Postnatal Fish Oil Supplementation in High-Risk Infants to Prevent Allergy: Randomized Controlled Trial Dietary long-chain polyunsaturated fatty acid supplementation in infants with phenylketonuria: a randomized controlled trial 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 a whey-predominant starter formula containing LCPUFAs and oligosaccharides (FOS/GOS) on gastrointestinal comfort in infants. Effect of two doses of docosahexaenoic acid (DHA) in the diet of preterm infants on infant fatty acid status: results from the DINO trial. Effect of DHA supplementation during pregnancy on maternal depression and neurodevelopment of young children: a randomized controlled trial. Modulation of DNA methylation states and infant immune system by dietary supplementation with ω-3 PUFA during pregnancy in an intervention study. The Groningen LCPUFA Study: No Effect of Short-Term Postnatal Long-Chain Polyunsaturated Fatty Acids in Healthy Term Infants on Cardiovascular and Anthropometric Development at 9 Years Long-chain PUFA supplementation in rural African infants: a randomized controlled trial of effects on gut integrity, growth, and cognitive development123 Increased intake of oily fish in pregnancy: effects on neonatal immune responses and on clinical outcomes in infants at 6 mo. 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. Molecular Fingerprints of the Human Fecal Microbiota From 9 to 18 Months Old and the Effect of Fish Oil Supplementation Dietary fat intakes for pregnant and lactating women. Fish oil intake compared with olive oil intake in late pregnancy and asthma in the offspring: 16 y of registry-based follow-up from a randomized controlled trial. Long-Chain Polyunsaturated Fatty Acid Supplementation in Infancy Reduces Heart Rate and Positively Affects Distribution of Attention Fish Oil Supplementation During Late Pregnancy Does Not Influence Plasma Lipids or Lipoprotein Levels in Young Adult Offspring Fish Oil Supplementation During Lactation: Effects on Cognition and Behavior at 7 Years of Age Higher dose of docosahexaenoic acid in the neonatal period improves visual acuity of preterm infants: results of a randomized controlled trial. Maternal diet during pregnancy in relation to eczema and allergic sensitization in the offspring at 2 y of age. Fish oil supplementation in early infancy modulates developing infant immune responses Double-blind, Placebo-controlled Trial Comparing Effects of Supplementation of Two Micronutrient Sprinkles on Fatty Acid Status in Cambodian Infants The impact of early nutrition on incidence of allergic manifestations and common respiratory illnesses in children. Pre- and post-term growth in pre-term infants supplemented with higher-dose DHA: a randomised controlled trial. Consumption of fish, butter and margarine during pregnancy and development of allergic sensitizations in the offspring: role of maternal atopy. DHA Supplementation during Pregnancy and Lactation Affects Infants' Cellular but Not Humoral Immune Response Maternal supplementation with docosahexaenoic acid during pregnancy does not affect early visual development in the infant: a randomized controlled trial. 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. High-Dose Docosahexaenoic Acid Supplementation of Preterm Infants: Respiratory and Allergy Outcomes Safety of supplementing infant formula with long-chain polyunsaturated fatty acids and Bifidobacterium lactis in term infants: a randomised controlled trial. Maternal fish oil supplementation during lactation may adversely affect long-term blood pressure, energy intake, and physical activity of 7-year-old boys. The DIAMOND (DHA Intake And Measurement Of Neural Development) Study: a double-masked, randomized controlled clinical trial of the maturation of infant visual acuity as a function of the dietary level of docosahexaenoic acid. Docosahexaenoic acid transfer into human milk after dietary supplementation: a randomized clinical trial. Intake of fish oil during pregnancy and adiposity in 19-y-old offspring: follow-up on a randomized controlled trial. Effects of long-chain polyunsaturated fatty acid supplementation of infant formula on cognition and behaviour at 9 years of age. DHA supplementation and pregnancy outcomes. Th1 and Th2 Chemokines, Vaccine-Induced Immunity, and Allergic Disease in Infants After Maternal ω-3 Fatty Acid Supplementation During Pregnancy and Lactation Maternal consumption of a DHA-containing functional food benefits infant sleep patterning: an early neurodevelopmental measure. Early-life supplementation of vitamins A and D, in water-soluble form or in peanut oil, and allergic diseases during childhood. Effects of high-dose fish oil supplementation during early infancy on neurodevelopment and language: a randomised controlled trial. The Effect of Fish Oil Supplementation on Heart rate in Healthy Danish Infants Effect of Feeding a Formula Supplemented With Long-chain Polyunsaturated Fatty Acids for 14 Weeks Improves the Ex Vivo Response to a Mitogen and Reduces the Response to a Soy Protein in Infants at Low Risk for Allergy Effect of n-3 long chain polyunsaturated fatty acid supplementation in pregnancy on infants’ allergies in first year of life: randomised controlled trial Early Infant Diet and the Omega 3 Fatty Acid DHA: Effects on Resting Cardiovascular Activity and Behavioral Development During the First Half-Year of Life Effects of docosahexaenoic acid supplementation during pregnancy on fetal heart rate and variability: a randomized clinical trial. Consumption of a DHA-containing functional food during pregnancy is associated with lower infant ponderal index and cord plasma insulin concentration. The effect of fish and omega-3 LCPUFA intake on low birth weight in Indian pregnant women. 10-year Cognition in Preterms After Random Assignment to Fatty Acid Supplementation in Infancy Omega-3 Fatty Acid Supplementation to Prevent Recurrent Preterm Birth: A Randomized Controlled Trial The effects of whole milk and infant formula on growth and IGF-I in late infancy A Randomized Controlled Intervention With Fish Oil Versus Sunflower Oil From 9 to 18 Months of Age: Exploring Changes in Growth and Skinfold Thicknesses Cognitive function in 18-month-old term infants of the DIAMOND study: a randomized, controlled clinical trial with multiple dietary levels of docosahexaenoic acid. Long-term effects of LCPUFA supplementation on childhood cognitive outcomes. Three randomized controlled trials of early long-chain polyunsaturated Fatty Acid supplementation on means-end problem solving in 9-month-olds. Breastfeeding, the use of docosahexaenoic acid-fortified formulas in infancy and neuropsychological function in childhood The 10-year follow-up of a randomised trial of long-chain polyunsaturated fatty acid supplementation in preterm infants: effects on growth and blood pressure Effects of prenatal fish-oil and 5-methyltetrahydrofolate supplementation on cognitive development of children at 6.5 y of age. Feeding preterm infants milk with a higher dose of docosahexaenoic acid than that used in current practice does not influence language or behavior in early childhood: a follow-up study of a randomized controlled trial. Docosahexaenoic acid supplementation and time at achievement of gross motor milestones in healthy infants: a randomized, prospective, double-blind, placebo-controlled trial. Dietary supplementation with n-3 polyunsaturated fatty acids in early childhood: effects on blood pressure and arterial structure and function at age 8 y. Auditory- and visual-evoked potentials in Mexican infants are not affected by maternal supplementation with 400 mg/d docosahexaenoic acid in the second half of pregnancy. Prenatal Docosahexaenoic Acid Supplementation and Infant Morbidity: Randomized Controlled Trial A randomized trial of DHA intake during infancy: school readiness and receptive vocabulary at 2-3.5 years of age. Influence of fish oil or folate supplementation on the time course of plasma redox markers during pregnancy. 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 Decreased cord blood IL-4, IL-13, and CCR4 and increased TGF-beta levels after fish oil supplementation of pregnant women. Fish-oil supplementation in pregnancy does not reduce the risk of gestational diabetes or preeclampsia. Modification of dietary polyunsaturated fatty acids via complementary food enhances n-3 long-chain polyunsaturated fatty acid synthesis in healthy infants: a double blinded randomised controlled trial Growth of infants fed formula rich in canola oil (low erucic acid rapeseed oil). Respiratory hospitalisation of infants supplemented with docosahexaenoic acid as preterm neonates. The Mothers, Omega-3, and Mental Health Study: a double-blind, randomized controlled trial. The Groningen LCPUFA study: no effect of postnatal long-chain polyunsaturated fatty acids in healthy term infants on neurological condition at 9 years. The effect of maternal fish oil supplementation during the last trimester of pregnancy on blood pressure, heart rate and heart rate variability in the 19-year-old offspring. Improved Cognitive Development Among Preterm Infants Attributable to Early Supplementation of Human Milk With Docosahexaenoic Acid and Arachidonic Acid Fish oil-supplementation from 9 to 12 months of age affects infant attention in a free-play test and is related to change in blood pressure. Salmon consumption during pregnancy alters fatty acid composition and secretory IgA concentration in human breast milk.
BACKGROUND AND OBJECTIVE : Relative deficiency of dietary omega 3 polyunsaturated fatty acids ( n-3 PUFA ) has been implicated in the rising allergy prevalence in Westernized countries . Fish oil supplementation may provide an intervention strategy for primary allergy prevention . The objective of this study was to assess the effect of fish oil n-3 PUFA supplementation from birth to 6 months of age on infant allergic disease . METHODS : In a double-blind r and omized controlled trial , 420 infants at high atopic risk received a daily supplement of fish oil containing 280 mg docosahexaenoic acid and 110 mg eicosapentaenoic acid or a control ( olive oil ) , from birth to age 6 months . PUFA levels were measured in 6-month-old infants ’ erythrocytes and plasma and their mothers ’ breast milk . Eczema , food allergy , asthma and sensitization were assessed in 323 infants for whom clinical follow-up was completed at 12 months of age . RESULTS : At 6 months of age , infant docosahexaenoic acid and eicosapentaenoic acid levels were significantly higher ( both P < .05 ) and erythrocyte arachidonic acid levels were lower ( P = .003 ) in the fish oil group . Although n-3 PUFA levels at 6 months were associated with lower risk of eczema ( P = .033 ) and recurrent wheeze ( P = .027 ) , the association with eczema was not significant after multiple comparisons and there was no effect of the intervention per se on the primary study outcomes . Specifically , between-group comparisons revealed no differences in the occurrence of allergic outcomes including sensitization , eczema , asthma , or food allergy . CONCLUSIONS : Postnatal fish oil supplementation improved infant n-3 status but did not prevent childhood allergic disease Summary Background Pre- and postnatal tissue accretion of long-chain polyunsaturated fatty acids ( LCPUFA ) has been related to visual and cognitive development in healthy children in several studies . Children with phenylketonuria ( PKU ) consume diets with very low contents of preformed LCPUFA . We studied prospect ively the LCPUFA status in infants with PKU without or with LCPUFA supplementation during the first year of life . Subjects and methods Infants with PKU were enrolled at diagnosis ( < 4 weeks of age ) and r and omized double blind to phenylalanine-free amino acid supplements without LCPUFA ( n=11 ) or with both arachidonic ( AA , 0.46 wt% ) and docosahexaenoic acids ( DHA , 0.27 wt% ) ( n=10 ) . At enrolment and again at 1 , 2 , 3 , 4 , 6 , 9 and 12 months , plasma phospholipid fatty acids were measured and dietary intakes were calculated from dietary protocol s. Results Unsupplemented patients showed a marked LCPUFA depletion to levels clearly below those observed in healthy breast-fed infants . In contrast , supplemented infants had stable and higher LCPUFA levels than unsupplemented infants , reaching significant differences for AA values at 3 , 4 and 6 months , and for DHA values at 1 , 3 , 4 , 6 , 9 and 12 months . Plasma phospholipid levels correlated closely with estimated dietary intakes of preformed LCPUFA . Conclusion Low LCPUFA intakes with PKU diets induce marked depletion of AA and particularly of DHA in the first year of life . Thus endogenous synthesis of LCPUFA from precursors supplied by diet seems unable to compensate for low LCPUFA intakes . LCPUFA supplementation of PKU diets during the first year of life effectively enhances LCPUFA status to levels comparable to those of healthy breast-fed infants 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 Development of new infant formulas aims to replicate the benefits of breast milk . One benefit of breast milk over infant formulas is greater gastrointestinal comfort . We compared indicators of gastrointestinal comfort in infants fed a whey-predominant formula containing long-chain polyunsaturated fatty acids , galacto-oligo-saccharides and fructo-oligosaccharides , and infants fed a control casein-predominant formula without additional ingredients . The single-centre , prospect i ve , double-blind , controlled trial r and omly assigned healthy , full-term infants ( n=144 ) to receive exclusively either experimental or control formula from 30 days to 4 months of age . A group of exclusively breast-fed infants served as reference ( n=80 ) . At 1 , 2 , 3 , and 4 months , infants ' growth parameters were measured and their health assessed . Parents recorded frequency and physical characteristics of infants ' stool , frequency of regurgitation , vomiting , crying and colic . At 2-months , gastric emptying ( ultrasound ) and intestinal transit time ( H2 breath test ) were measured , and stool sample s collected for bacterial analysis . Compared to the control ( n=69 ) , fewer of the experimental group ( n=67 ) had hard stools ( 0.7 vs 7.5 % , p<0.001 ) and more had soft stools ( 90.8 vs 82.3 % , p<0.05 ) . Also compared to the control , the experimental group 's stool microbiota composition ( mean % bifidobacteria : 78.1 ( experimental , n=17 ) , 63.7 ( control , n=16 ) , 74.3 ( breast-fed , n=20 ) , gastric transit times ( 59.6 ( experimental , n=53 ) , 61.4 ( control , n=62 ) , 55.9 ( breast-fed , n=67 ) minutes ) and intestinal transit times ( data not shown ) were closer to that of the breast-fed group . Growth parameter values were similar for all groups . The data suggest that , in infants , the prebiotic-containing whey-based formula provides superior gastrointestinal comfort than a control formula 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 CONTEXT Uncertainty about the benefits of dietary docosahexaenoic acid ( DHA ) for pregnant women and their children exists , despite international recommendations that pregnant women increase their DHA intakes . OBJECTIVE To determine whether increasing DHA during the last half of pregnancy will result in fewer women with high levels of depressive symptoms and enhance the neurodevelopmental outcome of their children . DESIGN , SETTING , AND PARTICIPANTS A double-blind , multicenter , r and omized controlled trial ( DHA to Optimize Mother Infant Outcome [ DOMInO ] trial ) in 5 Australian maternity hospitals of 2399 women who were less than 21 weeks ' gestation with singleton pregnancies and who were recruited between October 31 , 2005 , and January 11 , 2008 . Follow-up of children ( n = 726 ) was completed December 16 , 2009 . INTERVENTION Docosahexaenoic acid-rich fish oil capsules ( providing 800 mg/d of DHA ) or matched vegetable oil capsules without DHA from study entry to birth . MAIN OUTCOME MEASURES High levels of depressive symptoms in mothers as indicated by a score of more than 12 on the Edinburgh Postnatal Depression Scale at 6 weeks or 6 months postpartum . Cognitive and language development in children as assessed by the Bayley Scales of Infant and Toddler Development , Third Edition , at 18 months . RESULTS Of 2399 women enrolled , 96.7 % completed the trial . The percentage of women with high levels of depressive symptoms during the first 6 months postpartum did not differ between the DHA and control groups ( 9.67 % vs 11.19 % ; adjusted relative risk , 0.85 ; 95 % confidence interval [ CI ] , 0.70 - 1.02 ; P = .09 ) . Mean cognitive composite scores ( adjusted mean difference , 0.01 ; 95 % CI , -1.36 to 1.37 ; P = .99 ) and mean language composite scores ( adjusted mean difference , -1.42 ; 95 % CI , -3.07 to 0.22 ; P = .09 ) of children in the DHA group did not differ from children in the control group . CONCLUSION The use of DHA-rich fish oil capsules compared with vegetable oil capsules during pregnancy did not result in lower levels of postpartum depression in mothers or improved cognitive and language development in their offspring during early childhood . TRIAL REGISTRATION anzctr.org.au Identifier : ACTRN12605000569606 BACKGROUND Early-life exposures to tobacco smoke and some dietary factors have been identified to induce epigenetic changes in genes involved in allergy and asthma development . Omega-3 ( n-3 ) polyunsaturated fatty acid ( PUFA ) intake during pregnancy could modulate key cytokines and T helper ( Th ) cell maturation ; however , little is known about the mechanism by which ω-3 PUFA could have a beneficial effect in preventing inflammatory disorders . OBJECTIVE We sought to test whether prenatal dietary supplementation with ω-3 PUFA during pregnancy may modulate epigenetic states in the infant immune system . DESIGN This study was based on a r and omized intervention trial conducted in Mexican pregnant women supplemented daily with 400 mg docosahexaenoic acid ( DHA ) or a placebo from 18 to 22 wk of gestation to parturition . We applied quantitative profiling of DNA methylation states in Th1 , Th2 , Th17 , and regulatory T-relevant genes as well as LINE1 repetitive elements of cord blood mononuclear cells ( n = 261 ) . RESULTS No significant difference in promoter methylation levels was shown between ω-3 PUFA-supplemented and control groups for the genes analyzed ; however , ω-3 PUFA supplementation was associated with changes in methylation levels in LINE1 repetitive elements ( P = 0.03 ) in infants of mothers who smoked during pregnancy . Furthermore , an association between the promoter methylation levels of IFNγ and IL13 was modulated by ω-3 PUFA supplementation ( P = 0.06 ) . CONCLUSIONS Our results indicate that maternal supplementation with ω-3 PUFA during pregnancy may modulate global methylation levels and the Th1/Th2 balance in infants . Therefore , the epigenetic mechanisms could provide attractive targets for prenatal modulation and prevention of inflammatory disorders and potentially other related diseases in childhood and adulthood Conflicting evidence exists on the effect of long-chain polyunsaturated fatty acid ( LCPUFA ) formula supplementation on cardiovascular health in term infants . It is known that LCPUFA supplementation does not affect infant growth , but long term outcome data are not available . The current study investigates whether 2 mo LCPUFA formula supplementation affects cardiovascular and anthropometric development at 9 y. A prospect i ve , double-blind , r and omized trial was performed in healthy term infants : a st and ard formula control group ( CF , n = 169 ) and a LCPUFA-supplemented group [ LF , n = 145 ; 0.45 % ( by wt ) AA  and 0.30 % ( by wt ) docosahexaenoic acid ( DHA ) ] . A breastfed group ( BF ; n = 159 ) served as reference . At the age of 9 y , systolic and diastolic blood pressure , heart rate , head circumference , weight , and height were measured . Univariate and multivariate analyses were performed ; 63 to 79 % of children were assessed . None of the cardiovascular or anthropometric measurements differed between the formula groups . Breastfed children had a marginally lower heart rate than formula-fed children , in particular compared with children fed control formula . Blood pressure and parameters of growth including BMI of breast and formula-fed children did not differ . In conclusion , the study suggests that short-term LCPUFA supplementation does not influence cardiovascular and anthropometric development at 9 Background : Intestinal damage and malabsorption caused by chronic environmental enteropathy are associated with growth faltering seen in infants in less-developed countries . Evidence has suggested that supplementary omega-3 ( n−3 ) long-chain PUFAs ( LC-PUFAs ) might ameliorate this damage by reducing gastrointestinal inflammation . LC-PUFA supplementation may also benefit cognitive development . Objective : We tested whether early n−3 LC-PUFA supplementation improves  infant intestinal integrity , growth , and cognitive function . Design : A r and omized , double-blind , controlled trial [ 200 mg DHA and 300 mg EPA or 2 mL olive oil/d for 6 mo ] was conducted in a population of 172 rural Gambian infants aged 3–9 mo . The primary endpoints were anthropometric measures and gut integrity [ assessed by using urinary lactulose : mannitol ratios ( LMRs ) ] . Plasma fatty acid status , intestinal mucosal inflammation ( fecal calprotectin ) , daily morbidity , and cognitive development ( 2-step means-end test and an attention assessment ) were secondary endpoints . Results : PUFA supplementation result ed in a significant increase in plasma n−3 LC-PUFA concentrations ( P < 0.001 for both DHA and EPA ) and midupper arm circumference ( MUAC ) ( effect size : 0.31 z scores ; 95 % CI : 0.06 , 0.56 ; P = 0.017 ) at 9 mo of age . At 12 mo , MUAC remained greater in the intervention group , and we observed significant increases in skinfold thicknesses ( P ≤ 0.022 for all ) . No other significant differences between treatment groups were detected for growth or LMRs at 9 mo or for secondary outcomes . Conclusions : Fish-oil supplementation successfully increased plasma n−3 fatty acid status . However , in young , breastfed Gambian infants , the intervention failed to improve linear growth , intestinal integrity , morbidity , or selected measures of cognitive development . The trial was registered at www.is rct n.org as IS RCT N66645725 BACKGROUND Long-chain n-3 PUFAs found in oily fish may have a role in lowering the risk of allergic disease . OBJECTIVE The objective was to assess whether an increased intake of oily fish in pregnancy modifies neonatal immune responses and early markers of atopy . DESIGN Women ( n = 123 ) were r and omly assigned to continue their habitual diet , which was low in oily fish , or to consume 2 portions of salmon per week ( providing 3.45 g EPA plus DHA ) from 20 wk gestation until delivery . In umbilical cord blood sample s ( n = 101 ) , we measured n-3 fatty acids , IgE concentrations , and immunologic responses . Infants were clinical ly evaluated at age 6 mo ( n = 86 ) . RESULTS Cord blood mononuclear cell ( C BMC ) production of interleukin (IL)-2 , IL-4 , IL-5 , IL-10 , and tumor necrosis factor-α in response to phytohemagglutinin ( PHA ) and of IL-2 in response to Dermatophagoides pteronyssinus allergen 1 ( Derp1 ) was lower in the salmon group ( all P ≤ 0.03 ) . In the subgroup of C BMC s in which an allergic phenotype was confirmed in the mother or father , IL-10 production in response to Toll-like receptor 2 , 3 , and 4 agonists , ovalbumin , salmon parvalbumin , or Derp1 and prostagl and in E(2 ) production in response to lipopolysaccharide or PHA was lower in the salmon group ( all P ≤ 0.045 ) . Total IgE at birth and total IgE , incidence and severity of atopic dermatitis , and skin-prick-test positivity at 6 mo of age were not different between the 2 groups . CONCLUSION Oily fish intervention in pregnancy modifies neonatal immune responses but may not affect markers of infant atopy assessed at 6 mo of age . This trial is registered at clinical trials.gov as NCT00801502 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 Objectives : The aim of this study was to monitor changes in the fecal microbiota from 9 to 18 months and to investigate the effect of increasing dietary n-3 polyunsaturated fatty acids on the fecal microbiota . Patients and Methods : In a double-blind controlled trial with r and om allocation to daily supplementation with 5 mL of fish oil ( FO ) or sunflower oil ( SO ) from 9 to 18 months of age , stool sample s were collected from 132 healthy Danish infants .  Molecular fingerprints of the bacterial DNA were obtained by terminal restriction fragment length polymorphism ( T-RFLP ) . Results : The T-RFLP profiles indicated that a few T-RFs became dominant with age ( bp100 and 102 , both presumed to be Bacteroidetes ) concomitantly with an overall increase in the microbial diversity ( P = 0.04 ) . Breast-feeding influenced both the T-RFLP profiles at 9 months and the changes from 9 to 18 months , and breast-feeding cessation during the trial modified the response to the dietary oils . In the FO group , the increase in bp102 was significantly reduced among children weaned before compared with those weaned during the trial ( P = 0.027 ) , whereas the increase in bp100 was reduced in the preweaned children of the SO group relative to those weaned during the trial ( P = 0.004 ) . This was supported by intervention group differences in the changes in bp102 and bp100 among the earlier weaned children ( P = 0.06 and P = 0.09 , respectively ) . Conclusions : Cessation of breast-feeding played a dominant role relative to developmental changes in the fecal microbiota from 9 to 18 months . FO compared with SO supplementation affected changes in large bacterial groups , but only among children who had stopped breast-feeding before 9 months of age 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 BACKGROUND Evidence suggests that asthma is rooted in the intrauterine environment and that intake of marine n-3 polyunsaturated fatty acids ( n-3 PUFAs ) in pregnancy may have immunomodulatory effects on the child . OBJECTIVE Our aim was to examine whether increasing maternal intake of n-3 PUFAs in pregnancy may affect offspring risk of asthma . DESIGN In 1990 , a population -based sample of 533 women with normal pregnancies were r and omly assigned 2:1:1 to receive four 1-g gelatin capsules/d with fish oil providing 2.7 g n-3 PUFAs ( n = 266 ) ; four 1-g , similar-looking capsules/d with olive oil ( n = 136 ) ; or no oil capsules ( n = 131 ) . Women were recruited and r and omly assigned around gestation week 30 and asked to take capsules until delivery . Among 531 live-born children , 528 were identified in registries and 523 were still alive by August 2006 .  Diagnoses from the International Coding of Diseases version 10 were extracted from a m and atory registry that recorded diagnoses reported from hospital contacts . RESULTS During the 16 y that passed since childbirth , 19 children from the fish oil  and  olive oil groups had received an asthma-related diagnosis ; 10 had received the diagnosis allergic asthma . The hazard rate of asthma was reduced by 63 % ( 95 % CI : 8 % , 85 % ; P = 0.03 ) , whereas the hazard rate of allergic asthma was reduced by 87 % ( 95 % CI : 40 % , 97 % ; P = 0.01 ) in the fish oil compared with the olive oil group . CONCLUSION Under the assumption that intake of olive oil in the dose provided here was inert , our results support that increasing n-3 PUFAs in late pregnancy may carry an important prophylactic potential in relation to offspring asthma A double-blind , r and omized , controlled , parallel-group prospect i ve trial was conducted to determine whether a dose-response existed for four different levels of docosahexaenoic acid ( DHA ) supplementation on the cognitive performance of infants . A total of 122 term infants were fed one of four different formulas varying in their DHA composition ( 0.00 , 0.32 , 0.64 , and 0.96 % of total fatty acids as DHA ) from birth to 12 mo . The three DHA-supplemented formulas also contained 0.64 % of total fatty acids as arachidonic acid ( ARA , 20:4n-6 ) . Infants were tested at 4 , 6 , and 9 mo of age on a visual habituation protocol that yielded both behavioral and psychophysiological indices of attention . Infants in all DHA+ARA-supplemented conditions had lower heart rates than those in the unsupplemented condition ; there was no dose-response for this effect . The distribution of time that infants spent in different phases of attention ( a cognitive index derived from the convergence of behavioral and cardiac responses ) varied as a function of dosage . Infants supplemented at the two lower DHA doses spent proportionately more time engaged in active stimulus processing than infants fed the unsupplemented formula , whereas infants fed the highest dose were intermediate and did not differ from any other group Nutritional influences on cardiovascular disease operate throughout life . Studies in both experimental animals and humans have suggested that changes in the peri- and early post-natal nutrition can affect the development of the various components of the metabolic syndrome in adult life . This has lead to the hypothesis that n-3 fatty acid supplementation in pregnancy may have a beneficial effect on lipid profile in the offspring . The aim of the present study was to investigate the effect of supplementation with n-3 fatty acids during the third trimester of pregnancy on lipids and lipoproteins in the 19-year-old offspring . The study was based on the follow-up of a r and omized controlled trial from 1990 where 533 pregnant women were r and omized to fish oil ( n = 266 ) , olive oil ( n = 136 ) or no oil ( n = 131 ) . In 2009 , the offspring were invited to a physical examination including blood sampling . A total of 243 of the offspring participated .  Lipid values did not differ between the fish oil and olive oil groups . The relative adjusted difference ( 95 % confidence intervals ) in lipid concentrations was −3 % ( −11 ; 7 ) for LDL cholesterol , 3 % ( −3 ; 10 ) for HDL cholesterol , −1 % ( −6 ; 5 ) for total cholesterol,−4 % ( −16 ; 10 ) for TAG concentrations , 2%(−2 ; 7 ) for apolipoprotein A1 , −1 % ( −9 ; 7 ) for apolipoprotein B and 3 % ( −7 ; 15 ) in relative abundance of small dense LDL . In conclusion , there was no effect of fish oil supplementation during the third trimester of pregnancy on offspring plasma lipids and lipoproteins in adolescence 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 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 Maternal diet during pregnancy might be one of the factors that influences fetal immune responses associated with childhood allergy . OBJECTIVE We analyzed the association between maternal diet during the last 4 wk of pregnancy and allergic sensitization and eczema in the offspring at 2 y of age . DESIGN Data from 2641 children at 2 y of age were analyzed within a German prospect i ve birth cohort study ( LISA ) . Maternal diet during the last 4 wk of pregnancy was assessed with a semiquantitative food-frequency question naire , which was administered shortly after childbirth . RESULTS High maternal intake of margarine [ adjusted odds ratio ( aOR ) : 1 . 49 ; 95 % CI : 1.08 , 2.04 ] and vegetable oils ( aOR : 1.48 ; 95 % CI : 1.14 , 1.91 ) during the last 4 wk of pregnancy was positively associated and high maternal fish intake ( aOR : 0.75 ; 95 % CI : 0.57 , 0.98 ) was inversely associated with eczema during the first 2 y in the offspring . High celery ( aOR : 1.85 ; 95 % CI : 1.18 , 2.89 ) and citrus fruit ( aOR : 1.73 ; 95 % CI : 1.18 , 2.53 ) intakes increased the risk of sensitization against food allergens . In turn , sensitization against inhalant allergens was positively related to a high maternal intake of deep-frying vegetable fat ( aOR : 1.61 ; 95 % CI : 1.02 , 2.54 ) , raw sweet pepper ( aOR : 2.16 ; 95 % CI : 1.20 , 3.90 ) , and citrus fruit ( aOR : 1.72 ; 95 % CI : 1.02 , 2.92 ) . CONCLUSIONS We suggest that the intake of allergenic foods and foods rich in n-6 polyunsaturated fatty acids during pregnancy may increase and foods rich in n-3 polyunsaturated fatty acids may decrease the risk of allergic diseases in the offspring Maternal fish oil supplementation during pregnancy has been associated with altered infant  immune responses and a reduced risk of infant sensitization and eczema Background : Infants in developing countries require early dietary interventions to prevent nutritional deficiencies , above all protein , energy , iron and zinc . To what extent these interventions may affect the fatty acid ( FA ) status is still unknown . Objectives : To examine and compare the effects of 2 micronutrient “ sprinkles ” supplementations ( iron 12.5 mg + folic acid 150 μg , iron/folate and iron 12.5 mg + folic acid 150 μg + zinc 5 mg + vitamins A , C and D3 , mineral/micronutrient [ MMN ] ) versus placebo on the FA status of Cambodian infants . Methods : A total of 204 infants age 6 mo and living in Kompong Chhnang Province , Cambodia , were r and omly assigned to receive daily supplementation of MMN ( n = 68 ) and iron/folate ( n = 68 ) or placebo ( n = 68 ) for a 12-mo period in powder form as sprinkles . At the end of the intervention period , FAs in the range of 16 to 24 C were determined in blood drops absorbed on a strip collected from 182 subjects , and values among the 3 intervention subgroups and those of 21 Italian 18-mo-old , normal-growing infants as the reference group were compared . Results : At the end of the supplementation trial , higher levels of the 2 essential FAs ( EFAs ) ( linoleic acid , 18:2n-6 , and α-linolenic acid , 18:3n-3 ) were found in the MMN group . No differences occurred for the major longer chain derivatives of both EFAs arachidonic acid ( 20:4n-6 ) and docosahexaenoic acid ( 22:6n-3 ) . In MMN supplemented Cambodians , blood levels of linoleic acid approached those of Italian infants , and in addition their α-linolenic acid levels were improved . Cambodian infants , mostly still breast-fed through the second year of life , showed significantly higher levels of long-chain derivatives of both the n-6 and the n-3 series compared with Italians . Conclusions : Supplementation with iron , folic acid , zinc and vitamins was associated with an increase of linoleic acid and α-linolenic acid levels in Cambodian infants  versus placebo , without significant changes in the concentrations of their longer chain derivatives , result ing in a FA status closer to Italian counterparts for the essential polyunsaturated FA levels . The iron/folate – treated infants showed no differences compared with the other 2 groups . Studies are needed to differentiate the potential effects of the supplemented micronutrients on the FA status OBJECTIVE To investigate the incidence of  allergic and respiratory diseases  through age 3 years in children fed docosahexaenoic acid (DHA)- and arachidonic acid (ARA)-supplemented formula during infancy . STUDY DESIGN Children who completed r and omized , double-blind studies of DHA/ARA-supplemented  ( 0.32%-0.36%/0.64%-0.72 % of total fatty acids , respectively ) versus nonsupplemented ( control ) formulas , fed during the first year of life , were eligible . Blinded study nurses review ed medical charts for upper respiratory infection ( URI ) , wheezing , asthma , bronchiolitis , bronchitis , allergic rhinitis , allergic conjunctivitis , otitis media , sinusitis , atopic dermatitis ( AD ) , and urticaria . RESULTS From the 2 original cohorts , 89/179 children participated ; 38/89 were fed DHA/ARA formula . The DHA/ARA group had significantly lower odds for developing URI ( odds ratio [ OR ] , 0.22 ; 95 % confidence interval [ CI ] , 0.08 - 0.58 ) , wheezing/asthma ( OR , 0.32 ; 95 % CI , 0.11 - 0.97 ) , wheezing/asthma/AD ( OR , 0.25 ; 95 % CI , 0.09 - 0.67 ) , or any allergy ( OR , 0.28 ; 95 % CI , 0.10 - 0.72 ) . The control group had significantly shorter time to first diagnosis of URI ( P = .006 ) , wheezing/asthma ( P = .03 ) , or any allergy ( P = .006 ) . CONCLUSIONS DHA/ARA supplementation was associated with delayed onset and reduced incidence of URIs and common allergic diseases up to 3 years of age The effect of the dietary n-3 long-chain PUFA , DHA ( 22 : 6n-3 ) , on the growth of pre-term infants is controversial . We tested the effect of higher-dose DHA ( approximately 1 % dietary fatty acids ) on the growth of pre-term infants to 18 months corrected age compared with st and ard feeding practice ( 0·2 - 0·3 % DHA ) in a r and omised controlled trial . Infants born < 33 weeks gestation ( n 657 ) were r and omly allocated to receive breast milk and /or formula with higher DHA or st and ard DHA according to a concealed schedule stratified for sex and birth-weight ( < 1250 and ≥ 1250 g ) . The dietary arachidonic acid content of both diets was constant at approximately 0·4 % total fatty acids . The intervention was from day 2 to 5 of life until the infant 's expected date of delivery ( EDD ) . Growth was assessed at EDD , and at 4 , 12 and 18 months corrected age . There was no effect of higher DHA on weight or head circumference at any age , but infants fed higher DHA were 0·7 cm ( 95 % CI 0·1 , 1·4 cm ; P = 0·02 ) longer at 18 months corrected age . There was an interaction effect between treatment and birth weight strata for weight ( P = 0·01 ) and length ( P = 0·04 ) . Higher DHA result ed in increased length in infants born weighing ≥ 1250 g at 4 months corrected age and in both weight and length at 12 and 18 months corrected age . Our data show that DHA up to 1 % total dietary fatty acids does not adversely affect growth It has been suggested that changes in dietary habits , particularly increased consumption of omega-6 polyunsaturated fatty acids ( PUFA ) and decreased consumption of omega-3 PUFAs may explain the increase in atopic disease seen in recent years . Furthermore , it seems possible that it is mainly prenatal or very early life environmental factors that influence the development of allergic diseases . It has also been suggested that intrauterine risk factors may act differently if mother themselves suffer from allergic disease . The aim of this study was to investigate whether the consumption of fish , butter and margarine during pregnancy might influence the development of allergic sensitizations in the offspring . The study population was divided into the offspring of allergic and non-allergic mothers . This was a retrospective cohort study enrolling 295 offspring of allergic mothers and 693 of non-allergic mothers . Information regarding maternal intake of fish , butter and margarine during pregnancy as well as other prenatal and perinatal confounding factors were retrospectively assessed by parental report via a st and ardized question naire . Atopy was determined by skin-prick tests ( SPT ) to eight prevalent inhalant allergens and two foods . In the allergic mothers ' group there is no clear correlation between maternal intakes of fish , butter and margarine  and sensitizations to food or inhalants . In the non-allergic mothers ' group there was no correlation between butter and margarine  intake and food or inhalant sensitizations . On the contrary , a protective effect of fish intake on SPT positivity was observed . In particular , frequent maternal intake ( ' 2 - 3 times/wk or more ' ) of fish reduced the risk of food sensitizations by over a third ( aOR 0.23 ; 95 % CI : 0.08 - 0.69 ) . A similar trend , even if not significant , was found for inhalants . Finally , even in the whole study population , i.e. allergic group plus non-allergic group , there was a similar trend between increased consumption of fish and decreased prevalence of SPT positivity for foods . This study shows that frequent intake of fish during pregnancy may contrast the development of SPT sensitizations for foods in the offspring of mothers without atopic disease . Therefore , larger prospect i ve studies are needed , enrolling mothers with and without allergic disease , to confirm these results 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 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 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 BACKGROUND : Docosahexaenoic acid ( DHA ) has been associated with downregulation of inflammatory responses . OBJECTIVE : To report the effect of DHA supplementation on  long-term atopic and respiratory outcomes in preterm infants . METHODS : This study is a multicenter , r and omized controlled trial comparing the outcomes for preterm infants <33 weeks ' gestation who consumed expressed breast milk from mothers taking either tuna oil ( high-DHA diet ) or soy oil ( st and ard-DHA ) capsules .  Data collected included incidence of bronchopulmonary dysplasia ( BPD ) and parental reporting of atopic conditions over the first 18 months of life . RESULTS : Six hundred fifty-seven infants were enrolled ( 322 to high-DHA diet , 335 to st and ard ) , and 93.5 % completed the 18-month follow-up . There was a reduction in BPD in boys ( relative risk [ RR ] : 0.67 [ 95 % confidence interval ( CI ) : 0.47–0.96 ] ; P = .03 ) and in all infants with a birth weight of < 1250 g ( RR : 0.75 [ 95 % CI : 0.57–0.98 ] ; P = .04 ) . There was no effect on duration of respiratory support , admission length , or home oxygen requirement . There was a reduction in reported hay fever in all infants in the high-DHA group at either 12 or 18 months ( RR : 0.41 [ 95 % CI : 0.18–0.91 ] ; P = .03 ) and at either 12 or 18 months in boys ( RR : 0.15 [ 0.03–0.64 ] ; P = .01 ) . There was no effect on asthma , eczema , or food allergy . CONCLUSIONS : DHA supplementation for infants of <33 weeks ' gestation reduced the incidence of BPD in boys and in all infants with a birth weight of < 1250 g and reduced the incidence of reported hay fever in boys at either 12 or 18 months Probiotics and long-chain PUFA ( LC-PUFA ) may be beneficial supplements for infants who are not breast-fed . The aim of the present study is to evaluate the safety of an infant formula containing the LC-PUFA DHA and arachidonic acid ( AA ) and the probiotic Bifidobacterium lactis by comparing the growth rate of infants fed the supplemented and unsupplemented formulas . One hundred and forty-two healthy , term infants were enrolled in a single-centre , r and omised , double-blind , controlled , parallel-group trial , and allocated to receive either st and ard or probiotic and LC-PUFA-containing experimental formulas . The infants were fed with their assigned formulas for 7 months . The primary outcome ( weight gain ) and the secondary outcomes ( length , head circumference and formula tolerance ) were measured throughout the study . LC-PUFA status was assessed at 4 months of age and immune response to childhood vaccines was measured at 7 months of age . There was no significant difference in growth between the two groups . The 90 % CI for the difference in mean weight gain was - 0.08 , 3.1 g in the intention-to-treat population and 0.1 - 3.8 g in the per protocol population , which lay within the predefined boundaries of equivalence , - 3.9 - 3.9 . There were no significant differences in mean length and head circumference . DHA and AA concentrations were higher in infants in the experimental formula group compared with the control formula group . No influence of the supplements on the response to vaccines was observed . Growth characteristics of term infants fed the starter formula containing a probiotic and LC-PUFA were similar to st and ard formula-fed infants 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 BACKGROUND The range of human milk docosahexaenoic acid ( DHA ) concentrations worldwide is much broader than the range explored in r and omized clinical trials to date . OBJECTIVE The primary objective was to determine the effect of 4 amounts of DHA supplementation on the visual acuity of formula-fed infants at 12 mo of age . Secondary objectives were to evaluate visual acuity maturation , red blood cell fatty acids , tolerance , anthropometric measures , and adverse events . DESIGN This double-masked , r and omized trial was conducted at 2 sites ( Dallas and Kansas City ) . Three hundred forty-three healthy , term , formula-fed infants were enrolled at 1 - 9 d of age and were r and omly assigned to be fed 1 of the following 4 infant formulas containing equivalent nutrient amounts , except for long-chain polyunsaturated fatty acids : control ( 0 % DHA ) , 0.32 % DHA , 0.64 % DHA , or 0.96 % DHA ; DHA-supplemented formulas also provided 0.64 % arachidonic acid .  Visual acuity was measured by visual evoked potentials in 244 infants who completed the 12-mo primary outcome examination . RESULTS Infants fed control formula had significantly poorer visual evoked potential visual acuity at 12 mo of age than did infants who received any of the DHA-supplemented formulas ( P < 0.001 ) . There were no significant differences in visual evoked potential visual acuity between the 3 amounts of DHA supplementation for either site at any age tested . CONCLUSIONS DHA supplementation of infant formula at 0.32 % of total fatty acids improves visual acuity . Higher amounts of DHA supplementation were not associated with additional improvement of visual acuity . This trial was registered at clinical trials.gov as NCT00753818 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 It is well established that obesity tends to track from early childhood into adult life . Studies in experimental animals have suggested that changes in the peri- and early postnatal intake of n-3 ( omega-3 ) polyunsaturated acids can affect the development of obesity in adult life . OBJECTIVE The aim of the current study was to investigate the effect of daily supplementation with 2.7 g long-chain n-3 fatty acids during the third trimester of pregnancy on adiposity in 19-y-old offspring . DESIGN The study was based on follow-up of a r and omized controlled trial from 1990 , in which 533 pregnant women were r and omly assigned to receive fish oil , olive oil , or no oil . At ≈19 y of age , the offspring of subjects from the r and omized controlled trial were invited to undergo a physical examination , including anthropometric measurements and fasting blood sampling . The blood sample was analyzed for insulin , glucose , glycated hemoglobin , leptin , adiponectin , insulin-like growth factor I , and high-sensitivity C-reactive protein . Multiple linear regression modeling , adjusted for sex , smoking , and parental overweight , was used to estimate the effect of fish oil relative to that of olive oil  on BMI ( in kg/m(2 ) ) , waist circumference , and biochemical measures . RESULTS A total of 243 of the offspring were followed up . We found no difference between the fish-oil and olive oil groups in BMI ( 0.13 ; -0.92 , 1.17 ) or waist circumference ( 0.7 cm ; -2.1 , 3.4 cm ) . Overall , results of the biochemical analyses supported the finding of no difference between the groups . CONCLUSION We detected no effect of fish-oil supplementation during pregnancy on offspring adiposity in adolescence AIM Long-chain polyunsaturated fatty acid ( LCPUFA ) supplementation of infant formula may have a beneficial effect on cognitive development . This study aim ed to investigate the effect of LCPUFA formula supplementation primarily on cognition and secondarily on behaviour at age 9 years . Special attention was paid to the potentially modifying effect of maternal smoking during pregnancy . METHOD A double-blind , r and omized control study was performed in two groups of healthy infants born at term : one group , constituting the control group , received st and ard formula ( n=169 ) and another group received st and ard formula supplemented with LCPUFAs ( n=146 ) . A breastfed group ( n=159 ) served as an additional reference . At 9 years of age , 72 % of the children ( control group : n=123 ; 71 males , 52 females ; LCPUFA group : n=91 ; 42 males , 49 females ; breastfed group : n=127 , 64 males , 63 females ) underwent extensive cognitive and behavioural testing . RESULTS An interaction between infant nutrition and smoking during pregnancy was found . Among children exposed to smoking during pregnancy , LCPUFA supplementation was associated with higher mean verbal IQ scores ( p=0.007 ) and learning and memory ( p=0.006 ) . Among children not exposed to smoking during pregnancy , LCPUFA supplementation was associated with lower mean verbal memory scores ( p=0.003 ) . Executive function scores were significantly lower in the LCPUFA-supplemented group than in the control group ( p=0.001 ) . Breastfeeding was associated with better performance on IQ ( p=0.005 ) . INTERPRETATION No consistent beneficial effect of LCPUFA formula supplementation on cognitive development in term-born infants was found . The study confirmed that breastfeeding is associated with better cognition BACKGROUND Observational studies associate higher intakes of n-3 ( omega-3 ) long-chain polyunsaturated fatty acids ( LCPUFAs ) during pregnancy with higher gestation duration and birth size .  The results of r and omized supplementation trials using various n-3 LCPUFA sources and amounts are mixed . OBJECTIVE We tested the hypothesis that 600 mg/d of the n-3 LCPUFA docosahexaenoic acid ( DHA ) can increase  maternal and newborn DHA status , gestation duration , birth weight , and length . Safety was assessed . DESIGN This phase III , double-blind , r and omized controlled trial was conducted between January 2006 and October 2011 . Women ( n = 350 ) consumed capsules ( placebo , DHA ) from < 20 wk of gestation to birth . Blood ( enrollment , birth , and cord ) was analyzed for red blood cell ( RBC ) phospholipid DHA . The statistical analysis was intent-to-treat . RESULTS Most of the capsules were consumed ( 76 % placebo ; 78 % DHA ) ; the mean DHA intake for the treated group was 469 mg/d . In comparison with placebo , DHA supplementation result ed in higher maternal and cord RBC-phospholipid-DHA ( 2.6 % ; P < 0.001 ) , longer gestation duration ( 2.9 d ; P = 0.041 ) , and greater birth weight ( 172 g ; P = 0.004 ) , length ( 0.7 cm ; P = 0.022 ) , and head circumference ( 0.5 cm ; P = 0.012 ) . In addition , the DHA group had fewer infants born at < 34 wk of gestation ( P = 0.025 ) and shorter hospital stays for infants born preterm ( 40.8 compared with 8.9 d ; P = 0.026 ) than did the placebo group . No safety concerns were identified . CONCLUSIONS A supplement of 600 mg DHA/d in the last half of gestation result ed in overall greater gestation duration and infant size . A reduction in early preterm and very-low birth weight could be important clinical and public health outcomes of DHA supplementation . This trial was registered at clinical trials.gov as NCT00266825 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 BACKGROUND Docosahexaenoic acid ( DHA ; 22:6n-3 ) is highly important during pregnancy for optimal development and functioning of fetal neural tissue . Infant ability to organize sleep and wake states following parturition is highly associated with later developmental outcomes . The impact of maternal DHA intake on sleep organization has not been previously investigated . AIMS To examine the effect of a DHA-containing functional food consumed during pregnancy on early neurobehavioral development as assessed by infant sleep patterning in the first 48 postnatal hours . STUDY DESIGN A longitudinal , r and omized , double-blinded , placebo-controlled design was used . SUBJECTS Women ( 18 - 35 y ) with no pregnancy complications consumed a cereal-based functional food ( 92 kcal ) containing 300 mg DHA an average of 5 d/week or placebo bars ( n=27 DHA , n=21 Placebo ) . The intervention began at 24 weeks gestation and continued until delivery ( 38 - 40 weeks ) . OUTCOME MEASURES Infant sleep/wake states were measured on postnatal days 1 ( D1 ) and 2 ( D2 ) using a pressure sensitive mattress recording respiration and body movements . RESULTS Using ANCOVA and controlling for ethnic variation , there were significant group differences in arousals in quiet sleep on D1 ( P=0.006 ) and D2 ( P=0.011 ) with fewer arousals in the DHA intervention group compared to the placebo group . Similarly , arousals in active sleep on D1 were significantly lower in the DHA-intervention group ( P=0.012 ) compared to the placebo group . CONCLUSIONS We conclude that increased prenatal supply of dietary DHA has a beneficial impact on infant sleep organization BACKGROUND Early vitamin supplementation is given routinely to infants in many countries , but it is unclear whether this affects the risk of allergic diseases . OBJECTIVES We sought to study the association between early-life supplementation of vitamins A and D in water-soluble form or in peanut oil and allergic diseases up to 4 years of age . METHODS A prospect i ve birth cohort of 4089 newborn infants was followed for 4 years using parental question naires repeatedly to collect information on exposure and health . At 4 years , the response rate was 90 % , and allergen-specific IgE levels to food and airborne allergens were measured in 2614 of the participating children . RESULTS Vitamins A and D were given to 98 % of the children in infancy , and vitamins based in peanut oil dominated ( 90 % ) . Children supplemented with vitamins A and D in water-soluble form during the first year of life had an almost 2-fold increased risk of asthma ( adjusted odds ratio [ OD ] , 2.18 ; 95 % CI , 1.45 - 3.28 ) , food hypersensitivity ( adjusted OR , 1.89 ; 95 % CI , 1.33 - 2.65 ) , and sensitization to common food and airborne allergens ( adjusted OR , 1.88 ; 95 % CI , 1.34 - 2.64 ) at age 4 years compared with those receiving vitamins in peanut oil . No increased risk of IgE antibodies to peanut was seen in children receiving vitamins in peanut oil . CONCLUSION Supplementation of vitamins A and D in water-soluble form seems to increase the risk of allergic disease up to the age of 4 years compared with supplementation with the same vitamins given in peanut oil . CLINICAL IMPLICATION S Vitamins A and D in oil does not seem to increase the risk of allergic disease during childhood n-3 Long-chain PUFA ( LC-PUFA ) intake during infancy is important for neurodevelopment ; however , previous studies of n-3 LC-PUFA supplementation have been inconclusive possibly due to an insufficient dose and limited methods of assessment . The present study aim ed to evaluate the effects of direct supplementation with high-dose fish oil ( FO ) on infant neurodevelopmental outcomes and language . In the present r and omised , double-blind , placebo-controlled trial , 420 healthy term infants were assigned to receive a DHA-enriched FO supplement ( containing at least 250 mg DHA/d and 60 mg EPA/d ) or a placebo ( olive oil ) from birth to 6 months . Assessment occurred at 18 months via the Bayley Scales of Infant and Toddler Development ( 3rd edition ; BSID-III ) and the Child Behavior Checklist . Language assessment occurred at 12 and 18 months via the Macarthur-Bates Communicative Development Inventory .  The FO group had significantly higher erythrocyte DHA ( P = 0·03 ) and plasma phospholipid DHA ( P = 0·01 ) levels at 6 months of age relative to placebo . In a small subset analysis ( about 40 % of the total population ) , children in the FO group had significantly higher percentile ranks of both later developing gestures at 12 and 18 months ( P = 0·007 ; P = 0·002 , respectively ) and the total number of gestures ( P = 0·023 ; P = 0·006 , respectively ) . There was no significant difference between the groups in the st and ard or composite scores of the BSID-III . The results suggest that improved postnatal n-3 LC-PUFA intake in the first 6 months of life using high-dose infant FO supplementation was not beneficial to global infant neurodevelopment . However , some indication of benefits to early communicative development was observed Polyunsaturated n-3 fatty acids ( n-3PUFA ) may improve brain development and prevent cardiovascular disease . Heart rhythm is autonomically controlled and among the affected cardiovascular risk markers in adults . The aim of the study was to examine whether fish oil supplementation in late infancy could modify heart rate ( HR ) and heart rate variability ( HRV ) . In a 2 × 2-intervention , 83 healthy Danish infants were r and omized to ± fish oil ( 3.4 ± 1.1 mL/d ) and cow 's milk or infant formula from 9 to 12 mo of age . In 57 infants , 0.5-h ECG recordings were successfully obtained before and after the intervention and erythrocyte fatty acid composition was determined in 30 of these . Fish oil supplementation raised erythrocyte n-3PUFA content ( p < 0.001 ) . No significant group differences were seen in HR or HRV . However , a fish-oil × gender interaction was observed on mean RR interval ( p = 0.001 ) with a 6 % longer mean RR interval in fish-oil-supplemented boys ( p = 0.007 ) . Irrespective of gender , there was a positive association between the 9- and 12-mo changes in RR interval and erythrocyte n-3PUFA ( p < 0.001 ) . In infants with confirmed changes in erythrocyte n-3PUFA , mean RR interval was found to be longer ( p = 0.011 ) in the fish-oil-supplemented groups . The study suggests that fish oil may affect heart rhythm in infants similar to that observed in adults . This may imply low n-3PUFA-status in late infancy and n-3PUFA influence on CNS function Background and Objective : Feeding long-chain polyunsaturated fatty acids ( LCP ) influences immunity in adults ; however , less is known about their effect during development . The aim of the study was to determine the effect of feeding LCP on immunity in healthy infants during the first 4 months of life . Patients and Methods : Formula-fed infants were r and omized at ≤14 days of age to st and ard term formula ( Formula ) or formula containing LCP ( Formula+LCP ) . Infants exclusively fed human milk ( HM ) were included for comparison . At 16 weeks of age , blood was collected and phenotypes , the ability to proliferate and produce cytokines ( interleukin [IL]-2 , IL-4 , IL-6 , IL-10 , IL-12 , interferon [IFN]-γ , tumor necrosis factor [TNF]-α , TGF-β ) after incubation with phytohemaglutinin ( PHA ) , β-lactoglobulin , or soy protein were measured . Results : Feeding LCP result ed in a higher than and more similar proliferation rate to PHA in HM-fed infants , possibly because of a greater TH1 type cytokine response and a higher percentage of antigen mature ( CD45RO+ ) cells ( P < 0.05 ) . The response to β-lactoglobulin did not differ among groups . After incubation with soy protein Formula+LCP , compared with Formula produced less IL-2 and more TNF-α and had a higher percentage of CD8 + and a lower percentage of CD20 + ( CD20+CD54 + ) cells poststimulation ( P < 0.05 ) . Both formula groups produced less IL-2 after PHA , had a lower percentage of CD80 + cells , and a higher percentage of CD54 + cells after incubation with food proteins ( P < 0.05 ) . Conclusions : Formula-fed infants , at low risk for allergy , respond differently to mitogen and food proteins ex vivo than those fed HM . Feeding LCP altered some of these differences in the direction that is hypothesized to confer immune benefits Objective To determine whether dietary n-3 long chain polyunsaturated fatty acid ( LCPUFA ) supplementation of pregnant women with a fetus at high risk of allergic disease reduces immunoglobulin E associated eczema or food allergy at 1 year of age . Design Follow-up of infants at high hereditary risk of allergic disease in the Docosahexaenoic Acid to Optimise Mother Infant Outcome ( DOMInO ) r and omised controlled trial . Setting Adelaide , South Australia . Participants 706 infants at high hereditary risk of developing allergic disease whose mothers were participating in the DOMInO trial . Interventions The intervention group ( n=368 ) was r and omly allocated to receive fish oil capsules ( providing 900 mg of n-3 LCPUFA daily ) from 21 weeks ’ gestation until birth ; the control group ( n=338 ) received matched vegetable oil capsules without n-3 LCPUFA . Main outcome measure Immunoglobulin E associated allergic disease ( eczema or food allergy with sensitisation ) at 1 year of age . Results No differences were seen in the overall percentage of infants with immunoglobulin E associated allergic disease between the n-3 LCPUFA and control groups ( 32/368 ( 9 % ) v 43/338 ( 13 % ) ; unadjusted relative risk 0.68 , 95 % confidence interval 0.43 to 1.05 , P=0.08 ; adjusted relative risk 0.70 , 0.45 to 1.09 , P=0.12 ) , although the percentage of infants diagnosed as having atopic eczema ( that is , eczema with associated sensitisation ) was lower in the n-3 LCPUFA group ( 26/368 ( 7 % ) v 39/338 ( 12 % ) ; unadjusted relative risk 0.61 , 0.38 to 0.98 , P=0.04 ; adjusted relative risk 0.64 , 0.40 to 1.02 , P=0.06 ) . Fewer infants were sensitised to egg in the n-3 LCPUFA group ( 34/368 ( 9 % ) v 52/338 ( 15 % ) ; unadjusted relative risk 0.61 , 0.40 to 0.91 , P=0.02 ; adjusted relative risk 0.62 , 0.41 to 0.93 , P=0.02 ) , but no difference between groups in immunoglobulin E associated food allergy was seen . Conclusion n-3 LCPUFA supplementation in pregnancy did not reduce the overall incidence of immunoglobulin E associated allergies in the first year of life , although atopic eczema and egg sensitisation were lower . Longer term follow-up is needed to determine if supplementation has an effect on respiratory allergic diseases and aeroallergen sensitisation in childhood . Trial registration Australian New Zeal and Clinical Trials Registry ACTRN12610000735055 ( DOMInO trial : ACTRN12605000569606 ) This investigation evaluated variations in resting heart rate ( HR ) measures during the first half year of life in healthy , full-term infants who were either breast-fed ( BF ) , or fed formula with ( milk-based : MF ; soy-based : SF ) or without ( soy-based : SF− ) commercially supplemented DHA ( decosahexaenoic acid ) . In infants fed the DHA-deficient diet , higher HR and lower values for heart rate variability measures were observed , indicating decreased parasympathetic tone in this group . These effects , appearing at 4 months and continuing for the remainder of the study period , are consistent with suggestions that the 3–5-month postnatal interval may be an important period in the development of cardiovascular regulation . The absence of these effects in SF infants receiving the DHA-supplemented formula suggests that neither soy protein nor the associated phytochemicals in soy formula contribute to these effects to any appreciable extent . In general , the results do not indicate differences in any of the study variables attributable to soy formula per se DHA ( 22:6n-3 ) supplementation  during infancy has been associated with lower heart rate ( HR ) and improved neurobehavioral outcomes . We hypothesized that maternal DHA supplementation would improve fetal cardiac autonomic control and newborn neurobehavior .  Pregnant women were r and omized to 600 mg/day of DHA or placebo oil capsules at 14.4 ( + /-4 ) weeks gestation . Fetal HR and HRV were calculated from magnetocardiograms ( MCGs ) at 24 , 32 and 36 weeks gestational age ( GA ) . Newborn neurobehavior was assessed using the Neonatal Behavioral Assessment Scale ( NBAS ) . Post-partum maternal and infant red blood cell ( RBC ) DHA was significantly higher in the supplemented group as were metrics of fetal HRV and newborn neurobehavior in the autonomic and motor clusters . Higher HRV is associated with more responsive and flexible autonomic nervous system ( ANS ) . Coupled with findings of improved autonomic and motor behavior , these data suggest that maternal DHA supplementation during pregnancy may impart an adaptive advantage to the fetus DHA ( 22 : 6n-3 ) in pregnancy has previously been shown to benefit infant brain and retinal development . Fatty acid consumption during pregnancy may also have an impact on infant adipose tissue development . The objective of the present study was to assess the prenatal impact of a DHA-containing functional food ( DHA-FF ) on  infant intra-uterine growth . This was a longitudinal , r and omised , double-blinded , placebo-controlled trial . Pregnant women were assigned to consume a DHA-FF or placebo bar from 24 weeks ' gestation until delivery . Blood sample s were collected from mothers at baseline and delivery and from the umbilical cord at delivery . Plasma and erythrocyte fatty acids were analysed by GLC and plasma insulin concentrations were analysed using a commercially available ELISA kit . Infant birth weight and length were obtained at delivery and ponderal index ( weight (g)/length (cm)3 × 100 ) was calculated . A total of forty-seven mothers completed the study . Infants of mothers consuming the DHA-FF during the last half of pregnancy had lower ponderal indices ( β = 0.198 , P < 0.05 ) and umbilical cord blood insulin concentrations ( β = 0.743 , P < 0.05 ) than infants of mothers consuming the placebo . Thus , DHA consumption during pregnancy may be advantageous with respect to infant body composition at birth and insulin sensitivity BACKGROUND Inadequate consumption of fish could be a risk factor for  low birth weight ( LBW ) .  This study assessed fish intake and omega-3 LCPUFA intake and status for their association with LBW in a cohort of urban , south Indian pregnant women . SUBJECTS/ METHODS In a prospect i ve cohort study , data on maternal fish intake and omega-3 LCPUFA intake and status of 676 women were obtained at baseline ( first trimester ) , the second and third trimesters of pregnancy . Infant birth weight was measured immediately following hospital delivery . The dropout rate was 7.6 % . RESULTS Fifty-six percent of the study women consumed fish with low daily median intakes ( 3.4 , 4.1 and 3.8 g day(-1 ) at the three trimesters , respectively ) . Consequently , the median intakes of EPA and DHA during pregnancy were also low at 2.1 and 10.1 mg day(-1 ) , respectively . EPA and DHA intakes were associated with their status in erythrocyte membrane phospholipids during pregnancy ( r=0.40 and 0.36 , r=0.34 and 0.32 and r=0.37 and 0.41 , at the three trimesters , respectively , all P<0.001 ) . Women who did not eat fish during the third trimester had a significantly higher risk of LBW ( OR : 2.49 , P=0.019 ) . Similarly , low EPA intake during the third trimester had an association with a higher risk of LBW ( OR : 2.75 , P=0.011 ) . CONCLUSIONS Among low fish-eating pregnant women , fish intake in the third trimester was closely associated with birth weight . Supplementation with omega-3 LCPUFA during pregnancy may have important implication s for fetal development in India OBJECTIVE : To test the hypothesis that long-chain polyunsaturated fatty acid ( LCPUFA ) supplementation in infancy would improve cognition into later childhood ( after 9 years ) at both general and specific levels . METHODS : A comprehensive cognitive battery was completed by 107 formerly preterm infants ( mean age : 128 months ) . As infants , they had been assigned r and omly to receive LCPUFA-supplemented ( N = 50 ) or control ( N = 57 ) formula , between birth and 9 months ; the docosahexaenoic acid level ( DHA ) in the supplemented formulas was 0.5 % . In addition to r and omized comparisons , we planned supplementary analyses to examine the effects of both gender and feeding group ( those receiving some maternal breast milk versus those receiving none ) . RESULTS : There were no significant differences between r and omized diet groups on any cognitive measure . There was significant interaction between gender and supplementation ; girls only showed beneficial effects of LCPUFAs on literacy . Significant interaction also occurred between feeding group and supplementation ; increases of 0.7 SD in verbal IQ , full-scale IQ , and memory scores were found for the LCPUFA group , but only for infants who received only formula and no maternal breast milk . CONCLUSIONS : The results of this post–9-year cognitive follow-up study in a r and omized trial of LCPUFA-supplemented formula for preterm infants suggest no overall group effects but indicate that gender-specific and diet-specific effects may exist . The data provide some evidence that LCPUFAs are a key factor in the cognitive benefits of breast milk . Caution is advised in data interpretation because of the small groups used OBJECTIVE : To assess whether the addition of an omega-3 long-chain polyunsaturated fatty acid supplement would reduce preterm birth in women with at least one prior spontaneous preterm birth receiving 17&agr;-hydroxyprogesterone caproate .  METHODS : We conducted a r and omized , double-masked , placebo-controlled trial in 13 centers . Women with a history of prior spontaneous singleton preterm birth and a current singleton gestation were assigned to either a daily omega-3 supplement ( 1,200 mg eicosapentaenoic acid and 800 mg docosahexaenoic acid ) or matching placebo from 16 - 22 through 36 weeks of gestation . All participants received weekly intramuscular 17&agr;-hydroxyprogesterone caproate ( 250 mg ) . The primary study outcome was delivery before 37 weeks of gestation . A sample size of 800 was necessary to have 80 % power to detect a 30 % reduction in the primary outcome from 30 % , assuming a type I error two-sided of 5 % . RESULTS : A total of 852 women were included , and none was lost to follow up . Delivery before 37 weeks of gestation occurred in 37.8 % ( 164/434 ) of women in the omega-3 group and 41.6 % ( 174/418 ) in the placebo group ( relative risk 0.91 , 95 % confidence interval 0.77 - 1.07 ) . CONCLUSION : Omega-3 long-chain polyunsaturated fatty acid supplementation offered no benefit in reducing preterm birth among women receiving 17&agr;-hydroxyprogesterone caproate who have a history of preterm delivery . CLINICAL TRIAL REGISTRATION : Clinical Trials.gov , www . clinical trials.gov , NCT00135902 . LEVEL OF EVIDENCE : Background / Objectives : High protein intake has been associated with increased growth . This may be linked to increased concentrations of insulin-like growth factor I ( IGF-I ) , which seems to be influenced by the diet , especially its protein component . The short-term effects of high protein intake in late infancy are not known . The objective was to investigate the effects of high protein intake in the form of whole milk ( WM ) on growth and IGF-I from 9 to 12 months of age . Subjects/ Methods : Healthy infants ( n=83 ) were r and omized to receive either WM or infant formula and fish oil or no fish oil ( 2 × 2 design ) . Anthropometric variables , IGF-I concentrations , serum urea nitrogen ( SUN ) and diet were recorded before and after the intervention . Results : Intake of WM significantly increased the protein energy percentage ( PE% ; P⩽0.001 ) and SUN ( P=0.01 ) , whereas there was no effect on size . The milk intervention increased IGF-I in boys ( P=0.034 ) but not in girls . Intake of fish oil had no effect on the outcomes . Including all infants in the analysis there was a significant correlation between weight and IGF-I at 12 months ( r=0.316 , P=0.017 ) , and PE% was positively associated with IGF-I after adjusting for sex and breastfeeding at both 9 ( r=0.329 , P=0.015 ) and 12 months ( r=0.272 , P=0.044 ) . Conclusions : R and omization to WM had no overall effect on growth . However , the positive effect of WM on IGF-I in boys and the positive association between PE% intake and IGF-I at 9 and 12 months is consistent with the hypothesis that a high milk intake stimulates growth n-3 long-chain polyunsaturated fatty acids ( n-3 LCPUFA ) , from fish oil ( FO ) , in rodents have been shown to reduce adipogenesis . Evidence of an effect on adipose tissue mass in humans is limited , and no studies have specifically aim ed to eluci date this in infancy . To explore whether n-3 LCPUFA intake affects adipose tissue growth , we r and omly allocated 154 healthy infants to daily supplementation with FO or sunflower oil ( SO ) from 9 to 18 mo of age and measured z-score changes in various anthropometric assessment s of body size and skinfold thicknesses and plasma adipokine concentrations . Among the 133 completing infants , erythrocyte n-3 PUFA increased more in those receiving FO than in infants receiving SO [ 12.2 ± 0.7 ( mean ± SE ) versus 2.0 ± 0.4 fatty acid percentage ( FA% ) , p < 0.001 ] with a concomitant larger decrease in n-6 PUFA ( −8.9 ± 0.7 versus −0.9 ± 0.6 FA% , p < 0.001 ) . We found no association between FO  consumption relative to  SO consumption and any of the anthropometric measures related to the size of the fat mass , but infants in the FO group had a lower skinfold ratio ( triceps/subscapular ) at 18 mo than those in SO group ( p = 0.02 ) . Our findings do not support the hypothesis that dietary n-3 LCPUFA is important for infant fat mass , but future studies testing this specifically are warranted BACKGROUND Studies investigating cognitive outcomes following docosahexaenoic acid ( DHA ) supplementation of infant formula yield conflicting results , perhaps due to inadequate dietary concentrations . AIM To determine the optimal DHA concentration in term formula to support cognitive maturation . DESIGN This was a double-masked , r and omized , controlled , prospect i ve trial . A total of 181 infants were enrolled at 1 - 9 days of age and assigned r and omly to receive one of four term infant formulas with one of four levels of docosahexaenoic acid : Control ( 0 % DHA ) , 0.32 % DHA , 0.64 % DHA , or 0.96 % DHA . All DHA-supplemented formulas contained 0.64 % arachidonic acid ( ARA ) .  Infants were fed the assigned formulas until 12 months of age . One hundred forty-one children completed the 12-month feeding trial and were eligible for this study .  Cognitive function was assessed in 131 children at 18 months of age using the Bayley Scales of Infant Development II ( BSID II ) . RESULTS There were no diet group differences on the Mental Development Index ( MDI ) , the Psychomotor Development Index ( PDI ) , or the Behavior Rating Scale ( BRS ) of the BSID II . However , when the scores of children who received any of the three DHA-supplemented formulas were combined and compared to control children , a significant difference emerged : the MDI scores of DHA-supplemented children were higher ( 104.1 v. 98.4 ; p=0.02 ) . CONCLUSIONS These results suggest that dietary supplementation of DHA during the first year of life leads to enhanced cognitive development at 18 months of age . DHA concentration of 0.32 % is adequate to improve cognitive function ; higher concentrations did not confer additional benefit BACKGROUND The effect of long-chain polyunsaturated fatty acid ( LCPUFA ) intake on cognitive development is controversial . Most r and omized trials have assessed cognition at 18 mo , although significant development of cognitive abilities ( early executive function ) emerge later . OBJECTIVE The objective was to evaluate cognition beyond 18 mo and longitudinal cognitive change from 18 mo to 6 y in children who were fed variable amounts of docosahexaenoic acid ( 0.32 % , 0.64 % , and 0.96 % of total fatty acids ) and arachidonic acid ( ARA ; 0.64 % ) compared with children who were not fed LCPUFA as infants . DESIGN Eighty-one children ( 19 placebo , 62 LCPUFA ) who participated in a double-blind , r and omized trial of LCPUFA supplementation as infants were re-enrolled at 18 mo and tested every 6 mo until 6 y on age-appropriate st and ardized and specific cognitive tests . RESULTS LCPUFA supplementation did not influence performance on st and ardized tests of language and performance at 18 mo ; however , significant positive effects were observed from 3 to 5 y on rule-learning and inhibition tasks , the Peabody Picture Vocabulary Test at 5 y , and the Weschler Primary Preschool Scales of Intelligence at 6 y. Effects of LCPUFAs were not found on tasks of spatial memory , simple inhibition , or advanced problem solving . CONCLUSIONS The data from this relatively small trial suggest that , although the effects of LCPUFAs may not always be evident on st and ardized developmental tasks at 18 mo , significant effects may emerge later on more specific or fine-grained tasks . The results imply that studies of nutrition and cognitive development should be powered to continue through early childhood . This parent trial was registered at clinical trials.gov as NCT00266825 This study examines whether feeding infants formula supplemented with long-chain polyunsaturated fatty acids ( LCPUFA ) improves cognitive function of 9-month-olds . Participants included 229 infants from 3 r and omized controlled trials . Children received either formula supplemented with docosahexaenoic acid and arachidonic acid , or a control formula beginning at 1 - 5 days ( 12-month feeding study ) , or following 6 weeks ( 6-week-weaning study ) or 4 - 6 months of breastfeeding ( 4-to 6-month weaning study ) . Infants were assessed with a 2-step problem solving task . In the 12-month feeding and 6-week weaning studies , supplemented children had more intentional solutions ( successful task completions ) and higher intention scores ( goal -directed behaviors ) than controls . These results suggest that LCPUFA supplementation improves means-end problem solving Objective To investigate the relation between breastfeeding , use of docosahexaenoic acid (DHA)-fortified formula and neuropsychological function in children . Design Prospect i ve cohort study . Setting Southampton , UK . Subjects 241 children aged 4 years followed up from birth . Main outcome measures IQ measured by the Wechsler Pre-School and Primary Scale of Intelligence ( 3rd edn ) , visual attention , visuomotor precision , sentence repetition and verbal fluency measured by the NEPSY , and visual form-constancy measured by the Test of Visual-Perceptual Skills ( Non-Motor ) . Results In unadjusted analyses , children for whom breast milk or DHA-fortified formula was the main method of feeding throughout the first 6 months of life had higher mean full-scale and verbal IQ scores at age 4 years than those fed mainly unfortified formula . After adjustment for potential confounding factors , particularly maternal IQ and educational attainment , the differences in IQ between children in the breast milk and unfortified formula groups were severely attenuated , but children who were fed DHA-fortified formula had full-scale and verbal IQ scores that were respectively 5.62 ( 0.98 to 10.2 ) and 7.02 ( 1.56 to 12.4 ) points higher than children fed unfortified formula . However , estimated total intake of DHA in milk up to age 6 months was not associated with subsequent IQ or with score on any other test . Conclusions Differences in children 's intelligence according to type of milk fed in infancy may be due more to confounding by maternal or family characteristics than to the amount of long-chain polyunsaturated fatty acids they receive in milk Objective To test the hypothesis that consumption of infant formulas containing long-chain polyunsaturated fatty acids ( LCPUFAs ) by preterm infants would favourably influence growth , body composition and blood pressure ( BP )  at age 10 years . Methods This was a follow-up study of a preterm cohort ( < 35 weeks and birth weight < 2000 g ) r and omly assigned to unsupplemented or LCPUFA-supplemented formulas to 9 months post term . The setting was a research clinic at Yorkhill Hospital for Sick Children , Glasgow , UK . A total of 107 children aged 9–11 years who participated in the original r and omised controlled trial ( 45 % follow-up ) took part . Main outcome measures were : ( 1 ) anthropometry , ( 2 ) body composition and ( 3 ) BP . Results There were no differences in growth or BP between r and omised groups for the whole cohort . However , girls who had received LCPUFA-supplemented formula were heavier ( 42.20 ( SD 9.61 ) vs 36.94 ( 9.46 ) kg , p=0.05 ) , had greater skin fold thicknesses ( biceps 10.7 ( 3.3 ) vs 8.5 ( 3.6 ) mm , p=0.03 ; suprailiac 16.7 ( 8.2 ) vs 12.0 ( 7.5 ) mm , p=0.03 ) and higher BP ( mean 82.2 ( 8.4 ) vs 78.1 ( 6.2 ) mm Hg , p=0.04 : systolic 111.4 ( 10.1 ) vs 105.9 ( 9.0 ) mm Hg , p=0.04 : diastolic 64.8 ( 8.4 ) vs 61.1 ( 5.4 ) mm Hg , p=0.05 ) . Differences in weight SD score ( 0.85 ( 95 % CI 0.13 to 1.58 ) , p=0.02 ) , Ln sum of skin fold thicknesses ( 0.27 ( 0.02 to 0.52 ) , p=0.04 ) and BP ( mean 4.6 mm Hg ( 0.43 to 8.84 ) , p=0.03 ; systolic 6.1 ( 0.45 to 11.7 ) , p=0.04 ) remained after adjustment for prer and omisation confounders . Differences in BP were not significant following adjustment for current weight . Conclusions Girls born preterm and r and omised to LCPUFA-supplemented formula showed increased weight , adiposity and BP at 9–11 years , which might have adverse consequences for later health . No effects were seen in boys . Long-term follow-up of other LCPUFA supplementation trials is required to further investigate this finding BACKGROUND The influence of prenatal long-chain polyunsaturated fatty acids ( LC-PUFAs ) and folate on neurologic development remains controversial . OBJECTIVE The objective was to assess the long-term effects of n-3 ( omega-3 ) LC-PUFA supplementation , 5-methyltetrahydrofolate ( 5-MTHF ) supplementation , or both in pregnant women on cognitive development of offspring at 6.5 y of age . DESIGN This was a follow-up study of the NUHEAL ( Nutraceuticals for a Healthier Life ) cohort . Healthy pregnant women in 3 European centers were r and omly assigned to 4 intervention groups . From the 20th week of pregnancy until delivery , they received a daily supplement of 500 mg docosahexaenoic acid ( DHA ) + 150 mg eicosapentaenoic acid [ fish oil ( FO ) ] , 400 μg 5-MTHF , or both or a placebo .  Infants received formula containing 0.5 % DHA and 0.4 % arachidonic acid ( AA ) if they were born to mothers receiving FO supplements or were virtually free of DHA and AA until the age of 6 mo if they belonged to the groups that were not supplemented with FO . Fatty acids and folate concentrations were determined in maternal blood at weeks 20 and 30 of pregnancy , at delivery , and in cord blood . Cognitive function was assessed at 6.5 y of age with the Kaufman Assessment Battery for Children ( K-ABC ) . RESULTS We observed no significant differences in K-ABC scores between intervention groups . Higher DHA in maternal erythrocytes at delivery was associated with a Mental Processing Composite Score higher than the 50th percentile in the offspring . CONCLUSION We observed no significant effect of supplementation on the cognitive function of children , but maternal DHA status may be related to later cognitive function in children . This trial was registered at clinical trials.gov as NCT01180933 BACKGROUND The visual and mental development of preterm infants improved after feeding them milk enriched with docosahexaenoic acid ( DHA ) in amounts matching the fetal accretion rate . OBJECTIVE The objective was to evaluate whether feeding preterm infants milk with a higher DHA content than that used in current practice influences language or behavior in early childhood . DESIGN This was a follow-up study in a subgroup of infants enrolled in the DINO ( Docosahexaenoic acid for the Improvement in Neurodevelopmental Outcome ) trial . In a double-blind r and omized controlled trial , infants born at <33 wk of gestation were fed milk containing 1 % of total fatty acids as DHA ( higher-DHA group ) or approximately 0.3 % DHA ( control group ) until reaching full-term equivalent age . The longer-term effects of the intervention on language , behavior , and temperament were measured by using the MacArthur Communicative Development Inventory ( MCDI ) at 26-mo corrected age , the Strengths and Difficulties Question naire ( SDQ ) , and the Short Temperament Scale for Children ( STSC ) between 3- and 5-y corrected age . RESULTS Mean ( + /-SD ) MCDI scores did not differ significantly ( adjusted P = 0.8 ) between the higher-DHA group ( 308 + /- 179 , n = 60 ) and the control group ( 316 + /- 192 , n = 67 ) per the Vocabulary Production subscale . Composite scores on the SDQ and STSC did not differ between the higher-DHA group and the control group [ SDQ Total Difficulties : higher-DHA group ( 10.3 + /- 6.0 , n = 61 ) , control group ( 9.5 + /- 5.5 , n = 64 ) , adjusted P = 0.5 ; STSC score : higher-DHA group ( 3.1 + /- 0.7 , n = 61 ) , control group ( 3.0 + /- 0.7 , n = 64 ) , adjusted P = 0.3 ] . CONCLUSIONS Feeding preterm infants milk containing 3 times the st and ard amount of DHA did not result in any clinical ly meaningful change to language development or behavior when assessed in early childhood . Whether longer-term effects of dietary DHA supplementation can be detected remains to be assessed . This trial was registered with the Australia and New Zeal and Clinical Trial Registry at www.anzctr.org.au as 12606000327583 BACKGROUND Docosahexaenoic acid ( DHA ) intake throughout the first year of life is associated with neurodevelopmental and neuropsychological benefits . Few studies have evaluated the role of DHA intakes on age at achievement of gross motor milestones . OBJECTIVE The objective was to assess the effects of DHA supplementation throughout the first year of life on the achievement of four gross motor milestones in healthy infants . DESIGN In this multicenter prospect i ve , r and omized , double-blind , placebo-controlled trial , 1160 healthy neonates were assigned to receive supplementation with either 20 mg liquid DHA ( n = 580 ) or placebo ( n = 580 ) orally once daily throughout the first year of life . The primary endpoint was the time at achievement of 4 gross motor milestones ( sitting without support , h and s- and -knees crawling , st and ing alone , and walking alone ) . All analyses were performed on an intention-to-treat basis . RESULTS The time to achievement of sitting without support was shorter ( P < 0.001 ) in infants who received DHA [ median : 26 wk ; interquartile range ( IQR ) : 24 - 29 wk ] than in those who received placebo ( 27 wk ; 26 - 31 wk ) . No significant difference between infants who received DHA or placebo was found for h and s- and -knees crawling [ 39 wk ( 34 - 44 wk ) compared with 40 wk ( 35 - 44 wk ) , respectively ] , st and ing alone [ 49 wk ( 43 - 55 wk ) compared with 49 wk ( 44 - 57 wk ) , respectively ] , and walking alone [ 55 wk ( 50 - 60 wk ) compared with 56 wk ( 52 - 61 wk ) , respectively ] . CONCLUSIONS Despite the 1-wk advance in sitting without support associated with DHA supplementation , no demonstrable persistent effects of DHA supplementation on later motor development milestones were found . Thus , the long-term clinical significance of the 1-wk change in sitting without support , if any , remains unknown . This trial is registered at ( clinical trials.gov ) as NCT00610922 BACKGROUND n-3 Fatty acid supplementation in adults results in cardiovascular benefits . However , the cardiovascular effects of n-3 supplementation in early childhood are unknown . OBJECTIVE The objective was to evaluate blood pressure ( BP ) and arterial structure and function in 8-y-old children who had participated in a r and omized controlled trial of dietary n-3 and n-6 modification over the first 5 y of life . DESIGN The children ( n = 616 ; 49 % girls ) were r and omly assigned antenatally to active ( n = 312 ; increase in n-3 intake and decrease in n-6 intake ) or control ( n = 304 ) diet interventions implemented from the time of weaning or introduction of solids until 5 y of age . At age 8.0 + /- 0.1 y , BP , carotid intima-media thickness , carotid artery distensibility , augmentation index , and brachial pulse wave velocity were measured in 405 of these children . Venous blood was collected for measurement of plasma fatty acids , lipoproteins , high-sensitivity C-reactive protein , and asymmetric dimethylarginine . Plasma fatty acid concentrations were also assessed during the intervention . RESULTS Plasma concentrations of n-3 fatty acids were higher and of n-6 were lower in the active than in the control diet group at 18 mo and 3 and 5 y ( P < 0.0001 ) . Concentrations of n-3 and n-6 fatty acids were similar at 8 y. At 8 y of age , no significant differences were found in BP , carotid intima-media thickness , carotid artery distensibility , augmentation index , asymmetric dimethylarginine , high-sensitivity C-reactive protein , or lipoproteins between diet groups . CONCLUSION A dietary supplement intervention to increase n-3 and decrease n-6 intakes from infancy until 5 y does not result in significant improvements in arterial structure and function at age 8 y. This trial was registered at the Australian Clinical Trials Registry as ACTRN012605000042640 The evidence relating prenatal supplementation with DHA to offspring neurological development is limited . We investigated the effect of prenatal DHA supplementation on infant brainstem auditory-evoked responses and visual- evoked potentials in a double-blind , r and omized controlled trial in Cuernavaca , Mexico . Pregnant women were supplemented daily with 400 mg DHA or placebo from gestation wk 18 - 22 through delivery . DHA and placebo groups did not differ in maternal characteristics at r and omization or infant characteristics at birth . Brainstem auditory-evoked responses were measured at 1 and 3 mo in 749 and 664 infants , respectively , and visual-evoked potentials were measured at 3 and 6 mo in 679 and 817 infants , respectively . Left-right brainstem auditory-evoked potentials were moderately correlated ( range , 0.26 - 0.43 ; all P < 0.001 ) and left-right visual-evoked potentials were strongly correlated ( range , 0.79 - 0.94 ; all P < 0.001 ) within any assessment . Correlations across visits were modest to moderate ( range , 0.09 - 0.38 ; all P < 0.01 ) . The offspring of  DHA-supplemented women did not differ from those of control women with respect to any outcome measure ( all comparisons P > 0.10 ) . We conclude that DHA supplementation during pregnancy did not influence brainstem auditory-evoked responses at 1 and 3 mo or visual-evoked potentials at 3 and 6 mo OBJECTIVE : Long-chain polyunsaturated fatty acids such as docosahexaenoic acid ( DHA ) influence immune function and inflammation ; however , the influence of maternal DHA supplementation on infant morbidity is unknown . We investigated the effects of prenatal DHA supplementation on  infant morbidity . METHODS : In a double-blind r and omized controlled trial conducted in Mexico , pregnant women received daily supplementation with 400 mg of DHA or placebo from 18 to 22 weeks ' gestation through parturition . In infants aged 1 , 3 , and 6 months , caregivers reported the occurrence of common illness symptoms in the preceding 15 days . RESULTS : Data were available at 1 , 3 , and 6 months for 849 , 834 , and 834 infants , respectively . The occurrence of specific illness symptoms did not differ between groups ; however , the occurrence of a combined measure of cold symptoms was lower in the DHA group at 1 month ( OR : 0.76 ; 95 % CI : 0.58–1.00 ) . At 1 month , the DHA group experienced 26 % , 15 % , and 30 % shorter duration of cough , phlegm , and wheezing , respectively , but 22 % longer duration of rash ( all P ≤ .01 ) . At 3 months , infants in the DHA group spent 14 % less time ill ( P < .0001 ) . At 6 months , infants in the DHA group experienced 20 % , 13 % , 54 % , 23 % , and 25 % shorter duration of fever , nasal secretion , difficulty breathing , rash , and “ other illness , ” respectively , but 74 % longer duration of vomiting ( all P < .05 ) . CONCLUSIONS : DHA supplementation during pregnancy decreased the occurrence of colds in children at 1 month and influenced illness symptom duration at 1 , 3 , and 6 months BACKGROUND Studies investigating the effects of docosahexaenoic acid ( DHA ) in infant formula on language development yield conflicting results . No study to date has investigated the effects of DHA in infant formula on school readiness . AIM To determine the effects of different dietary concentrations of DHA provided during the first 12 months of life on language development and school readiness . DESIGN This was a double-masked , r and omized , controlled , prospect i ve trial . A total of 182 infants were enrolled at 1 - 9 days of age and assigned r and omly to receive infant formula with one of four levels of DHA : control ( 0 % DHA ) , 0.32 % DHA , 0.64 % DHA , or 0.96 % DHA . All formulas with DHA also contained 0.64 % arachidonic acid .  One hundred forty-one children completed the 12-month feeding trial and were eligible for this study . Consent was obtained from 131 participants .  School readiness was assessed at 2.5 years using the Bracken Basic Concept Scale-Revised ( BBCS-R ) and receptive vocabulary was assessed at 2 and 3.5 years using the Peabody Picture Vocabulary Test-Third Edition ( PPVT-III ) . RESULTS There were no diet group differences on any of the BBCS-R subscales . On the PPVT-III , the control group had higher raw scores and st and ard scores than both the 0.32 % and 0.96 % groups at 2 years of age . These differences were not evident at 3.5 years . CONCLUSIONS Dietary DHA during the first year of life did not enhance school readiness or language development . Children who consumed infant formula with 0.32 % and 0.96 % DHA showed lower receptive vocabulary scores than controls at 2 but not 3.5 years of age Maternal supplementation with long-chain PUFA , to improve infant neurological development , might cause additional increase of oxidative stress . Pregnant women aged 18 - 41 years were r and omised into one of four supplementation groups . From week 22 on , they received supplements containing either modified fish oil ( n 69 ) , 5-methyl-tetrahydro-folate ( n 65 ) , both ( n 64 ) , or placebo ( n 72 ) . Plasma Trolox-equivalent antioxidative capacity ( TEAC ) , concentrations of alpha-tocopherol , retinol , beta-carotene , free thiol groups , uric acid and thiobarbituric acid-reactive substances ( TBARS ) were determined at weeks 20 and 30 and at delivery . The studied antioxidants showed no significant differences between the four supplementation groups . At week 30 plasma TBARS levels were found to be significantly higher in the fish oil group ( 0.80 ( sem 0.04 ) micromol/l ) than in the folate ( 0.67 ( sem 0.03 ) micromol/l ; P = 0.024 ) and control ( 0.69 ( sem 0.04 ) micromol/l ; P = 0.01 ) groups . Concentrations of retinol and free thiol groups decreased during pregnancy , whereas uric acid increased and beta-carotene as well as TEAC showed only minor changes . Fish oil supplementation during the second half of pregnancy appears not to decrease antioxidant status . The increased TBARS levels at week 30 may indicate a period of increased oxidative stress in plasma at this time 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 Altered intakes of n-3 and n-6 polyunsaturated fatty acids were suggested to modulate allergic disease , but intervention trials yielded inconclusive results . Because allergies are primed in early infancy and in utero , the fetus might be more accessible to nutritional intervention strategies . OBJECTIVE We sought to investigate how supplementation of pregnant women with a fish oil ( FO ) preparation  modulates allergy-related immune parameters in mothers and offspring . METHODS We performed a multicenter , r and omized , double-blind , placebo-controlled trial . Three hundred eleven pregnant women received daily either FO with 0.5 g of docosahexaenoic acid and 0.15 g of eicosapentaenoic acid , 400 mug of methyl-tetra-hydrofolic acid , both , or placebo from the 22nd gestational week . T(H)1/T(H)2-related molecules were quantified in 197 maternal and 195 cord blood sample s by using real-time RT-PCR . Data are given as geometric means [ 95 % CIs ] . RESULTS FO supplementation was associated with increased TGF-beta mRNA in maternal ( 0.85 [ 0.8 - 0.89 ] ; placebo : 0.68 [ 0.64 - 0.72 ] ) and cord blood ( 0.85 [ 0.81 - 0.9 ] ; placebo : 0.75 [ 0.71 - 0.79 ] ) . IL-1 ( 0.69 [ 0.66 - 0.73 ] ; placebo : 0.83 [ 0.79 - 0.88 ] ) and IFN-gamma ( 0.54 [ 0.51 - 0.57 ] ; placebo : 0.65 [ 0.61 - 0.69 ] ) were decreased in mothers only ( P < .001 ) . Cord blood mRNA levels of IL-4 ( 0.54 [ 0.52 - 0.57 ] ; placebo : 0.64 [ 0.61 - 0.68 ] ) , IL-13 ( 0.61 [ 0.58 - 0.65 ] ; placebo : 0.85 [ 0.80 - 0.89 ] ) , CCR4 ( 0.70 [ 0.67 - 0.73 ] ; placebo : 0.88 [ 0.84 - 0.92 ] ; all P < .001 ) , and natural killer ( P < .001 ) and CCR3+CD8 + T cells ( P < .04 ) were decreased in the FO group . CONCLUSION Supplementation with FO during pregnancy is associated with decreased mRNA levels of T(H)2-related molecules in the fetus and decreased maternal inflammatory cytokines . We speculate that both effects are mediated by TGF-beta BACKGROUND There is uncertainty regarding the efficacy of increasing n-3 long-chain PUFA ( LCPUFA ) intake during pregnancy in reducing the risk of  gestational diabetes mellitus ( GDM ) and preeclampsia .  OBJECTIVES The objective was to determine whether n-3 LCPUFA supplementation in pregnancy reduces the incidence of GDM or preeclampsia . A secondary objective was to assess the effect of n-3 LCPUFA supplementation on perinatal complications . DESIGN This was a double-blind , multicenter r and omized control trial-the DHA to Optimize Mother Infant Outcome ( DOMInO ) trial . Pregnant women ( n = 2399 ) of < 21 wk gestation were r and omly assigned to receive DHA-enriched fish oil ( 800 mg/d ) or vegetable oil capsules without DHA from trial entry to birth . The presence of GDM or preeclampsia was assessed through a blinded audit of medical records . Birth outcomes and prenatal complications were also assessed . RESULTS The overall incidences of GDM and preeclampsia were 8 % and 5 % , respectively , based on clinical diagnosis . The RR of GDM was 0.97 ( 95 % CI : 0.74 , 1.27 ) and of preeclampsia was 0.87 ( 95 % CI : 0.60 , 1.25 ) , and they did not differ significantly between the groups . Birth weight , length , and head circumference z scores also did not differ between the groups . There were 12 perinatal deaths and 5 neonatal convulsions in the control group compared with 3 perinatal deaths and no neonatal convulsions in the DHA group ( P = 0.03 in both cases ) . CONCLUSION DHA supplementation of 800 mg/d in the second half of pregnancy does not reduce the risk of GDM or preeclampsia . Whether supplementation reduces the risk of perinatal death and neonatal convulsions requires further investigation . The DOMInO trial was registered with the Australian New Zeal and Clinical Trials Registry as TRN12605000569606 Objective : To study the effect of modified polyunsaturated fatty acid ( PUFA ) profiles of complementary food on long-chain ( LC ) PUFA composition in healthy infants . Design : Double blinded , r and omised , controlled intervention trial . Setting : Dortmund , Germany . Patients : Free-living sample of healthy term infants . Methods : Participants were r and omly assigned within the first 2 months of life . During the intervention period from 4 to 10 months , the control group ( n = 53 ) received commercial complementary meals with corn oil ( 3.4 g/meal ) rich in n-6 linoleic acid ( LA ) , the intervention group ( n = 49 ) received the same meals with rapeseed oil ( 1.6 g/meal ) rich in n-3 alpha-linolenic acid ( ALA ) .  Fatty acid intake was assessed from dietary records throughout the intervention period . Fatty acid proportions ( % of total fatty acid ) in total plasma were analysed before and after the intervention . Results : Plasma fatty acid profiles did not differ between the intervention and control groups before the intervention . During the intervention , the only difference in fatty acid intake between the intervention and control groups was a higher intake of ALA in the intervention group , 21 % deriving from study food and a lower ratio of LA/ALA ( 10.7 vs 14.8 ) . At the end of the intervention , the plasma proportions of total n-3 fatty acids and of n-3 LC-PUFA , but not of ALA , were higher and the ratios of n-6/n-3 fatty acids were lower in the intervention group . Conclusions : Feasible dietary modifications of the precursor fatty acid profile via n-3 PUFA-rich vegetable oil favoured n-3 LC-PUFA synthesis in the complementary feeding period when LC-PUFA intake from breast milk and formula is decreasing BACKGROUND & AIMS Canola oil is a variety of rapeseed oil low in erucic acid ( < 2 % ) . For many years , canola oil has been widely used as an ingredient in infant formula in Europe , but not in North America due to safety concerns . A number of studies have used variable canola content of infant formulas to investigate the effects of linoleic acid : α-linolenic acid ratio on visual function of infants . However , little published data is available to compare the safety of canola versus non-canola containing infant formula . The aim of this study is to investigate whether infant formulas containing canola oil support normal growth in infants as assessed by weight and length gain . METHODS Re-analyses of data on infant weight and length gain from a prospect i ve r and omized double-blind trial in full-term infants in the German Infant Nutritional Intervention study ( GINI ) . This analysis compared growth in infants receiving infant formulas with or without canola oil from week 4 to month 7 . Absolute weight and length , weight and length gain in gram or cm per day and st and ardized weight and length measurements were analyzed by analyses of variance and a longitudinal r and om effects model . St and ardization was conducted according to the new WHO 2006 age- and sex-specific child growth st and ards . RESULTS Absolute and st and ardized weight and length measures did not differ between the formula groups with or without canola oil . This was true for both , analyses within each of the three anthropometric measurement periods ( 4 - 6 weeks , 3 - 4 months , 6 - 7 months ) and for the longitudinal analyses over the whole period from 4 weeks to 7 months of life . Power analyses confirmed that sample size was sufficient to detect a difference of 3 g per day between 14 and 120 days between the two formula groups . CONCLUSIONS Infant formula containing canola oil supports normal infant growth as assessed by weight and length gain AIM To determine the effect of neonatal docosahexaenoic acid ( DHA ) supplementation in preterm infants on later respiratory-related hospitalisations . METHODS We enrolled 657 infants in a multicentre , r and omised , controlled trial design ed to study the long-term efficacy of higher dose dietary DHA in infants born <33 weeks ' gestation . Treatment was with high DHA ( ∼1 % ) compared with st and ard DHA ( ∼0.3 % ) in breast milk or formula , given from the first week of life to term equivalent . Parent-reported hospital admissions to 18 months corrected age were recorded . The proportion of children hospitalised for lower respiratory tract ( LRT ) conditions and the mean number of hospitalisations per infant were determined . RESULTS Twenty-three per cent ( 154/657 ) of infants were hospitalised for LRT conditions . Seventy-three per cent ( 173/238 ) of admissions were for bronchiolitis . There was no significant effect of higher DHA on the proportion of infants admitted for LRT conditions ( high DHA 22 % vs. st and ard DHA 25 % , adjusted relative risk 0.92 , 95 % confidence interval ( CI ) 0.68 - 1.24 , P = 0.57 ) or in the mean number of admissions per infant ( high DHA 0.34 , st and ard DHA 0.38 , adjusted ratio of means 0.91 , 95 % CI 0.63 - 1.32 , P = 0.62 ) . The sexes responded differently to treatment ( interaction P = 0.046 ) , with reduced admissions in boys given high DHA , but this was not statistically significant ( high DHA 19 % , st and ard DHA 28 % , adjusted relative risk 0.69 , 95 % CI 0.46 - 1.04 , P = 0.08 ) . CONCLUSIONS Hospitalisation for LRT problems in the first 18 months for preterm infants was not reduced by neonatal supplementation with 1 % DHA OBJECTIVES Maternal deficiency of the omega-3 fatty acid , docosahexaenoic acid ( DHA ) , has been associated with perinatal depression , but there is evidence that supplementation with eicosapentaenoic acid ( EPA ) may be more effective than DHA in treating depressive symptoms . This trial tested the relative effects of EPA- and DHA-rich fish oils on prevention of depressive symptoms among pregnant women at an increased risk of depression . STUDY DESIGN We enrolled 126 pregnant women at risk for depression ( Edinburgh Postnatal Depression Scale score 9 - 19 or a history of depression ) in early pregnancy and r and omly assigned them to receive EPA-rich fish oil ( 1060 mg EPA plus 274 mg DHA ) , DHA-rich fish oil ( 900 mg DHA plus 180 mg EPA ) , or soy oil placebo . Subjects completed the Beck Depression Inventory ( BDI ) and Mini-International Neuropsychiatric Interview at enrollment , 26 - 28 weeks , 34 - 36 weeks , and at 6 - 8 weeks ' postpartum . Serum fatty acids were analyzed at entry and at 34 - 36 weeks ' gestation . RESULTS One hundred eighteen women completed the trial . There were no differences between groups in BDI scores or other depression endpoints at any of the 3 time points after supplementation . The EPA- and DHA-rich fish oil groups exhibited significantly increased postsupplementation concentrations of serum EPA and serum DHA respectively . Serum DHA- concentrations at 34 - 36 weeks were inversely related to BDI scores in late pregnancy . CONCLUSION EPA-rich fish oil and DHA-rich fish oil supplementation did not prevent depressive symptoms during pregnancy or postpartum Long-chain PUFA ( LCPUFA ) supplementation of formula can have beneficial effects on neurodevelopmental outcome in early infancy , but uncertainty exists regarding effects after 6 months . The present study is the first to investigate whether consumption by term infants of formula containing LCPUFA for the first 2 months after birth improves neurological condition of these children at 9 years of age . A prospect i ve , double-blind , r and omised control study was performed in two groups of healthy term infants : a control group with st and ard formula ( n 169 ) and a LCPUFA-supplemented group ( LF ; n 146 ) . A breast-fed group ( BF ; n 159 ) served as a reference . At age 9 years , children were neurologically assessed according to Touwen , result ing in a Neurological Optimality Score and information on severity and type of minor neurological dysfunction ( MND ) . Information on potential confounders was collected at enrollment and follow-up . Multivariate analyses were carried out to evaluate the effect of nutrition while adjusting for confounders . Attrition ( 28 % ) was selective : drop-outs in the LF group were more often boys and had a significantly lower mental developmental index at 18 months . Neurological optimality and severity and type of MND at 9 years did not differ between the two formula groups . Children in the BF group showed significantly less often fine manipulative dysfunction than formula-fed children . In conclusion , LCPUFA supplementation of formula during the first 2 postnatal months in healthy term infants does not alter neurological function at school age . The study confirmed that breast-fed infants have a slightly better neurodevelopmental outcome than formula-fed infants Studies in experimental animals and human subjects have suggested that intake of n-3 fatty acids in early life can affect cardiovascular risk factors in adult life . Therefore , the aim of the present study was to investigate the effect of fish oil ( FO ) supplementation during the third trimester of pregnancy on blood pressure ( BP ) , heart rate ( HR ) and HR variability ( HRV ) in the 19-year-old offspring . The study was based on follow-up of a r and omised , controlled trial from 1990 , in which 533 pregnant women were r and omised to FO , olive oil ( OO ) or no oil ( NO ) during the last trimester of pregnancy . The offspring was invited to a physical examination including BP , HR and HRV measurements . A subgroup consisting of the offspring of mothers with a low baseline fish intake also had 24 h HRV determined . The OO group was used as reference and multiple linear regression modelling was used to compare the FO and OO groups . A total of 180 of the offspring from the FO and OO groups agreed to participate in the study ( 45 % ) . The adjusted difference between the FO and OO groups was 2 ( 95 % CI -1 , 4 ) mmHg in systolic and 1 ( 95 % CI 0 , 3 ) mmHg in diastolic BP . The difference in HR was 1 ( 95 % CI -2 , 4 ) . Also , HRV indices did not differ significantly between groups . Hence , FO supplementation during late pregnancy was not associated with offspring BP , HR and HRV during adolescence 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 INTRODUCTION This intervention examined whether fish-oil-supplementation in late infancy modifies free-play test scores and if this is related to blood pressure ( BP ) and mean RR interval . PATIENTS AND METHODS 83 Danish 9-month-old infants were r and omized to ±fish oil ( FO ) ( 3.4±1.1mL/d ) for 3months and 61 of these completed the free-play-test before and after the intervention . RESULTS Most of the free-play scores changed during the intervention , but the intervention affected only the number of looks away from the toy , which was increased in + FO and decreased in -FO ( p=0.037 ) . The increased numbers of looks away were associated with an increase in erythrocyte eicosapentaenoic acid ( r=0.401 , p=0.017 , n=35 ) and were also associated with a decrease in systolic-BP ( r=-0.511 , p<0.001 , n=52 ) . CONCLUSIONS The results indicate that n-3 fatty acid intake also in late infancy can influence brain development and that the cognitive and cardiovascular effects may be related Fish oil supplementation during pregnancy alters breast milk composition , but there is little information about the impact of oily fish consumption . We determined whether increased salmon consumption during pregnancy alters breast milk fatty acid composition and immune factors . Women ( n = 123 ) who rarely ate oily fish  were r and omly assigned to consume their habitual diet or to consume 2 portions of farmed salmon per week from 20 wk of pregnancy until delivery . The salmon provided 3.45 g long-chain ( LC ) ( n-3 ) PUFA/wk . Breast milk fatty acid composition and immune factors [ soluble CD14 , transforming growth factor-β (TGFβ)1 , TGFβ2 , and secretory IgA ] were analyzed at 1 , 5 , 14 , and 28 d postpartum ( PP ) . Breast milk from the salmon group had higher proportions of EPA ( 80 % ) , docosapentaenoic acid ( 30 % ) , and DHA ( 90 % ) on d 5 PP compared with controls ( P < 0.01 ) . The LC ( n-6 ) PUFA : LC ( n-3 ) PUFA ratio was lower for the salmon group on all days of PP sampling ( P ≤ 0.004 ) , although individual ( n-6 ) PUFA proportions , including arachidonic acid , did not differ . All breast milk immune factors decreased between d 1 and 28 PP ( P < 0.001 ) . Breast milk secretory IgA ( sIgA ) was lower in the salmon group ( d 1 - 28 PP ; P = 0.006 ) . Salmon consumption during pregnancy , at the current recommended intakes , increases the LC ( n-3 ) PUFA concentration of breast milk in early lactation , thus improving the supply of these important fatty acids to the breast-fed neonate . The consequence of the lower breast milk concentration of sIgA in the salmon group is not clear
The Early Nutrition Academy supported a systematic review of human studies on the roles of pre- and postnatal long-chain polyunsaturated fatty acids ( LC-PUFA ) published from 2008 to 2013 and an expert workshop that review ed the information and developed recommendations , considering particularly Asian population s. An increased supply of n-3 LC-PUFA during pregnancy reduces the risk of preterm birth before 34 weeks of gestation .