish intake ( HFI ) was also followed . At the follow-up study at 2.5 y of age , BP and PWV were measured , and electrocardiograms were recorded for 0.5 h. FO supplementation significantly increased RBC levels of long-chain ( n-3 ) PUFA of the 4 mo-old children , but at 2.5 y , the FO and OO groups did not differ . BP , PWV , HR , and HRV also did not differ among the groups . However , for all 3 groups , the children 's intake of ( n-3 ) PUFA at 2.5 y was negatively correlated with mean arterial pressure after adjustment for outdoor temperature ( r = -0.245 , P = 0.04 ) . In conclusion , maternal FO supplementation had no overall effect on BP , PWV , or HRV of the children , indicating that ( n-3 ) PUFA intake of Danish mothers may be sufficient in this sense . However , children 's dietary intake of ( n-3 ) PUFA might have a beneficial effect on BP in childhood Trans fatty acids ( TFA ) are found naturally in some foods ( e.g. , dairy products ) as well as many processed foods made with partially hydrogenated vegetable oils ( PHVO ) . Data from a growing literature suggest that some TFA decrease milk fat in lactating animals . Because the physiologic effects of TFA in lactating women are unknown , this study was design ed to investigate the effects of TFA consumption on human milk fat . A r and omized , crossover design ( n = 12 ) was used to study the effect of 3 dietary treatments : high PHVO ( regular margarine ) , low PHVO ( low TFA margarine ) , or low PHVO but high in naturally occurring TFA ( butter ) on milk fat . Treatments were administered for 5 d , with 7-d washout periods .  Maternal adiposity  was estimated by dual-energy X-ray absorptiometry  . Milk and blood were collected on d 5 of each intervention period . In general , milk and serum fatty acid concentrations mirrored those of the dietary treatments . There were significant interactions between treatment and maternal adiposity on milk fat and infant milk consumption , as well as on serum glucose and nonesterified fatty acid ( NEFA ) concentrations . Consumption of regular margarine , compared with low TFA margarine , result ed in lower milk fat in leaner , but not in more obese women . Consumption of either regular or low TFA margarine , compared with butter , elevated serum NEFA concentrations in the more obese women . In summary , consumption of regular margarine , compared with low TFA margarine , decreased milk fat in lean women . Further studies are required to determine whether infant milk consumption might compensate for this potentially important change in milk composition The plasma cholesterol concentration and the composition of the plasma fatty acids was altered by dietary means in 10 lactating women . The effects of these changes in the plasma on the lipid constituents of mature human milk were studied over periods of several weeks . In eight infants who were being breast-fed , the changes in the plasma cholesterol concentration were correlated with the changes that were induced in the milk lipids . Significant alteration in the women 's plasma cholesterol levels did not change the cholesterol concentration in milk . The cholesterol content of milk was closely correlated with the concentrations of the other milk lipids , supporting a functional role for the cholesterol in the secretion of milk fat . In the maternal milk consumed by the eight infants the linoleate content rose from 9.4 % to 15.5 % of total fatty acids as a result of a moderate increase in dietary polyunsaturated fat . This led to a fall in the infants ' plasma cholesterol levels , from an average of 185 to 157 mg/100 ml OBJECTIVE There have been indications that high intake of n-3 long-chain polyunsaturated fatty acids ( PUFAs ) during pregnancy may increase birth weight and gestational length . In addition , n-3 long-chain PUFAs may be important for the neurobiological development of the infants . High levels of docosahexaenoic acid ( DHA , 22:6 n-3 ) are found in the gray matter of the cerebral cortex and in the retina , and it seems as if the availability of long-chain PUFAs may be limiting cerebral development . The fetus and the newborn are dependent on a high supply from their mothers , either via the placenta or via breast milk . We supplemented pregnant and lactating women with n-3 or n-6 long-chain PUFAs to evaluate the effect on birth weight , gestational length , and infant development . DESIGN We performed a double-blind , r and omized study recruiting 590 pregnant , healthy , nulli- or primiparous women ( 19 - 35 years old ) in weeks 17 to 19 of pregnancy . The women were provided 10 mL of either cod liver oil or corn oil daily until 3 months after delivery . MAIN OUTCOME MEASURES Primary outcomes were gestational length and birth weight . Electroencephalography ( EEG ) was done on the second day of life and at 3 months of age . Novelty preference ( Fagan test ) was used as an indicator of cognitive function at 6 and 9 months of age . The fatty acid pattern in umbilical plasma phospholipids and in breast milk was measured , and dietary assessment s were performed , both on the mothers during pregnancy and on the infants at 3 months of age . The growth of the infants was followed up to 1 year of age . RESULTS Three hundred forty-one mothers took part in the study until delivery . There were no significant differences in maternal body mass index before pregnancy and at birth , or parity between the 2 groups . Smoking habits and parental education were also similar in the 2 groups . The mean age of the mothers receiving cod liver oil was , by chance , 1 year higher than the age of the mothers receiving corn oil ( 28.6 [ 3.4 ] vs 27.6 [ 3.2 ] years ) . The maternal dietary intake in the 2 groups receiving cod liver oil or corn oil was similar , except for the supplementation . There were no differences in gestational length or birth weight between the cod liver oil group and the corn oil group ( 279.6 [ 9.2 ] vs 279.2 [ 9.3 ] days ; 3609 [ 493 ] vs 3618 [ 527 ] g , respectively ) . Birth length , head circumference , and placental weight were also similar in the 2 groups . The concentrations of the n-3 fatty acids eicosapentaenoic acid ( 20:5 n-3 ) , docosapentaenoic acid ( 22:5 n-3 ) , and DHA in umbilical plasma phospholipids were higher in the cod liver oil group compared with the corn oil group ( 10.8 [ 7.6 ] vs 2.5 [ 1.8 ] microg/mL , 5.0 [ 2.6 ] vs 2.9 [ 1.3 ] microg/mL , 55.8 [ 20.6 ] vs 45.3 [ 12.8 ] microg/mL , respectively ) . Neonates with high concentration of DHA in umbilical plasma phospholipids ( upper quartile ) had longer gestational length than neonates with low concentration ( lower quartile ; 282.5 [ 8.5 ] vs 275.4 [ 9.3 ] days ) . No differences in EEG scores or Fagan scores were found , but neonates with mature EEG ( N = 70 ) had a higher concentration of DHA in umbilical plasma phospholipids than neonates with immature EEG ( N = 51 ) on the second day of life . Dietary information from 251 infants at 3 months of age was collected and 85 % of these infants were exclusively breastfed , in addition to 12 % who were partly breastfed . The breast milk of mothers supplemented with cod liver oil contained more n-3 long-chain PUFAs and less n-6 long-chain PUFAs than breast milk of mothers supplemented with corn oil . There were no significant differences in infant growth during the first year of life between the 2 groups . CONCLUSIONS This study shows neither harmful nor beneficial effects of maternal supplementation of long-chain n-3 PUFAs regarding pregnancy outcome , cognitive development , or growth , as compared with supplementation with n-6 fatty acids . However , it confirms that DHA concentration may be related to gestational length and cerebral maturation of the newborn Fish oil addition to infant formulas has raised concern on whether increased intake of n-3 long-chain polyunsaturated fatty acid ( n-3LCPUFA ) affects infant growth .  The objective of this study was to determine whether maternal fish oil supplementation during 0–4 mo of lactation influences growth in infancy and early childhood . In a r and omized , blinded intervention trial , lactating Danish mothers with a fish intake below the population median were r and omized to 4.5 g/d fish oil or olive oil . A reference group of 53 mothers with a fish intake in the highest quartile of the population and their infants were included in the study .  Head circumference , weight , length , skinfold thickness , and waist circumference of children were measured at 2 , 4 , and 9 mo and at 2.5 y. One hundred children completed the intervention trial , and 72 were followed up at 2.5 y together with 29 from the reference group .  Growth in weight , length , and head circumference did not differ between the r and omized groups up to 9 mo , but at 2.5 y , body composition differed significantly . Children in the fish oil group had larger waist circumference body mass index ( BMI ; 0.6 kg/m2 ; p = 0.022 ) , and head circumference compared with those in the olive oil group . Adjusted for sex , ponderal index at birth and current energy intake , BMI at 2.5 y was associated with docosahexaenoic acid in maternal erythrocytes after the intervention . In conclusion , the n-3LCPUFA intake of lactating mothers may be important for growth of young children . The long-term effect on weight and BMI remains to be investigated Docosahexaenoic acid ( DHA ) accumulates in the brain during the 1st and 2nd years of life . The objective of this study was to see if an increased content of DHA in breast-milk via maternal fish oil (FO)-supplementation affects mental development in term infants . one hundred twenty-two Danish mothers with a habitual fish intake below the population median were r and omized to  4.5 g.d(-1 ) of FO or olive oil ( OO ) for the first four months of lactation .  Fifty-three mothers with habitual fish intake in the highest quartile were included as reference group . The effect of the result ing increase in infant DHA-intake and RBC-DHA level was assessed on problem solving ability at nine months and language at one and two years of age . Infants in the three groups performed equally well on the problem test and no association was observed between problem solving and erythrocyte-DHA at four months . Passive vocabulary at one year was lower in the children of the FO- compared with the OO-group ( P < 0.05 ) , but no differences were found at two years of age . Word comprehension at one year was inversely associated with erythrocyte-DHA at four months . The trial indicate a small effect of DHA levels in breast-milk on early language development of breast-fed infants Background . It is currently recommended that diet of pregnant mothers contain 200–300 mg DHA/day . Aim . To determine whether DHA supplementation during pregnancy and lactation affects infants ' immune response . Methods . 60 women in ≥3rd pregnancy studied ; 30 r and omly assigned to receive DHA 400 mg/day from 12th week gestation until 4 months postpartum . From breast-fed infants , blood obtained for anti-HBs antibodies , immunoglobulins , lymphocyte subset phenotyping , and intracellular cytokine production . Results . CD4 + lymphocytes did not differ between groups , but CD4CD45RA/CD4 ( naïve cells ) significantly higher in infants in DHA+ group . Proportion of CD4 and CD8 cells producing IFNγ significantly lower in DHA+ group , with no differences in proportion of IL4-producing cells . Immunoglobulins and anti-HBs levels did not differ between groups . Conclusions . In infants of mothers  receiving DHA supplementation , a higher percentage of CD4 naïve cells and decreased CD4 and CD8 IFNγ production is compatible with attenuation of a proinflammatory response Total fat content and therefore total energy content and the content of essential fatty acids ( EFAs ) in milk are known to decline with prolonged breast feeding . In a placebo-controlled study a variety of evening primrose oil ( Efamol ) rich in linoleic and gamma-linolenic acids , or a matching placebo were given to 39 women for a period of 8 months starting between the 2nd and 6th months of lactation . Total fat and EFA contents of the milk declined in the placebo group but rose in the primrose oil supplemented group . A surprisingly high proportion of the supplemented dietary fatty acids could be accounted for by appearance in the milk . The milk composition can be readily manipulated by changing the fatty acid composition of the maternal diet BACKGROUND The docosahexaenoic acid ( DHA ) intake of pregnant women is lower than estimates of the DHA accretion by the fetus , and recommendations were made to increase the DHA intake of pregnant women . OBJECTIVE The objective of this study was to determine whether the supplementation of pregnant women with DHA improved the visual acuity of infants at 4 mo . DESIGN We conducted a blinded assessment of a subset of healthy , full-term infants born to women enrolled in a double-blind , r and omized controlled trial called the DHA for Maternal and Infant Outcomes ( DOMInO ) trial . Women were r and omly assigned to consume DHA-rich fish-oil capsules ( ≈800 mg DHA/d in the treatment group ) or vegetable oil capsules ( control group ) from midpregnancy to delivery . The primary outcome was the sweep visual evoked potential ( VEP ) acuity at 4 mo . The VEP latency at 4 mo was a secondary outcome . RESULTS Mean ( ±SD ) VEP acuity did not differ between treatment and control groups [ treatment group : 8.37 ± 2.11 cycles per degree ( cpd ) , n = 89 ; control group : 8.55 ± 1.86 cpd , n = 93 ; P = 0.55 ] . VEP latencies also did not differ between groups . Irrespective of the group , maternal smoking in pregnancy was independently associated with poorer VEP acuity in the infant . CONCLUSIONS DHA supplementation in women with singleton pregnancies does not enhance infant visual acuity in infants at 4 mo of age . Visual acuity in infancy is adversely associated with maternal smoking in pregnancy . This trial was registered at www.anzctr.org.au as ACTRN12606000327583 . The DOMInO trial was registered at www.anzctr.org.au as ACTRN12605000569606 IMPORTANCE Breastfeeding may benefit child cognitive development , but few studies have quantified breastfeeding duration or exclusivity , nor has any study to date examined the role of maternal diet during lactation on child cognition . OBJECTIVES To examine relationships of breastfeeding duration and exclusivity with child cognition at ages 3 and 7 years and to evaluate the extent to which maternal fish intake during lactation modifies associations of infant feeding with later cognition . DESIGN , SETTING , AND PARTICIPANTS Prospect i ve cohort study ( Project Viva ) , a US prebirth cohort that enrolled mothers from April 22 , 1999 , to July 31 , 2002 , and followed up children to age 7 years , including 1312 Project Viva mothers and children . MAIN EXPOSURE Duration of any breastfeeding to age 12 months . MAIN OUTCOMES AND MEASURES Child receptive language assessed with the Peabody Picture Vocabulary Test at age 3 years , Wide Range Assessment of Visual Motor Abilities at ages 3 and 7 years , and Kaufman Brief Intelligence Test and Wide Range Assessment of Memory and Learning at age 7 years . RESULTS Adjusting for sociodemographics , maternal intelligence , and home environment in linear regression , longer breastfeeding duration was associated with higher Peabody Picture Vocabulary Test score at age 3 years ( 0.21 ; 95 % CI , 0.03 - 0.38 points per month breastfed ) and with higher intelligence on the Kaufman Brief Intelligence Test at age 7 years ( 0.35 ; 0.16 - 0.53 verbal points per month breastfed ; and 0.29 ; 0.05 - 0.54 nonverbal points per month breastfed ) . Breastfeeding duration was not associated with Wide Range Assessment of Memory and Learning scores . Beneficial effects of breastfeeding on the Wide Range Assessment of Visual Motor Abilities at age 3 years seemed greater for women who consumed 2 or more servings of fish per week ( 0.24 ; 0.00 - 0.47 points per month breastfed ) compared with less than 2 servings of fish per week ( −0.01 ; −0.22 to 0.20 points per month breastfed ) ( P = .16 for interaction ) . CONCLUSIONS AND RELEVANCE Our results support a causal relationship of breastfeeding duration with receptive language and verbal and nonverbal intelligence later in life BACKGROUND The composition of long-chain PUFAs ( LCPUFAs ) in the maternal diet may affect obesity risk in the mother 's offspring . OBJECTIVE We hypothesized that a reduction in the n-6 (omega-6):n-3 ( omega-3 ) LCPUFA ratio in the diet of pregnant women and breastfeeding mothers may prevent expansive adipose tissue growth in their infants during the first year of life . DESIGN In a r and omized controlled trial , 208 healthy pregnant women were r and omly assigned to an intervention ( 1200 mg n-3 LCPUFAs as a supplement per day and a concomitant reduction in arachidonic acid intake ) or a control diet from the 15th wk of pregnancy to 4 mo of lactation . The primary outcome was infant fat mass estimated by skinfold thickness ( SFT ) measurements at 4 body sites at 3 - 5 d , 6 wk , and 4 and 12 mo postpartum . Secondary endpoints included sonographic assessment of abdominal subcutaneous and preperitoneal fat , fat distribution , and child growth . RESULTS Infants did not differ in the sum of their 4 SFTs at ≤1 y of life [ intervention : 24.1 ± 4.4 mm ( n = 85 ) ; control : 24.1 ± 4.1 mm ( n = 80 ) ; mean difference : -0.0 mm ( 95 % CI : -1.3 , 1.3 mm ) ] or in growth . Likewise , longitudinal ultrasonography showed no significant differences in abdominal fat mass or fat distribution . CONCLUSIONS We showed no evidence that supplementation with n-3 fatty acids and instructions to reduce arachidonic acid intake during pregnancy and lactation relevantly affects fat mass in offspring during the first year of life . Prospect i ve long-term studies are needed to explore the efficacy of this dietary approach for primary prevention . This trial was registered at clinical trials.gov as NCT00362089 Lactation hampers normalization of the maternal arachidonic acid ( AA ) status , which is reduced after pregnancy and can further decline by the presently recommended increased consumption of ( n-3 ) long-chain PUFA [ ( n-3 ) LCPUFA ] . This may be unfavorable for breast-fed infants , because they also require an optimum supply of ( n-6 ) LCPUFA . We therefore investigated the LCPUFA responses in nursing mothers upon increased consumption of AA and ( n-3 ) LCPUFA . In a parallel , double-blind , controlled trial , lactating women received for 8 wk no extra LCPUFA ( control group , n = 8) , 200 ( low AA group , n = 9 ) , or 400 ( high AA group , n = 8) mg/d AA in combination with ( n-3 ) LCPUFA [ 320 mg/d docosahexaenoic acid ( DHA ) , 80 mg/d eicosapentaenoic acid , and 80 mg/d other ( n-3 ) fatty acids ] , or this dose of ( n-3 ) LCPUFA alone [ DHA + eicosapentaenoic acid group , n = 8 ] . Relative concentrations of AA , DHA , and sums of ( n-6 ) and ( n-3 ) LCPUFA were measured in milk total lipids ( TL ) and erythrocyte phospholipids ( PL ) after 2 and 8 wk and changes were compared by ANCOVA . The combined consumption of AA and ( n-3 ) LCPUFA caused dose-dependent elevations of AA and total ( n-6 ) LCPUFA concentrations in milk TL and did not significantly affect the DHA and total ( n-3 ) LCPUFA increases caused by ( n-3 ) LCPUFA supplementation only . This latter treatment did not significantly affect breast milk AA and total ( n-6 ) LCPUFA concentrations . AA and DHA concentrations in milk TL and their changes were strongly and positively correlated with their corresponding values in erythrocyte PL ( r(2 ) = 0.27 - 0.50 ; P < /= 0.002 ) . We thus concluded that the consumption by lactating women of AA in addition to extra ( n-3 ) LCPUFA dose dependently increased the AA concentration of their milk TL Early nutrition may program obesity and cardiovascular risk later in life , and one of the potential agents is ( n-3 ) long-chain PUFA ( LCPUFA ) . In this study , our objective was to examine whether fish oil ( FO ) supplementation during lactation affects  blood pressure and body composition of children . Danish mothers ( n = 122 ) were r and omized to FO [ 1.5 g/d ( n-3 ) LCPUFA ] or olive oil ( OO ) supplementations during the first 4 mo of lactation . The trial also included a high-fish intake reference group ( n = 53 ) . Ninety-eight children were followed-up with blood pressure and anthropometry measurements at 7 y. Diet and physical activity level ( PAL ) were assessed by 4-d weighed dietary records and ActiReg . The PAL value was 4 % lower ( P = 0.048 ) and energy intake ( EI ) of the boys was 1.1 + /- 0.4 MJ/d higher ( P = 0.014 ) in the FO group than in the OO group . Starch intake was 15 + /- 6 g/d higher ( P = 0.012 ) in the FO group , but there were no other differences in diet . Body composition did not differ between the r and omized groups with or without adjustment for starch intake , EI , and PAL . FO boys had 6 mm Hg higher diastolic and mean arterial blood pressure than OO boys ( P < 0.01 ) , but girls did not differ . Within the r and omized groups , blood pressure was not correlated with maternal RBC ( n-3 ) LCPUFA after the intervention , but PAL values were ( r = -0.277 ; P = 0.038 ) . We previously found higher BMI at 2.5 y in the FO group , but the difference did not persist . The differences in blood pressure , EI , and PAL , particularly among boys , suggest that early ( n-3 ) LCPUFA intake may have adverse effects , which should be investigated in future studies DHA and arachidonic acid ( AA ) are important for neurodevelopment . A traditional neonatal neurological examination and the evaluation of general movement quality are sensitive techniques for assessing neurodevelopment in young infants . Mildly abnormal general movements at 3 months have been associated with a non-optimal current brain condition . We investigated whether supplementation of DHA during pregnancy and lactation influences the infant 's brain development and whether additional AA modulates this effect . Healthy women were r and omly assigned to DHA ( 220 mg/d , n 42 ) , DHA+AA ( 220 mg each/d , n 41 ) or control ( n 36 ) , from about week 17 ( range 14 - 20 weeks ) of pregnancy until 12 weeks postpartum . The control and the DHA+AA groups had approximately comparable dietary DHA/AA ratios . The st and ardised neonatal neurological examination was carried out at 2 weeks . General movement quality was assessed at 2 and 12 weeks . Neither DHA alone nor DHA+AA influenced outcomes in the traditional examination . General movement quality of infants in the DHA group was lower than that of infants in the other two groups , especially at 12 weeks : 61 % of the infants in the DHA group showed mildly abnormal general movements compared with 31 % in the control group ( P = 0.008 ) and 34 % in the DHA+AA group ( P = 0.015 ) . We conclude that general movement quality at 12 weeks is sensitive to the maternal dietary DHA/AA balance Docosahexaenoic acid ( DHA ) is important for infant development . The DHA transfer from maternal diet into human milk has not been investigated in detail . We studied the effects of DHA supplementation on the fatty acid composition of human milk and the secretion of dietary (13)C-labeled fatty acids , including DHA , into human milk . Ten lactating women were r and omized to consume , from 4 to 6 weeks postpartum , an oil rich in DHA ( DHASCO , 200 mg of DHA/day ) ( n = 5 ) or a placebo oil ( n = 5 ) . Dietary intakes were followed by 7-day protocol s. On study day 14 a single dose of [U-(13)C]DHASCO was given orally , milk sample s were collected over 48 h , and milk production was recorded . Milk fatty acid composition was determined by gas-liquid chromatography and isotopic enrichment was determined by gas chromatography- combustion-isotope ratio mass spectrometry ( GC-C-IRMS ) . Milk DHA content did not differ between the supplemented and placebo group at study entry ( 0.29 vs. 0.28 wt% , median ) . After 2 weeks of supplementation the milk DHA content was almost 2-fold higher in the supplemented versus placebo group ( 0.37 vs. 0.21 wt% , P = 0.003 ) . Cumulative recovery of [(13)C]palmitic , [(13)C]oleic , and [(13)C]docosahexaenoic acids in human milk at 48 h was similar between supplemented and placebo groups ( palmitic acid 7.40 vs. 8 . 14 % , oleic acid 9.14 vs. 9.97 % , and docosahexaenoic acid 9.09 vs. 8 . 03 % of dose , respectively ) . Notable lower recovery was observed for [(13)C]myristic acid in both the supplemented and placebo groups , 0 . 62 versus 0.77 % of dose . Dietary DHA supplementation increases the DHA content in human milk . DHA transfer from the diet into human milk is comparable to palmitic and oleic acid transfer Background : There is some evidence that the n-6/n-3 long-chain polyunsaturated fatty acids ( LCPUFAs ) ratio in early nutrition , and thus in breast milk , could influence infant body composition . Methods : In an open-label r and omized controlled trial ( RCT ) , 208 healthy pregnant women were allocated to a dietary intervention ( supplementation with 1,200 mg n-3 LCPUFAs per day and instructions to reduce arachidonic acid ( AA ) intake ) from the 15th wk of gestation until 4 mo of lactation or to follow their habitual diet . Breast milk LCPUFAs at 6 wk and 4 mo postpartum were related to infant body composition assessed by skinfold thickness ( SFT ) measurements and ultrasonography during the first year of life . Results : Dietary intervention significantly reduced breast milk n-6/n-3 LCPUFAs ratio . In the whole sample , early breast milk docosahexaenoic acid ( DHA ) , eicosapentaenoic acid ( EPA ) , and n-3 LCPUFAs at 6 wk postpartum were positively related to the sum of four SFT measurements at age 1 . Breast milk AA and n-6 LCPUFAs at 6 wk postpartum were negatively associated with weight , BMI , and lean body mass ( LBM ) up to 4 mo postpartum . Conclusion : Breast milk n-3 LCPUFAs appear to stimulate fat mass growth over the first year of life , whereas AA seems to be involved in the regulation of overall growth , especially in the early postpartum period We investigated whether the previously reported preventive effect of maternal ω-3 fatty acid supplementation on  IgE-associated allergic disease in infancy may be mediated by facilitating a balanced circulating Th2/Th1 chemokine profile in the infant . Vaccine-induced immune responses at 2 y of age were also evaluated . Pregnant women , at risk of having an allergic infant , were r and omized to daily supplementation with 1.6 g eicosapentaenoic acid and 1.1 g docosahexaenoic acid or placebo from the 25th gestational week through 3.5 mo of breastfeeding . Infant plasma was analyzed for chemokines ( cord blood , 3 , 12 , 24 mo ) and anti-tetanus and anti-diphtheria IgG ( 24 mo ) . High Th2-associated CC-chemokine lig and 17 ( CCL17 ) levels were associated with infant allergic disease ( p < 0.05 ) . In infants without , but not with , maternal history of allergy , the ω-3 supplementation was related to lower CCL17/CXC-chemokine lig and 11 ( CXCL11 ) ( Th2/Th1 ) ratios ( p < 0.05 ) . Furthermore , in nonallergic , but not in allergic infants , ω-3 supplementation was linked with higher Th1-associated CXCL11 levels ( p < 0.05 ) , as well as increased IgG titers to diphtheria ( p = 0.01 ) and tetanus ( p = 0.05 ) toxins . Thus , the prospect of balancing the infant immune system toward a less Th2-dominated response , by maternal ω-3 fatty acid supplementation , seems to be influenced by allergic status OBJECTIVE The purpose of this study was to determine the effect of docosahexaenoic acid supplementation on plasma phospholipid docosahexaenoic acid content and indices of depression and information processing for women who breast-feed . STUDY DESIGN Mothers who planned to breast-feed their infants were assigned r and omly in a double-masked fashion to receive either docosahexaenoic acid ( approximately 200 mg/d ) or placebo for the first 4 months after the delivery . Major outcome variables included plasma phospholipid fatty acid patterns and scores on a self-rating question naire of current depression symptoms . A structured clinical interview of depression , scores on another self-rating question naire of depression symptoms , and a laboratory measure of information processing were obtained in subgroups of the total population . RESULTS Plasma phospholipid contents of docosahexaenoic acid at baseline were 3.15 + /- 0.78 and 3.31 + /- 0.70 ( mg/dL of total fatty acids ) in the docosahexaenoic acid and placebo groups , respectively . After 4 months , the plasma phospholipid docosahexaenoic acid content of the docosahexaenoic acid group was 8 % higher ( 3.40 + /- 0.97 mg/dL ) , whereas that of the placebo group was 31 % lower ( 2.27 + /- 0.87 mg/dL ) . Despite the higher plasma phospholipid docosahexaenoic acid content of the supplemented group after 4 months , there was no difference between groups in either self-rating or diagnostic measures of depression ; information processing scores of the two groups also did not differ . CONCLUSION Docosahexaenoic acid supplementation ( approximately 200 mg/d ) for 4 months after the delivery prevented the usual decline in plasma phospholipid docosahexaenoic acid content of women who breastfeed but did not influence self-ratings of depression , diagnostic measures of depression , or information processing Abstract Fetuses and breastfed children depend on the maternal docosahexaenoic acid ( DHA ) supply , which might have long-lasting consequences . We studied the growth of 6-year-old children whose mothers received supplemental DHA from midpregnancy to 3 months after delivery . One hundred and forty-four pregnant women had been r and omized to receive one of three vitamin-mineral supplements  , one supplying an additional 200 mg/day DHA . Of the original sample , 120 children were measured at age 6 years with st and ardized methods . As one objective of the follow-up was to investigate the DHA influence on normal growth , the DHA group was compared with the pooled controls after exclusion of five premature infants . The weight , length , body mass index ( BMI ) , head circumference , and skin-fold thickness at 6 years were similar in the 41 children of the DHA group and the 74 controls . Longitudinally , the BMI z-scores of the DHA group increased up at a later age than that of the controls . We found a highly significant negative correlation between height at 6 years and the increase in red blood cell DHA concentration of mothers from 22 to 37 weeks of pregnancy . We conclude that DHA supplements during midpregnancy corrected a low maternal DHA status ( which correlated with children ’s height ) and was favorable in regard to the BMI development up to 6 years Background : We studied the oxidation of an oil rich in docosahexaenoic acid ( DHA ; DHASCO ® ) in lactating mothers receiving a dietary DHA supplement or a placebo .  The results were compared with the oxidation of linoleic acid . Methods : Breast-feeding mothers received a dietary supplement ( DHASCO ; 200 mg DHA/day , n = 5 ) or a placebo ( n = 5 ) for 14 days . Six weeks post partum all 10 mothers received a single dose of 2 mg/kg body weight uniformly 13C-labeled DHASCO . In a previously reported study 6 mothers received 1 mg/kg body weight uniformly 13C-labeled linoleic acid . Breath sample s were collected over 48 h after tracer application . The total CO2 production was measured by indirect calorimetry and the 13C isotopic enrichment of labeled CO2 by isotopic ratio mass spectrometry . Results : The oxidation of 13C-labeled DHASCO in the supplemented and placebo groups was similar . Maximal 13C enrichment was reached earlier in the group receiving 13C-DHASCO ( median 1.0 vs. 3.0 h in the linoleic acid group ) . The cumulative 13C recovery in breath was higher in the DHASCO versus the linoleic acid group until 10 h after tracer application and comparable thereafter . Conclusions : The difference in oxidation of DHASCO versus linoleic acid after tracer ingestion might be partly due to a faster absorption and oxidation of shorter chain saturated fatty acids contained in DHASCO . The cumulative oxidation of DHASCO and linoleic acid 24 and 48 h after tracer ingestion is similar To determine whether docosahexaenoic acid ( DHA ) supplementation of breast-feeding mothers increases the DHA contents of breast milk and infant plasma phospholipids ( PPs ) , breast-feeding women were r and omly assigned to 3 DHA-supplementation groups ( 170 - 260 mg/d ) or a control group . Group 1 ( n = 6 ) consumed an algae-produced high-DHA triacylglycerol ; group 2 ( n = 6 ) consumed high-DHA eggs ; group 3 ( n = 6 ) consumed a high-DHA , low-eicosapentaenoic acid marine oil ; and group 4 ( n = 6 ) received no supplementation . From before to after supplementation ( 2 and 8 wk postpartum ) , mean ( + /-SD ) maternal PP DHA increased in groups 1 , 2 , and 3 by 1.20 + /- 0.53 , 0.63 + /- 0.82 , and 0.76 + /- 0.35 mol% of fatty acids , respectively ( 23 - 41 % ) , but decreased in group 4 by 0.44 + /- 0.34 mol% ( 15 % ) . Breast-milk DHA of groups 1 , 2 , and 3 increased by 0.21 + /- 0.16 , 0.07 + /- 0.11 , and 0 . 12 + /- 0.07 mol% , respectively ( 32 - 91 % ) but decreased in group 4 by 0.03 + /- 0.04 mol% ( 17 % ) . Mean infant PP DHA in groups 1 , 2 , and 3 increased by 1.63 + /- 0.79 , 0.40 + /- 1.0 , and 0.98 + /- 0.61 mol% , respectively ( 11 - 42 % ) , but only by 0.18 + /- 0.74 mol% ( 5 % ) in group 4 . Correlations between the DHA contents of maternal plasma and breast milk and of milk and infant PPs were significant . Breast-milk and maternal and infant PP 22:5n-6 concentrations were lowest in group 2 . DHA supplementation increases the plasma and breast-milk DHA concentrations of lactating women , result ing in higher PP DHA concentrations in infants Background / Aims : The supply of docosahexaenoic acid ( DHA , 22:6ω–3 ) , important for fetal/infant neurodevelopment , depends on the maternal fatty acid ( FA ) status , which may be marginal in central Europe . Therefore , we investigated the effect of a daily vitamin/mineral supplement with and without 200 mg DHA from mid-pregnancy through lactation on the DHA concentrations in maternal and infant red blood cell phospholipids ( RBC% ) , and in breast milk FA ( % ) . Methods : At 21 weeks ’ gestation , 144 women were enrolled into a r and omised , double-blind clinical trial receiving daily : ( 1 ) a basic vitamin-mineral supplement ( Vit/Min group ) , ( 2 ) Vit/Min plus 4.5 g fructo-oligosaccharide ( FOS group ) , or ( 3 ) Vit/Min plus 4.5 g FOS plus 200 mg fish oil-derived DHA ( DHA-FOS group ) . FAs were determined by capillary gas-liquid chromatography . Results : While maternal RBC-DHA% at enrolment was not different , at 37 weeks gestation , and 3 months after delivery RBC-DHA% were significantly higher in the DHA-FOS group . The breast milk DHA% was twice as high in the DHA-FOS group ( 0.50 % ) than in the two others ( 0.25 % ) ( p < 0.001 ) , and the ratio ARA/DHA in the DHA-FOS group was 1.0 ± 0.43 , in the others 2.1 ± 0.43 ( p < 0.001 ) . The RBC-DHA% of the infants in the DHA-FOS group was also significantly higher , and correlated significantly with maternal RBC-DHA% before and 3 months after delivery . Conclusions : In central Europe , a dose of 200 mg/day DHA from mid-pregnancy through lactation seems appropriate to improve the DHA status of mothers and infants Docosahexaenoic acid ( DHA ) and arachidonic acid ( AA ) are important nutrients in the preterm diet and fixed ratios have been proposed for formula . We evaluated the intra- and inter-individual variation in milk fatty acids from mothers of preterm infants involved in a r and omised trial of tuna oil or placebo supplementation .  Milk sample s were collected every 2 weeks while infants were hospitalised and fatty acids analysed by capillary gas chromatography . DHA was higher in milk of supplemented mothers than control ( % total fatty acids , mean+/-SD , treatment 0.9+/-0.4 , control 0.3+/-0.1 , p<0.0005 ) and ranged between 0.3 - 2.5 % and 0.1 - 1.1 % , respectively . AA did not differ between groups and ranged between 0.2 - 0.9 % and 0.3 - 0.9 % , respectively . Control mothers milk had wider AA : DHA ratio than treatment mothers ( 0.4 - 3.2 versus 0.2 - 2.1 ) . Due to the wide variation in milk AA and DHA , statements recommending infant formula based on a fixed AA : DHA ratio should be re-examined Objectives : 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 . Design and Setting Double blind , placebo controlled study of infants recruited from postnatal wards at Flinders Medical Centre . Subjects : Fifty-two healthy term infants who were breast fed for at least 12 weeks and were from middle class families . Intervention : 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 DHA was related to infant plasma ( r=0.89 , P<0.001 ) and erythrocyte ( r=0.88 , P<0.001 ) phospholipids in a saturable curvilinear manner so that breast milk DHA above 0.8 % of total fatty acids result ed 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 . Sponsorship : Financial support was provided by Martek Biosciences , MD , USA and the National Health and Medical Research Council , Australia OBJECTIVE Examine the impact of providing yogurt to women enrolled in the Special Supplemental Nutrition Program for Women , Infants , and Children ( WIC ) . DESIGN R and omized , controlled intervention trial . SETTING Two California WIC local agency sites . PARTICIPANTS 511 pregnant , breast-feeding , or postpartum women . INTERVENTION Substitution of part of the WIC milk allowance with yogurt accompanied with educational material s. MAIN OUTCOME MEASURES Participants ' consumption and attitudes regarding yogurt provision . ANALYSIS Chi-square , Fisher exact , and Student t test to compare pre- versus post-intervention responses . Nonparametric Wilcoxon , chi-square , and t test to compare changes in response in intervention versus controls . Analysis of covariance models to test the influence of language preference on outcomes . RESULTS Over 86 % of women wanted to substitute some of their milk vouchers with yogurt . Among these , 62 % reported preferring yogurt to milk . The majority ( 89 % ) redeemed the yogurt coupons . Compared to controls , intervention women reported a trend ( P = .09 ) toward an increase in yogurt intake of 1.0 fl oz/day while not decreasing other dairy consumption . Those in the intervention group with the lowest tertile of yogurt intake at baseline increased yogurt consumption by 2.8 fl oz/day ( P = .003 ) relative to controls with lowest intake . CONCLUSIONS Yogurt is likely to be a popular substitute for milk and could contribute to increased dairy intake among women if it were an option in WIC Recent observational studies suggest that mean birth weight and body fat growth in the first year of life have increased continuously over the last decades . Both elevated birth weight and early fat mass are potential risk factors for childhood obesity . Experimental and limited clinical data suggest that the dietary ratio of n–6 to n–3 fatty acids ( FAs ) during pregnancy is critical for early adipose tissue growth . The aim of this r and omized controlled study is to examine the effect of the supplementation with n–3 long-chain polyunsaturated FAs and reduction in the n–6/n–3 ratio in the diet of pregnant women/breast-feeding mothers on adipose tissue growth in their newborns using various methods for the assessment of body fat mass . Measurement of skinfold thickness in the newborn is the primary outcome parameter . Two hundred and four pregnant women will be recruited before the 15th week of gestation and r and omly assigned to either active intervention or an isocaloric control diet . This upcoming study will explore the potential of this dietary approach to limit early adipose tissue growth and may contribute to the development of a new strategy for the primary prevention of childhood obesity BACKGROUND Docosahexaenoic acid ( DHA ) is a long-chain polyunsaturated fatty acid important for neonatal neurodevelopment and immune homeostasis . Preterm infants fed donor milk from a Midwestern source receive only 20 % of the intrauterine accretion of DHA . We tested the hypothesis that DHA supplementation of donor mothers would provide preterm infants with DHA intake equivalent to fetal accretion . SUBJECTS AND METHODS After Institutional Review Board approval and informed consent , human milk donors to the Mother 's Milk Bank of Ohio were r and omized to receive 1 g of DHA ( Martek ( ® ) [ now DSM Nutritional Lipids , Columbia , MD ] ) or placebo soy oil .  Dietary intake data were collected and analyzed by a registered dietitian . Fatty acids were measured by gas chromatography/flame ionization detection . Statistical analysis used linear mixed models . RESULTS Twenty-one mothers were r and omly assigned to either the DHA group ( n=10 ) or the placebo group ( n=11 ) . Donor age was a median of 31 years in both groups with a mean lactational stage of 19 weeks . Dietary intake of DHA at baseline in both groups was a median of 23 mg/day ( range , 0 - 194 mg ) , significantly ( p<0.0001 ) less than the minimum recommended intake of 200 mg/day . The DHA content of milk increased in the DHA-supplemented group ( p<0.05 ) . CONCLUSIONS The women enrolled in this study had low dietary DHA intake . Supplementation with preformed DHA at 1 g/day result ed in increased DHA concentrations in the donor milk with no adverse outcomes . Infants fed donor milk from supplemented women receive dietary DHA levels that closely mimic normal intrauterine accretion during the third trimester OBJECTIVES . Arachidonic acid ( 20:4n-6 ) and docosahexaenoic acid ( 22:6n-3 ) are essential for brain growth and cognitive development . We have reported that supplementing pregnant and lactating women with n-3 very-long-chain polyunsaturated fatty acids promotes higher IQ scores at 4 years of age as compared with maternal supplementation with n-6 polyunsaturated fatty acids . In our present study , the children were examined at 7 years of age with the same cognitive tests as at 4 years of age . We also examined the relation between plasma fatty acid pattern and BMI in children , because an association between arachidonic acid and adipose tissue size has been suggested . METHODS . The study was r and omized and double-blinded . The mothers took 10 mL of cod liver oil or corn oil from week 18 of pregnancy until 3 months after delivery . Their children were tested with the Kaufman Assessment Battery for Children at 7 years of age , and their height and weight were measured . RESULTS . We did not find any significant differences in scores on the Kaufman Assessment Battery for Children test at 7 years of age between children whose mothers had taken cod liver oil ( n = 82 ) or corn oil ( n = 61 ) . We observed , however , that maternal plasma phospholipid concentrations of α-linolenic acid ( 18:3n-3 ) and docosahexaenoic acid during pregnancy were correlated to sequential processing at 7 years of age . We observed no correlation between fatty acid status at birth or during the first 3 months of life and BMI at 7 years of age . CONCLUSION . This study suggests that maternal concentration of n-3 very-long-chain polyunsaturated fatty acids during pregnancy might be of importance for later cognitive function , such as sequential processing , although we observed no significant effect of n-3 fatty acid intervention on global IQs . Neonatal fatty acid status had no influence on BMI at 7 years of age Background Maternal avoidance of egg intake has been recommended to treat egg allergy in breastfed infants Abstract We compared growth of infants whose mothers either did or did not receive docosahexaenoic acid ( DHA ) supplements during pregnancy and lactation . At 21 weeks ' gestation , 144 women were enrolled into a r and omized , double-blind clinical trial receiving : ( 1 ) a basic supplement consisting of vitamins and minerals ( BS ) , or ( 2 ) BS plus 4.5 g fructooligosaccharide ( BSF ) , or ( 3 ) BSF plus fish oil DHA ( 200 mg ) until the end of the third month of lactation .  Infants ' length , weight and head circumference were measured at birth and at 1 , 3 and 21 months . A total of 51 mothers/infants were lost to follow-up by the third month and 24 at 21 months . The two groups not receiving DHA were combined into a control group . Analysis with mixed models adjusted for confounding factors showed a significant time dependent effect for the DHA group on the development of the body mass index ( BMI ) ( P=0.037 ) , and of weight ( P=0.046 ) , but no effect on the development of length ( P=0.537 ) , or of head circumference ( P=0.267 ) . At 21 months , weight of the  DHA group was lower by −601 g ( 95 % CI −171 ; −1030 g ) and BMI was lower by −0.76 kg/m2 ( 95 % CI −0.07 ; −1.46 ) compared to controls . The results indicate that DHA taken by pregnant and lactating mothers may reduce BMI in late infancy CONTEXT Uncertainty exists about the benefit of dietary docosahexaenoic acid ( DHA ) on the  neurodevelopment of preterm infants . OBJECTIVE To determine the effect of meeting the estimated DHA requirement of preterm infants on neurodevelopment at 18 months ' corrected age . DESIGN , SETTING , AND PARTICIPANTS R and omized , double-blind controlled trial enrolling infants born at less than 33 weeks ' gestation from April 2001 to October 2005 at 5 Australian tertiary hospitals , with follow-up to 18 months . INTERVENTION High-DHA ( approximately 1 % total fatty acids ) enteral feeds compared with st and ard DHA ( approximately 0.3 % total fatty acids ) from day 2 to 4 of life until term corrected age . MAIN OUTCOME MEASURES Bayley Mental Development Index ( MDI ) at 18 months ' corrected age . A priori subgroup analyses were conducted based on r and omization strata ( sex and birth weight < 1250 g vs > or = 1250 g ) . RESULTS Of the 657 infants enrolled , 93.5 % completed the 18-month follow-up . Bayley MDI scores did not differ between the high- and st and ard-DHA groups ( mean difference , 1.9 ; 95 % confidence interval [ CI ] , -1.0 to 4.7 ) . The MDI among girls fed the high-DHA diet was higher than girls fed st and ard DHA in unadjusted and adjusted analyses ( unadjusted mean difference , 4.7 ; 95 % CI , 0.5 - 8.8 ; adjusted mean difference , 4.5 ; 95 % CI , 0.5 - 8.5 ) . The MDI among boys did not differ between groups . For infants born weighing less than 1250 g , the MDI in the high-DHA group was higher than with st and ard DHA in the unadjusted comparison ( mean difference , 4.7 ; 95 % CI , 0.2 - 9.2 ) but did not reach statistical significance following adjustment for gestational age , sex , maternal education , and birth order ( mean difference , 3.8 ; 95 % CI , -0.5 to 8.0 ) . The MDI among infants born weighing at least 1250 g did not differ between groups . CONCLUSION A DHA dose of approximately 1 % total fatty acids in early life did not increase MDI scores of preterm infants overall born earlier than 33 weeks but did improve the MDI scores of girls . TRIAL REGISTRATION anzctr.org.au Identifier : ACTRN12606000327583 OBJECTIVE . The objective of our study was to evaluate the effect of supplementation with docosahexaenoic acid and arachidonic acid for human milk-fed preterm infants . The primary end point was cognitive development at 6 months of age . METHODS . The study was a r and omized , double-blind , placebo-controlled study among 141 infants with birth weights of < 1500 g. The intervention with 32 mg of docosahexaenoic acid and 31 mg of arachidonic acid per 100 mL of human milk started 1 week after birth and lasted until discharge from the hospital ( on average , 9 weeks ) . Cognitive development was evaluated at 6 months of age by using the Ages and Stages Question naire and event-related potentials , a measure of brain correlates related to recognition memory . RESULTS . There was no difference in adverse events or growth between the 2 groups . At the 6-month follow-up evaluation , the intervention group performed better on the problem-solving subscore , compared with the control group ( 53.4 vs 49.5 points ) . There was also a nonsignificant higher total score ( 221 vs 215 points ) . The event-related potential data revealed that infants in the intervention group had significantly lower responses after the st and ard image , compared with the control group ( 8.6 vs 13.2 ) . There was no difference in responses to novel images . CONCLUSIONS . Supplementation with docosahexaenoic acid and arachidonic acid for very preterm infants fed human milk in the early neonatal period was associated with better recognition memory and higher problem-solving scores at 6 months
BACKGROUND Long chain polyunsaturated fatty acids ( LCPUFA ) , especially docosahexaenoic acid ( DHA ) , are the most abundant fatty acids in the brain and are necessary for growth and maturation of an infant 's brain and retina .
LCPUFAs are named " essential " because they can not be synthesis ed efficiently by the human body and come from maternal diet .
It remains controversial whether LCPUFA supplementation to breastfeeding mothers is beneficial for the development of their infants .
OBJECTIVES To assess the effectiveness and safety of supplementation with LCPUFA in breastfeeding mothers in the cognitive and physical development of their infants as well as safety for the mother and infant .