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

TLDR

This review summarizes current evidence on the importance of long‑chain polyunsaturated fatty acids, particularly DHA and AA, for maternal nutrition and infant visual and cognitive development. The authors recommend that pregnant and lactating women consume at least 200 mg DHA daily, that infants receive sufficient LC‑PUFA for optimal development, and that breastfeeding be preferred, with formula containing 0.2–0.5 wt % DHA and at least equal AA when breastfeeding is not possible. Consensus guidelines endorse LC‑PUFA intake during pregnancy and lactation, noting that n‑3‑rich oils reduce early preterm birth risk, and recommend continued LC‑PUFA after six months despite limited quantitative data.

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, 20:4n-6), 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.