The roles of long-chain polyunsaturated fatty acids in pregnancy, lactation and infancy: review of current knowledge and consensus recommendations

Abstract

This paper reviews current knowledge on the role of the long-chain polyunsaturated fatty acids (LC-PUFA), docosahexaenoic acid (DHA, C22:6n-3) and arachidonic acid (AA,, in maternal and term infant nutrition as well as infant development. Consensus recommendations and practice guidelines for health-care providers supported by the World Association of Perinatal Medicine, the Early Nutrition Academy, and the Child Health Foundation are provided. The fetus and neonate should receive LC-PUFA in amounts sufficient to support optimal visual and cognitive development. Moreover, the consumption of oils rich in n-3 LC-PUFA during pregnancy reduces the risk for early premature birth. Pregnant and lactating women should aim to achieve an average daily intake of at least 200 mg DHA. For healthy term infants, we recommend and fully endorse breastfeeding, which supplies preformed LC-PUFA, as the preferred method of feeding. When breastfeeding is not possible, we recommend use of an infant formula providing DHA at levels between 0.2 and 0.5 weight percent of total fat, and with the minimum amount of AA equivalent to the contents of DHA. Dietary LC-PUFA supply should continue after the first six months of life, but currently there is not sufficient information for quantitative recommendations.

Supplementation with the omega-3 docosahexaenoic acid: influence on the lipid composition and fatty acid profile of human milk

“…This suggests that higher DHA intake may influence its content in human milk, especially during the first weeks after delivery. This result is in agreement with those of other studies that demonstrated the positive influence of omega-3 supplementation on the milk of mothers taking such supplements 1,17,21,28,30 . Lauritzen et al 44 also observed an increase in the omega-3 content of human milk after fish oil supplementation.…”

“…The fat profile found for the CG were similar to those found by Silva et al 39 , Cunha et al 40 and Patin et al 21 , while studying the fat profile of the milk of Brazilian women, including EPA and DHA. Trans fatty acids were also found by Kolelzko et al 17 and by authors of other countries whose results were discussed by Costa & Sabarense 24 .…”

Role of Vaginal DHA on Uterine Contractions in Patients at Low Risk for Preterm Birth

“…Variation of dietary intake plays a key role in reducing some risks associated with pregnancy, such as risk of fetal and infant mortality, low birth weight [12,13] and premature births [2]. In this study, we observed that vaginally administered DHA during pregnancy acts on uterine contractions, in symptomatic women resulting in muscle relaxation and induces disappearance of spontaneous contractions in many cases.…”

“…Several randomized controlled trials have shown that supplementation with omega-3 may influence the birth process by delaying the onset of labor, reducing the risk of recurrent preterm birth and in animal studies it seems to have a tocolytic effect [2,15]. The exact DHA's mechanisms of action are not well understood, the eicosanoid-mediated changes on myometrial contractions and the connective tissue remodeling [5,12,15] seem involved. A high omega-6/omega-3 fatty acid ratio will result in increasing proinflammatory eicosanoid production; these metabolites have been associated with labor at term and preterm.…”

Hydroelectric reservoir inundation (Rio Madeira Basin, Amazon) and changes in traditional lifestyle: impact on growth and neurodevelopment of pre-school children

“…Fish is also the main source for n-3 PUFA; these nutrients are important in the maternal diet during pregnancy and lactation (19) . These elongated fatty acids include DHA and EPA, which are essential for optimal neural tissue development and function (20) .…”