| Atalah et al55. Atalah SE, Araya BM, Rosselot PG, et al. Consumption of a DHAenriched milk drink by pregnant and lactating women, on the fatty acid composition of red blood cells, breast milk, and in the newborn. Arch Latinoam Nutr 2009;59(03):271-277
|
Median |
Age, schooling, parity, initial weight, height, GA at baseline |
GA < 14 weeks, age ≥18 years, primiparous, absence of chronic pathologies |
NI |
50% increase in omega-3 concentration in total fatty acids in HM, a non-statistically significant value (p= 0.06), probably due to the small sample size and insufficient adhesion level |
| Bergmann et al3838. Bergmann RL, Haschke-Becher E, Klassen-Wigger P, et al. Supplementation with 200 mg/day docosahexaenoic acid from midpregnancy through lactation improves the docosahexaenoic acid status of mothers with a habitually low fish intake and of their infants. Ann Nutr Metab 2008;52(02):157-166
|
Average |
Age, pregestational BMI, gestational weight gain, gestational age, parity type, parity, marital status, nationality, work, education, female gender, Apgar ≤ 7 in 10 minutes, umbilical cord pH ≤ 7.2, weight, length and head circumference |
Pregnant, caucasian, healthy women, aged > 18 years and intending to breastfeed for at least 3 months |
Severe illness, age < 18 years, non-Caucasian, increased risk of preterm or multiple pregnancy, allergy to cow milk protein, lactose intolerance, diabetes, smoking, alcohol consumption, participation in another study, consumption of other supplements, prematurity malformations, hospitalization > 1 week |
The percentage of DHA in the breast milk was twice as high in the DHA-FOS group (0.50%) (p< 0.001), and the ratio of ARA to DHA in the DHA-FOS group compared with the other two groups was significantly reduced from 2.1 ± 0.76 to 1.0 ± 0.43 (p< 0.001). The Authors concluded that 200mg/day of DHA from mid-pregnancy to lactation appears to be adequate to improve the state of DHA in mothers and infants |
| Boris et al2727. Boris J, Jensen B, Salvig JD, Secher NJ, Olsen SF. A randomized controlled trial of the effect of fish oil supplementation in late pregnancy and early lactation on the n-3 fatty acid content in human breast milk. Lipids 2004;39(12):1191-1196
|
Average |
NI |
NI |
NI |
Comparing the two intervention groups, it was observed that women who received fish oil during gestation and lactation had increased levels of omega-3 compared with those who received until gestation only |
| Bortolozo et al22. Bortolozo EAFQ, Sauer E, Santos MS, et al. Supplementation with the omega-3 docosahexaenoic acid: influence on the lipid composition and fatty acid profile of HM. Rev Nutr 2013;26(01): 27-36
|
Average |
Age, schooling and income |
Healthy, pregnant women aged 18–38 years, in the last trimester of pregnancy, non-smokers, no high-risk pregnancies, and adequate dietary patterns |
NI |
The milk of the mothers of the intervention group presented high levels of DHA and EPA at the 30th and 60th days, demonstrating that higher consumption of omega-3 could influence their concentration in HM, and there was no change between omega-3 and omega-6 |
| Dunstan et al2020. Dunstan JA, Mitoulas LR, Dixon G, et al. The effects of fish oil supplementation in pregnancy on breast milk fatty acid composition over the course of lactation: a randomized controlled trial. Pediatr Res 2007;62(06):689-694
|
Correlation coefficient (R2) |
Parity, pre-gestational BMI, age and maternal allergy (allergic rhinitis or asthma) |
Pregnant women between the 16th to the 20th gestational weeks and who had delivered after the 36th gestational week, with presence of allergic rhinitis, asthma or positive test in the Prick test |
Pregnant smokers, with health problems and with fish consumption above two meals per week |
In the intervention group, colostrum presented a high proportion of DHA and EPA when compared with the control group (p< 0.001). During the three moments, the drop was higher in the intervention group when compared with the control group (p< 0.001). However, the amount of DHA and EPA remained higher in the intervention group at 6 weeks postpartum when compared with the control group ( p< 0.001). At 6 months, no differences were found between groups |
| Fidler et al1717. Fidler N, Sauerwald T, Pohl A, Demmelmair H, Koletzko B. Docosahexaenoic acid transfer into human milk after dietary supplementation: a randomized clinical trial. J Lipid Res 2000; 41(09):1376-1383
|
Correlation coefficient (R2) |
Maternal age, height, weight (day 0), weight (day 14), BMI (day 14), milk secretion (mL/day), TL in HM (g/100 mL) |
Healthy lactating mother, with omnivorous diet, with single, full-term, healthy newborns |
NI |
At baseline, there was no difference in fatty acid composition between the intervention and the placebo group. After two weeks of supplementation with 200mg of DHA/day, the milk from the intervention group contained a significantly higher percentage of DHA relative to milk from the placebo group (p= 0.003), a content almost 1.8 times higher of DHA. There was no significant difference in the content of any other fatty acids at any time point after supplementation. |
| Francois et al3636. Francois CA, Connor SL, Bolewicz LC, ConnorWE. Supplementing lactating women with flaxseed oil does not increase docosahexaenoic acid in their milk. Am J Clin Nutr 2003;77(01):226-233
|
Average |
NI |
Healthy women aged 28–39 years |
NI |
The omega-3 content in HM increased significantly over time, from 1.0% of total lipids (TL) at baseline to 6.8% of TL after one week of linseed oil supplementation. The omega-3 content remained high at 2 and 4 weeks. After 4 weeks of supplementation, the omega-3 concentration reached a peak of 7.7% of TL, and then returned to baseline (≈1.9% of TL) at 1 week after supplementation |
| Gaete and Atalah11. Gaete GM, Atalah SE. Niveles de LC-PUFA n-3 en la leche materna después de incentivar el consumo de alimentosmarinos. Rev Chil Pediatr 2003;74(02):158-165
|
Median |
Weight, height and BMI |
GA > 37 weeks and exclusive breastfeeding |
Women with diabetes, altered lipid metabolism and alcohol and drug dependence |
After food education, the consumption of fish increased three times in relation to the initial consumption. The increased intake of DHA did not significantly modify the DHA content of the milk. However, in mothers with an intake of DHA > 200 mg/day there was a positive correlation between intake and milk content (r = 0.71, p< 0.05) |
| Gaete et al3131. Gaete MG, Atalah ES, Araya JA. Efecto de la suplementación de la dieta de la madre durante la lactancia con ácidos grasos omega 3 en la composición de los lípidos de la leche. Rev Chil Pediatr 2002; 73(03):239-247
|
Median |
Weight, height, BMI, parity, age of the newborn |
GA > 37 weeks and exclusive breastfeeding |
Women with diabetes, altered lipid metabolism and alcohol and drug dependence |
After supplementation, an increase in the amount of EPA and DHA in HM was observed. DHA consumption in the intervention group increased significantly from 64 mg to 335.9 mg daily |
| van Goor et al3939. van Goor SA, Dijck-Brouwer DA, Hadders-Algra M, et al. Human milk arachidonic acid and docosahexaenoic acid contents increase following supplementation during pregnancy and lactation. Prostaglandins Leukot Essent Fatty Acids 2009; 80(01):65-69
|
Median |
Maternal age, pregestational BMI, weight, gestational weight gain, GA at birth, birth weight and parity |
Women with low risk, first or second pregnancy, and with single gestation |
Vegetarian/vegan women and/or with diabetes mellitus |
Compared with placebo, supplementation of ARA + DHA or DHA alone significantly increased the concentration of DHA in milk in both the second (59% and 43%, respectively) and in the 12th (56% and 52%, respectively) week after delivery |
| Hawkes et al4040. Hawkes JS, Bryan DL, Neumann MA, Makrides M, Gibson RA. Transforming growth factor beta in human milk does not change in response to modest intakes of docosahexaenoic acid. Lipids 2001;36(10):1179-1181
|
Average |
Maternal age, fish consumption, smoking, alcoholic beverages and side effects |
Healthy women, age ≥18 years, single full-term infants, and breast-feeding for ≥ 12 weeks |
Inflammatory diseases, use of anti-inflammatory drugs or fish oil supplements |
The concentration of DHA in HM increased linearly in response to the diet with DHA. The authors concluded that the consumption of ≤ 600 mg/day of DHA and 140 mg/day of EPA for 4 weeks increased the concentrations of omega-3 and its metabolites in relevant tissues but did not cause changes in the concentrations of cytokines in human milk |
| Imhoff-Kunsch et al1313. Imhoff-Kunsch B, Stein AD, Martorell R, Parra-Cabrera S, Romieu I, Ramakrishnan U. Prenatal docosahexaenoic acid supplementation and infantmorbidity: randomized controlled trial. Pediatrics 2011;128(03):e505-e512
|
Correlation coefficient (R2) |
Age, GA, parity, BMI, schooling, GA at birth, prematurity and birth weight of the newborn |
Women of gestational age between 18–22 weeks, who planned to breastfeed for at least 3 months, aged 18–35 years |
High risk pregnancy, lipid absorption or metabolism disorder, regular intake of fish oil or supplements rich in DHA, and frequent use of certain medications |
The concentration of DHA in breast milk in the intervention group was higher than for the placebo group (p< 0.01) |
| Jensen et al1818. Jensen CL, Maude M, Anderson RE, Heird WC. Effect of docosahexaenoic acid supplementation of lactating women on the fatty acid composition of breast milk lipids and maternal and infant plasma phospholipids. Am J Clin Nutr 2000;71(1, Suppl):292S-299S
|
Correlation coefficient (R2) |
Age, parity, weight, height, GA, birth weight of the newborn |
Pregnant women with the intention to exclusively breastfeed |
Maternal age at birth < 19 or > 35 years, diabetes, egg allergy, gestational age < 37 weeks, and birth weight < 2,500 g or > 4,200 g |
DHA supplementation increased plasma DHA concentrations in lactating women and in breast milk, resulting in a higher plasma concentration of DHA in children. A positive correlation was found between the DHA, EPA and ARA contents in maternal plasma and breast milk (r2= 66.2%, p< 0.001) |
| Marc et al3232. Marc I, Plourde M, Lucas M, et al. Early docosahexaenoic acid supplementation of mothers during lactation leads to high plasma concentrations in very preterm infants. J Nutr 2011; 141(02):231-236
|
Average |
Age, BMI, parity, schooling, work, marital status, use of vitamins, race and income |
Childbirth with GA ≤29 weeks and intending to breastfeed |
Age < 18 years or > 40 years, > 3 fish servings/week, use of omega-3 supplements, fish allergy, coagulation disorder, drug or alcohol use |
The dietary DHA supplement provided during lactation increased the concentration of DHA in breast milk in mothers of preterm infants (GA ≤29 weeks) and in the plasma of these infants |
| Olafsdottir et al4141. Olafsdottir AS, Thorsdottir I, Wagner KH, Elmadfa I. Polyunsaturated fatty acids in the diet and breast milk of lactating icelandic women with traditional fish and cod liver oil consumption. Ann Nutr Metab 2006;50(03):270-276
|
Correlation coefficient (R2) |
Food intake, smoking, alcohol, drug use and schooling |
Irish or having lived in the country for at least 15 years, single birth and breastfeeding |
NI |
EPA and DHA were significantly different between the groups, being 1.3–2.3 times higher in the milk of the intervention group when compared with the control group, without any negative effect on another fatty acids |
| Patin et al3535. Patin RV, VítoloMR, ValverdeMA, Carvalho PO, Pastore GM, Lopez FA. The influence of sardine consumption on the omega-3 fatty acid content of mature human milk. J Pediatr (Rio J) 2006;82(01): 63-69
|
Correlation coefficient (R2) |
Age, BMI, Parity, gestational weight gain, weight and length of the newborn at birth |
Exclusive breastfeeding, no smoking, no allergy/intolerance to sardines, birth weight ≥2500 g, GA between 37 and 42 weeks |
NI |
Consumption of 300 g of sardines per week increased DHA levels in HM |
| Ribeiro et al3030. Ribeiro P, Carvalho FD, Abreu AdeA, Sant'anna MdeT, Lima RJ, Carvalho PdeO. Effect of fish oil supplementation in pregnancy on the fatty acid composition of erythrocyte phospholipids and breast milk lipids. Int J Food Sci Nutr 2012;63(01):36-40
|
Averageand correlation coefficient (R2) |
NI |
Age between 20–30 years, 30th week of gestation, no use of medication, no intolerance/allergy to fish, no use of dietary supplements with omega-3 and omega-6, and with intention to breastfeed exclusively |
NI |
The data confirmed that the omega-3 content in HM, DHA in particular, is influenced by the consumption of omega-3 by the pregnant woman. A positive correlation was found between omega-3 content in the phospholipids of erythrocytes of pregnant women and the content of these fatty acids in breast milk |
| Sherry et al4242. Sherry CL, Oliver JS, Marriage BJ. Docosahexaenoic acid supplementation in lactating women increases breast milk and plasma docosahexaenoic acid concentrations and alters infant omega 6:3 fatty acid ratio. Prostaglandins Leukot Essent Fatty Acids 2015; 95:63-69
|
Average |
Age, BMI and skin color |
Age ≥18 years, with full term infants, 4–6 weeks postpartum and who planned to breastfeed for ≥ 6 weeks |
NI |
Lactating women consumed ∼ 25% of the recommended amount of DHA/day. The data found demonstrated that supplementation significantly increased DHA in HM, as well as decreased the ratio of omega-6/omega-3 |
| Smit et al3737. Smit EN, Koopmann M, Boersma ER, Muskiet FA. Effect of supplementation of arachidonic acid (AA) or a combination of AA plus docosahexaenoic acid on breastmilk fatty acid composition. Prostaglandins Leukot Essent Fatty Acids 2000;62(06):335-340
|
Average |
Maternal age, number of children and duration of lactation |
Infants between the third and tenth months of breastfeeding |
NI |
The administration of 300 mg ARA + 110 mg EPA + 400 mg DHA increased the LCPUFAs content in HM, with no significant result |
| Smithers et al4343. Smithers LG, Markrides M, Gibson RA. Human milk fatty acids fromlactating mothers of preterminfants: a study revealing wide intra- and inter-individual variation. Prostaglandins Leukot Essent Fatty Acids 2010;83(01):9-13
|
Average |
Age, smoking, schooling, human milk production, breastfeeding at the end of the intervention, single gestation, gestational age at birth, gender and birth weight of the newborn |
GA < 33 weeks |
Coagulation disorders, congenital or chromosomal anomalies, and multiple births in which not all live births were eligible |
Mothers in the intervention group had 3-fold higher levels of DHA in HM compared with women in the placebo group but also had slightly lower linoleic acid content |
| Valentine et al4444. Valentine CJ, Morrow G, Pennell M, et al. Randomized controlled trial of docosahexaenoic acid supplementation in midwestern U. S. human milk donors. Breastfeed Med 2013;8(01):86-91
|
Median |
Age and stage of lactation |
Donor to the human milk bank |
Women who did not have enough milk to donate |
The DHA content of the milk increased in the group supplemented with DHA capsules (p< 0.05) |
| Weseler et al4545. Weseler AR, Dirix CE, Bruins MJ, Hornstra G. Dietary arachidonic acid dose-dependently increases the arachidonic acid concentration in human milk. J Nutr 2008;138(11):2190-2197
|
Correlation coefficient (R2) |
Age, pregestational BMI, blood pressure, number of gestations, total fatty acids in milk and erythrocyte |
GA (34–35 weeks), intention to breastfeed, pregestational BMI (18–27 kg/m2), consumption of fish < 2x per week, without use of omega-3 supplements, alcohol, cigarette, drugs or supplements |
GA < 37 or > 43 weeks, allergy/intolerance to supplements and vegetarian components |
It was observed that the concentrations of DHA in HM increased significantly after 2 weeks of supplement intake (320 mg DHA + 80 mg EPA) |
