人乳中乳铁蛋白含量的初步检测分析

目的 了解人乳乳铁蛋白水平.方法 利用酶联免疫吸附双抗体夹心法(ELISA),分别测定36名产妇产后2、3 d的初乳,6、7 d的过渡乳及42 d的成熟乳标本中乳铁蛋白水平.结果 初乳的乳铁蛋白含量最高,过渡乳组和成熟乳组依次降低,分别为初乳组(2.63 ± 1.11) g/L、过渡乳组(1.96 ± 1.05) g/L、成熟乳组(1.42 ± 1.01) g/L,三组差异有统计学意义(P ＜ 0.01).剖宫产与顺产产妇的乳铁蛋白差异无统计学意义(P ＞ 0.05).产妇年龄＜ 28岁与≥ 28岁的乳铁蛋白含量差异无统计学意义(P ＞ 0.05).结论 人乳乳铁蛋白在初乳、过渡乳、成熟乳中的下降趋势与国外报道相符,但三组测定值均低于国外水平,尤其是初乳乳铁蛋白明显低于国外报道.     

我国5个地区人乳中脂肪酸成分的分析

目的了解我国不同地区人乳脂肪酸成分的最新数据。方法选择上海、重庆、长春、广州和呼和浩特共156名健康足月分娩妇女,连续采集产后第1~7天和第42天的乳汁,采用石英毛细管柱气相色谱法测定人乳中的脂肪酸成分。结果人乳中总脂肪酸(TFA)含量从产后第1~7天至第42天逐渐增加,差异有统计学意义(P0.01);上海42d人乳中TFA含量较高(34.96g/L),广州较低(29.72g/L)。人乳中饱和脂肪酸(SFA)含量在产后第1~7天逐渐增加,而第42天则有所降低,差异均有统计学意义(P0.05);呼和浩特42 d人乳中SFA百分含量较高(37.43%),长春较低(32.80%)。单不饱和脂肪酸(MUFA)百分含量在重庆42d人乳中较高(44.06%),长春较低(32.57%);油酸(C18:1 n-9)是人乳中含量最高的MUFA,重庆42 d人乳中油酸的百分含量较高(39.97%)。亚油酸(LA)百分含量在长春42 d人乳中较高(30.82%),重庆较低(18.40%),α-亚麻酸(ALA)百分含量在长春42 d人乳中也较高(2.12%),广州较低(0.79%);二十二碳六烯酸(DHA)百分含量在上海和广州42 d人乳中较高(均为0.41%),呼和浩特较低(0.19%);花生四烯酸(AA)百分含量在广州42 d人乳中含量较高。结论我国不同地区人乳中的脂肪酸成分有较大差别。     

上海和重庆两地区人乳中脂肪酸成份的研究

目的 近年来我国居民的饮食结构有了较大的变化,因此有必要对中国人乳中的脂肪酸成份再次进行分析测定,以提供我国人乳中脂肪酸成份的最新数据.方法 在中国东部的上海市区和西部的重庆市区选择62例健康产妇.连续采集每位产妇产后1 ～ 7 d的初乳和42 d的成熟乳.采用日本岛津公司的GC-2010气相色谱仪对人乳中的脂肪酸进行分析测定.结果 人乳中总脂肪酸的含量从初乳至成熟乳逐渐增加,两地人乳中的总脂肪酸含量差异无统计学意义(P ＞ 0.05).重庆市成熟人乳中单不饱和脂肪酸(MUFA)的百分含量(44.06%)显著高于上海市(33.85%)(P ＜ 0.01).重庆市成熟人乳中亚油酸(LA,C18 : 2)的含量(18.43%)显著低于上海市(27.62%)(P ＜ 0.01);花生四烯酸(AA,C20 : 4)在两个地区的成熟人乳中差异无统计学意义(P ＞ 0.05).上海市成熟人乳中DHA(0.41%)显著高于重庆市(0.29%)(P ＜ 0.01).结论 随着哺乳期的延长,人乳中的脂肪酸含量会有较大变化.重庆和上海由于地域和饮食习惯的不同,人乳中的脂肪酸成份也有较大的差别.

Abstract：

Objective Since there are significant variation of the dietary structure recent years in China,it is necessary to re-investigate the fatty acid composition of human breast milk for the presentation of the latest data of fatty acid composition in China. Methods Using a gas chromatography GC-2010,the composition of fatty acids was detected in the human colostrums and the mature breast milk(consecutively from postnatal day 1 to day 7 and from postnatal day 42)obtained from 62 healthy postpartum women in Shanghai and Chongqing,two big cities of China,from Jan to July,2008. Results The level of total fatty acid(TFA)tended to increase significantly from the colostrums to the mature breast milk. No significant difference in the level of TFA was found between two cities. The significantly higher monounsaturates(MUFA)level(44.06% vs. 33.85%,P ＜ 0.01)and lower linoleic acid(LA,C18 : 2n-6)level(18.43% vs. 27.62%,P ＜ 0.01)of the mature breast milk were observed in Chongqing women compared with those in Shanghai women. The docosahexenoic acid(DHA)level of the mature breast milk in Shanghai women was significantly higher than that in Chongqing women(0.41% vs. 0.29%,P ＜ 0.01). There was no significant difference in the level of arachidonic acid(AA,C20 : 4n-6)between two cities. Conclusions The fatty acid composition in human breast milk tends to vary with the extension of the lactation. There is significant difference in the fatty acid compositions in human breast milk between Shanghai and Chongqing owing to different dietary habits in the different regions of China.     

早产儿母乳宏量营养素和总能量横断面调查

背景：中国早产儿母乳成分的报告不多,早产儿母乳成分可能受遗传、饮食习惯等影响。 目的探索不同孕周、不同分娩方式的早产儿母亲在不同泌乳阶段乳汁的宏量营养素含量及其变化情况。 设计：横断面调查。 方法：纳入NICU收治的出生体重<2 500 g、孕周<37周的早产儿母亲,母亲年龄＞18岁、无严重先天畸形,未使用免疫抑制剂,无母乳喂养禁忌证,自愿提供新鲜母乳,以双侧电动吸奶器收集早上4～5时双侧乳房全乳至一次性储奶瓶,冷链运送,从母亲采集母乳至上机行成分分析的过程在4 h内完成,采用 MIRIS HMA 母乳分析仪（瑞典 Miris AB 公司）,检测时用超声技术进行匀化。通过婴儿病例资料获取临床信息,根据纳入母亲分娩孕周分为<28周组、～32周组和～＜37周组;根据纳入母亲分娩年龄分为适龄产妇（≤34岁）和高龄产妇（＞35岁）;根据采集母乳发生于产后时间分为产后初乳（1～7 d）、过渡乳(～14 d)、成熟乳(～42 d)。 主要结局指标：早产儿母亲不同泌乳阶段乳汁的宏量营养素含量。 结果：符合本文纳入标准的早产儿母亲191例,阴道分娩79例（41.4%）,分娩年龄18～44（31.1±4.5）岁,分娩时孕周为（29.2±2.2)周;分娩191例婴儿,男婴102例（53.4%）,女婴89例,出生体重 (1 286±344)g。共收集到母乳305份,其中初乳55份,过渡乳72份,成熟乳178份。初乳、过渡乳和成熟乳的脂肪含量呈递增趋势,蛋白质呈递减趋势,差异均有统计学意义;初乳、过渡乳和成熟乳多重比较结果显示,碳水化合物和总能量差异有统计学意义,但过渡乳和成熟乳的碳水化合物、总能量差异无统计学意义。不同孕周的早产儿母亲的母乳中宏量营养素及总能量多重分析差异均无统计学意义。过渡乳中的蛋白质含量＜28周高于～32周和～＜37周,过渡乳中的碳水化合物含量~28周和～32周高于～＜37周,差异均有统计学意义。初乳中的脂肪含量阴道分娩低于剖宫产,过渡乳和成熟乳中的蛋白质含量阴道分娩均低于剖宫产,成熟乳中的碳水化合物含量阴道分娩高于剖宫产,差异均有统计学意义。成熟乳中的脂肪含量和总能量适龄产妇低于高龄产妇,差异均有统计学意义。 结论：不同泌乳阶段早产儿母乳中的宏量营养元素和总能量有明显差别,未来可考虑开展母乳成分分析以指导早产儿个体化母乳喂养。     

母乳糖巨肽水平检测及其与多种初生婴儿配方奶粉的比较

目的 探讨人母乳糖巨肽(GMP)的水平,为优化初生婴儿配方奶粉的营养成分提供参考.方法 选取身体健康、无特殊饮食习惯、生活安定、奶量充足,年龄25 ～ 39岁,第1胎足月经阴道自然分娩的产妇30例.分为初乳组和成熟乳组,每组15例,每例采集5 mL母乳(前段乳汁).初乳组采集的时间为产后第2天,成熟乳组采集的时间为产后第42天.采用凝乳酶对母乳进行水解,再采用唾液酸测试盒检测上清液中唾液酸水平(比色法),并以此代表GMP的相对水平.另外,选取6种市售品牌配方奶粉作为奶粉组,各自配制成液态标准奶,用同样方法检测其唾液酸水平.采用方差分析法比较各组唾液酸水平.结果 GMP最佳酶解条件:酶液质量浓度0.25 g/L,酶解时间120 min.初乳组唾液酸质量浓度为(3486.98±406.70) mg/L,成熟乳组唾液酸质量浓度为(2687.95±375.85) mg/L,2组比较差异具有统计学意义(P＜0.01),前者高于后者,且各组内个体间差异小(CV初乳=0.12,CV成熟乳=0.14).配方奶粉组唾液酸质量浓度为(1196.93 ± 608.40) mg/L,低于初乳和成熟乳中的水平,差异均具有统计学意义(P均＜0.01)；各种品牌配方奶粉的平均唾液酸水平差异较大(CV=0.63).结论 人初乳中GMP的水平较成熟乳高；不同品牌婴幼儿配方奶粉中的GMP水平多寡不均,测得值与人乳比较也存在较大差异.但由于人乳和牛乳GMP分子质量及所含氨基酸残基数量不同,因而达到同样的GMP生理功效所需人乳或牛乳GMP水平可能不同.为优化初生婴儿配方奶粉的营养成分,使之更接近人乳,有必要进一步探讨相对于人乳的最佳配方奶粉GMP水平.     

正常妊娠妇女血液、胎盘和脐血中脂肪酸成分测定

目的了解新生儿和母体的脂肪酸营养状况以及胎盘在胎儿营养中的作用。方法采用气相色谱方法测定和分析20组的正常妊娠妇女血液、胎盘和新生儿脐血中的脂肪酸成分。结果共20例孕妇,平均年龄(27.0±4.5)岁,平均孕周为(38.0±3.0)周,娩出新生儿平均出生体质量(3 320±127)g。测得母血、脐血和胎盘中的脂肪酸共18种,包括饱和脂肪酸、单不饱和脂肪酸和多不饱和脂肪酸,其中母血中的总脂肪酸含量(3.51±0.57)g/L明显高于新生儿脐血中的含量(0.74±0.18)g/L,近5倍,差异有统计学意义(P0.05);母血中的亚油酸(LA)含量高于新生儿脐血和胎盘,胎盘中花生四烯酸(AA)和二十二碳六烯酸(DHA)的含量明显高于母血和新生儿脐血,新生儿脐血中的二十碳五烯酸(EPA)含量高于母血和胎盘,差异均有统计学意义(P0.05)。结论母体通过胎盘优先转运长链多不饱和脂肪酸AA和DHA来满足胎儿和新生儿生长发育的需要。     

早产儿和足月儿母乳中脂肪酸组成比较研究

为进一步提倡母乳喂养，本研究采用气相色谱法分析了不同泌乳期３８例早产儿和足月儿母乳中脂肪酸的组成。结果：初乳中总饱和脂肪酸百分含量较低，总不饱和脂肪酸百分含量较高，尤其是长链多价不饱和脂肪酸含量丰富，随着泌乳期的延长，母乳中Ｃ８０、Ｃ１００、Ｃ１２０和Ｃ１６１百分含量逐渐升高，而Ｃ１６０、Ｃ１８０、Ｃ２０４ω６和Ｃ２２６ω３百分含量逐渐下降，早产儿母乳成熟乳中总饱和脂肪酸及中链脂肪酸Ｃ８０～Ｃ１４０百分含量明显高于足月儿母乳。结论：初乳，特别是第１、２天的初乳，应尽量哺喂新生儿。对于早产儿，更应鼓励母乳喂养。     

动态观察母乳中表皮生长因子,骨钙素,铁蛋白及生长激素

采用放免法对77例不同哺乳期母乳中表皮生长因子（EGF）、骨钙素（BGP）、铁蛋白及生长激素（GH）含量进行测定。结果表明，EGF在初乳和过渡乳含量明显高于成熟乳和晚乳（P＜0．001）；铁蛋白在初乳中含量最高，以后逐渐减低（P＜0．05）；BGP和GH在各期母乳间无显著性差异。认为乳中EGF、BGP、铁蛋白、GH及在各期间的变化对儿童的生长发育十分重要。     

不同阶段母乳中α-生育酚浓度的研究

目的　研究初乳、过渡乳及成熟乳三个阶段母乳中α 生育酚的浓度及相关关系 ,同时探讨产前母血与新生儿脐血及各阶段母乳中α 生育酚浓度的相关关系。方法　应用高效液相色谱法 (HPLC)测定 4 0例产前母血清、脐带血清、初乳、过渡乳及成熟乳中α 生育酚的浓度。样本来源于孕期健康、足月顺产健康新生儿妇女。所得数据经SPSS统计软件处理。结果　初乳中α 生育酚浓度明显高于过渡乳 (P <0 0 1) ,过渡乳中α 生育酚浓度明显高于成熟乳 (P <0 0 5 )。过渡乳与初乳的α 生育酚浓度呈正相关 (r =0 4 3,P <0 0 1)。成熟乳与过渡乳的浓度呈正相关关系 (r =0 6 0 6 ,P <0 0 1)。初乳中α 生育酚浓度虽然明显高于成熟乳 (P <0 0 1) ,但两者间无明显相关关系 (P >0 0 5 )。产前母血中α 生育酚浓度高于脐血近 4倍 (P <0 0 0 1) ,但两者间无相关关系 (P>0 0 5 ) ,产前母血与各阶段母乳之间α 生育酚浓度也无相关关系 (P >0 0 5 )。结论　α 生育酚在母乳中以初乳中的含量最高 ,是过渡乳浓度的 2倍 ,是成熟乳的 2 7倍。而且初乳中α 生育酚浓度能影响过渡乳中的α 生育酚浓度 ;过渡乳中α 生育酚浓度也能影响成熟乳中的α 生育酚浓度 ;产前母血中α 生育酚的浓度处于较高水平 ,但不能影响新生儿血及产后     

妊娠糖尿病母亲母乳中真胰岛素水平及对婴儿生长的影响

目的:探讨妊娠糖尿病(GDM)哺乳期妇女初乳、42天和90天成熟乳中真胰岛素水平,分析其相关因素及其对婴儿体格发育的影响.方法:采用双位点单克隆抗体夹心放大酶联免疫分析法(BA-ELISA)测定GDM产妇和健康产妇初乳、42天和90天成熟乳及新生儿脐血中真胰岛素水平,监测婴儿90天内生长情况.结果GDM组初乳及90天成熟乳中真胰岛素水平均高于对照组(22.8μU/ml比20.4μU/ml,33.6μU/ml比23.5μU/ml,P均<0.05).母亲孕前、产前、产后42天和90天的体质指数(BMI)与90天成熟乳中真胰岛素水平正相关,产后42天BMI与42天成熟乳中真胰岛素水平正相关,孕期糖化血红蛋白百分比与90天成熟乳中真胰岛素水平正相关,剖宫产者初乳真胰岛素水平低于阴道分娩者(21.2μU/ml比96.3μU/ml,P<0.05).42天时高母乳喂养组母乳中真胰岛素水平低于低母乳喂养组(29.7μU/ml比69.6μU/ml,P<0.05).脐血中真胰岛素水平与出生体重和身长正相关,42天成熟乳中真胰岛素水平与出生至42天的体重增长值负相关,90天成熟乳中真胰岛素水平与90天头围负相关.结论:GDM哺乳期妇女母乳中真胰岛素水平较正常哺乳期妇女高,分娩方式和喂养方式对成熟乳中真胰岛素水平有影响,母乳中真胰岛素水平与孕产妇的BMI值呈正相关,对婴儿体格生长起调节作用.     

Fatty acid composition in breast milk and serum phospholipids of healthy term Chinese infants during first 6 weeks of life

AIM: To compare the fatty acid (FA) pattern in early and mature breast milk with that in plasma phospholipids of cord blood and breast-fed infants. METHODS: Forty-five mother-infant pairs from western Shanghai were studied. All infants, born at term with normal weight and length, were examined at birth and days 5 and 42. FA was analyzed by capillary gas-liquid chromatography. RESULTS: Cord blood showed higher concentration of long-chain polyunsaturated FA (LCPUFA) but lower saturated (SFA) and monounsaturated (MUFA) FA than postnatal infants' plasma. SFA decreased with age in the infants, but MUFA and linoleic acid (LA, 18:2omega6) increased. LCPUFA were lower in the plasma of 5-day-old infants than in cord blood, but LA was 80%, alpha-linolenic acid (ALA, 18:3omega3) 33% and the ratio omega-6/omega-3 42% higher. At day 42, LA increased further, LCPUFA remained similar, and was in breast milk lower than at day 5, while ALA and gamma-linolenic acid (18:3omega6) were higher. The activity index of desaturases indicated high Delta9 activity in breast milk and high activity of Delta5 desaturase in the infants. CONCLUSION: Breast milk FA composition changed markedly from day 5 to 42 with increasing correlation to infants' plasma. Calculation of desaturase activities suggested high capacity of LCPUFA synthesis.     

Composition of long chain polyunsaturated fatty acids in human milk and growth of young infants in rural areas of northern China

The main source of fat in the diet in rural areas of northern China is soybean oil, therefore the pattern of essential fatty acids in human milk may be assumed to differ from that in milk from women in Western countries and to be similar to that of vegans. The concentrations of long chain polyunsaturated fatty acids in human milk and information on diet were analysed for 41 lactating women in rural areas of north China, and the growth of their infants was measured. The subjects were divided into two groups (group I, 1 mo postpartum; group II, 3 mo postpartum). The dietary intake of the mothers was high in carbohydrate and low in fat, protein and energy. The concentrations of linoleic acid (LA) and alpha-linolenic acid (LNA) were high. The ratio of LA to LNA, (21.6), was higher than has been reported from other countries. The concentration of docosa-hexaenoic acid (DHA) was low and the ratio of arachidonic acid (AA) to DHA was much higher (2.8) than recommended and similar to that found in vegans. The concentrations of AA and DHA in the milk correlated positively with the infants' weight gain at the third month (p<0.05) and of DHA with length gain at the first and third months (p<0.01). Since the concentration of AA and, particularly, DHA in the milk declined during lactation, DHA deficiency may appear after 3-4 mo of age in breastfed Chinese rural infants. Further studies of Chinese rural mother-infant pairs are necessary to prove whether supplementation with suitable sources of AA and DHA, such as fish oil, should be recommended as lactation is lengthened to ensure optimal infant growth and development.     

Fatty acid composition of plasma and red cell phospholipids of preterm babies fed on breast milk and formulae

Fatty acids of plasma and red cells of preterm babies, gestational age 28–33 weeks, weighing less than 2200 g were studied between birth and the expected date of delivery (EDD). Babies were fed either mothers' breast milk, or if they were unable, or chose not to breastfeed, randomly assigned to milk formula A or B. Milk B had 26% oleic acid, 0.5% docosahexaenoic acid (DHA) and 0.12% arachidonic (AA); A had 13% oleic acid, less than 0.05% AA and no DHA. The proportions of gamma linoleic and the other fatty acids, and the ratio of linoleic acid (LA)/alpha linolenic acid (ALA) were comparable in the two formulae. Diet and/or physiological adaptation seemed to be responsible for the significant changes in the proportions of certain fatty acids between birth and EDD. Incorporation of DHA in formula B increased its concentration in plasma and red cells, and reduced the conversion of LA to AA. With respect to maintenance of DHA status, milk B was superior to milk A but did not match breast milk.Conclusion Fortification of formula with DHA without concomitant incorporation of AA may precipitate AA insufficiency and may have developmental implications.     

Long-chain polyunsaturated fatty acids in Chinese and Swedish mothers: diet, breast milk and infant growth

Long-chain polyunsaturated fatty acids (LC-PUFAs) are essential dietary nutrients required for the optimal growth and development of infants, particularly of the brain and retina. It is important for exclusively breastfed infants to receive milk of a correct balance between omega-6 and omega-3 fatty acids. In this study, we compared the composition of LC-PUFAs in the diet and milk of mothers and their infants' growth between Chinese and Swedish. Twenty-three and 19 mother-term infant pairs from a rural area of northern Beijing, China, and Stockholm, Sweden, who were 3 mo old and exclusively breastfed, were studied. The Chinese diet was higher in carbohydrate (17% of energy) but lower in protein (4% of energy) and fat (12% of energy) than the Swedish diet. The intake of Chinese mothers contained more linoleic acid (LA, C(18 ratio 2 omega-6)) and less arachidonic acid (AA, C(20 ratio 4 omega-6)), eicosapentaenoic acid (EPA, C(20 ratio 5 omega-3)) and docosahexaenoic acid (DHA, C(22 ratio 6 omega-3)) than that of Swedish mothers. The breast milk of the Chinese mothers had significantly higher LA and lower EPA and DHA levels than that of the Swedish mothers. However, in Chinese breast milk the AA level was significantly higher than that in Swedish breast milk. The recommended ranges of the ratios of LA to alpha-linolenic acid (LNA, C(18 ratio 3 omega-3)) and of AA to DHA in human milk are 5-10 and 0.5-1 compared with 23.0 and 3.1 in the Chinese breast milk, and 7.5 and 1.6 in the Swedish breast milk, respectively.Conclusion: The diet of the studied Chinese mothers is less balanced with regard to the levels of omega-6 and omega-3 polyunsaturated fatty acids (PUFAs) than that of the Swedish mothers, which is also mirrored in the breast milk of these mothers. The clinical relevance of the difference between the levels of LC-PUFAs in the breast milk of Chinese and Swedish mothers may be elucidated by a follow-up study of the cognitive and visual functions of the infants involved.     

Maternal fatty acid status during pregnancy and lactation and relation to newborn and infant status

The present review of determinants of infant fatty acid status was undertaken as part of a conference on 'Fatty acid status in early life in low-income countries: determinants and consequences'. Emphasis is placed on the essential fatty acids, and particularly the physiologically important long chain polyunsaturated fatty acids (LCPUFAs) of 20 and 22 carbons. We are unaware of any studies of determinants of infant fatty acid status in populations with a cultural dietary pattern with low amounts of linoleic acid (LA, 18:2n-6) and α-linolenic acid (ALA,18:3n-3). Many reports suggest that there may be adverse health effects related to the increased proportion of LA in relation to ALA, which have occurred worldwide due to the increased availability of vegetable oils high in LA. The issue of dietary n-6 to n-3 balance may apply to infant fatty acid status both during fetal and post-natal life; however, this review focuses on the n-3 and n-6 LCPUFA, in particular, docosahexaenoic acid (DHA, 22:6n-3) and arachidonic acid (AA, 20:4n-6), which are the predominant n-3 and n-6 LCPUFA found in cell membranes. The evidence that these fatty acids are preferentially transferred from maternal to fetal circulation across the placenta, and the sources and mechanisms for this transfer, are reviewed. We also address the sources of DHA and AA for the newborn including human milk DHA and AA and the factors that influence maternal DHA status and consequently the amount of DHA available for transfer to the fetus and infant via human milk.     

A dose-response relationship between fish consumption and human milk DHA content among Filipino women in Cebu City, Philippines

Aims: Human milk is the primary source of docosahexaenoic acid (DHA) for most infants, an important fatty acid for neurological development. Milk DHA is largely incorporated from the maternal diet. Little is known about whether milk DHA varies within populations with differences in maternal fish consumption. Here, we investigate this association in a sample of marginally nourished Filipino women. Methods: Milk samples were collected during in‐home interviews with 117 lactating Filipino mothers from Cebu City, Philippines, nursing infants <24 months of age. Anthropometric data and dietary recalls were also collected. Samples were analysed for total fatty acid composition using gas chromatography. Multivariate regression was used to test the association between fish consumption and milk DHA. Results: Milk DHA showed a positive, dose–response relationship with maternal fish consumption (p < 0.011, r² = 0.21). Milk DHA was also positively related to protein intake, likely reflecting the association between fish and protein intake (p < 0.009). Unlike prior studies, parity predicted increased milk DHA (p = 0.03). Conclusions: Increasing fish consumption during lactation may be a cost‐effective means of maximizing DHA delivery to infants particularly in populations with marginal energy intakes during lactation. However, this must be weighed against the potential dangers of increasing exposure to fish‐based pollutants.     

The role of long chain polyunsaturated fatty acids (LCPUFA) in neonatal nutrition*

Exciting new research has shown that both preterm and term infants can actively convert the essential fatty acids linoleic acid (LA, 18:2n-6) and α-linolenic acid (ALA, 18:3n-3) to long chain polyunsaturated fatty acids (LCPUFA). However, the amount of LCPUFA being produced, particularly of docosahexaenoic acid (DHA, 22:6n-3), may not be sufficient to meet the developmental requirement of the infant. Because DHA is a major component of retinal and brain tissues, a number of studies have been initiated to test the effect of dietary LCPUFA on neural outcomes in infants. These studies have largely involved a comparison of neural responses from infants fed standard infant formula (no LCPUFA) with infants receiving LCPUFA from either supplemented formula or breast milk. The results have been equivocal and may be due to the variety of LCPUFA supplements and formula fat blends used, differing testing techniques as well as variations in clinical trial conduct, but are clearer in preterm than term infants. Overall the results indicate a possible role for LCPUFA in neurodevelopment.     

Essential fats: how do they affect growth and development of infants and young children in developing countries? A literature review

Omega-3 and omega-6 fatty acids, particularly docosahexaenoic acid (DHA), are known to play an essential role in the development of the brain and retina. Intakes in pregnancy and early life affect growth and cognitive performance later in childhood. However, total fat intake, alpha-linolenic acid (ALA) and DHA intakes are often low among pregnant and lactating women, infants and young children in developing countries. As breast milk is one of the best sources of ALA and DHA, breastfed infants are less likely to be at risk of insufficient intakes than those not breastfed. Enhancing intake of ALA through plant food products (soy beans and oil, canola oil, and foods containing these products such as lipid-based nutrient supplements) has been shown to be feasible. However, because of the low conversion rates of ALA to DHA, it may be more efficient to increase DHA status through increasing fish consumption or DHA fortification, but these approaches may be more costly. In addition, breastfeeding up to 2 years and beyond is recommended to ensure an adequate essential fat intake in early life. Data from developing countries have shown that a higher omega-3 fatty acid intake or supplementation during pregnancy may result in small improvements in birthweight, length and gestational age based on two randomized controlled trials and one cross-sectional study. More rigorous randomized controlled trials are needed to confirm this effect. Limited data from developing countries suggest that ALA or DHA supplementation during lactation and in infants may be beneficial for growth and development of young children 6-24 months of age in these settings. These benefits are more pronounced in undernourished children. However, there is no evidence for improvements in growth following omega-3 fatty acid supplementation in children >2 years of age.     

Milk of northern Sudanese mothers whose traditional diet is high in carbohydrate contains low docosahexaenoic acid

Aim: The suckling neonates and infants are reliant primarily on the mother for optimal supply of docosahexaenoic acid (DHA). The richest source of preformed DHA is cold‐water oily fish. Although there is paucity of data, existing evidence suggest women with restricted access to these foods have low or marginal DHA status. The aim of the study was to investigate milk fatty acids of Sudanese mothers whose traditional diet is high in carbohydrate and low in fat and gain some insight into the provision of DHA to the suckling offspring. Methods: Colostrum (n = 26), transitional (n = 20) and mature (n = 14) milk samples were obtained from Northern Sudanese women (NSW) recruited prior to delivery from Ibrahim Malik and Khartoum Teaching Hospitals. Results: The arachidonic acid content of the colostrum (0.87 ± 0.28%) and transitional (0.89 ± 0.29%) and mature (0.48 ± 0.12%) milk of the NSW were broadly comparable with published international values. In contrast, the DHA level (colostrum 0.13 ± 0.07%, transitional 0.13 ± 0.06% and mature milk 0.06 ± 0.05%) was very low. Conclusion: The study reveals breast milk of NSW, whose traditional diet is almost devoid of fish and fish products, is unlikely to provide sufficient DHA to support optimal postnatal neuro‐visual development.