[1355.6] High Dose of Docosahexaenoic Acid (DHA) for Very Premature Infants: Effects of Mother Supplementation on Breastfed Infant Fatty Acid Status
Isabelle Marc, Bruno Piedboeuf, Michel Lucas, Stephen C. Cunnane, Melanie Plourde, Anca Sterescu, Anne-Monique Nuyt, Emile Levy, Alexandra Dufresne, Sylvie Dodin. Pediatrics, Centre Hospitalier Universitaire de Quebec, Universite Laval, Quebec, Canada; Chaire Approche Intégrée en Santé, Université Laval, Quebec, Canada; Centre de Recherche du CHU Ste-Justine, Université de Montreal, Montreal, Canada; Centre de Recherche sur le Vieillissement, Université de Sherbrooke, Sherbrooke, Canada; Pediatrics, Hôpital Ste-Justine, Montreal, Canada.
BACKGROUND: Very premature infants are vulnerable to deficiency of omega-3 fatty acids, particularly DHA. Gastro-intestinal immaturity and acute health problems worsen the risk of malnutrition and complications related to low enteral intake.
OBJECTIVE: Is DHA supplementation of mothers with very premature infants able to increase DHA levels in the breastfed infants?
DESIGN/METHODS: Mothers who delivered prematurely (< 30 wk gestation) and planned to breastfeed received DHA supplementation (1.2g/d) until 36 wk post conception. Along with early maternal supplementation with high dosage of DHA, the intervention supported a high proportion of human milk in preterm diet and gave priority to the intake of maternal fresh expressed milk in the preterm feeding. We longitudinally assessed daily DHA intakes in the preterms from birth to day 49th. Fatty acid profiles were determined in breast-milk (weekly), and plasma phospholipids of mothers and premature infants (baseline, day 14th, day 49th). At day 49th, we compared fatty acid profiles with those of a reference group of very premature.
RESULTS: We respectively included ten and 22 mothers and their twelve and 24 infants in the DHA and reference groups. We achieved 1% DHA content in the milk provided to the preterm before reaching the 3rd wk of life and full enteral feeding. Although there is no difference in the enteral feeding intake at day 49th, infants of the DHA group received 55.2±37.6 mg/kg/day of DHA compared with 7.2±11.1 in the reference group. In infants, the intervention results in a positive significant trend in the DHA plasma concentrations over the study period (p=0.0143) with a significant difference between the two groups at Day 49th (60.3ng/ml ± 23.5 in DHA group (n=12) and 31.7ng/ml ±10.7 in the reference group (n=21), p=0.0014). Changes in the fatty acid composition suggested that intervention did not significantly alter AA and EPA content in preterm's plasma and mother's milk.
CONCLUSIONS: Maternal DHA supplementation increase DHA in breast-milk and, compared to reference group, better optimize DHA levels in the very premature infant. Consequently, more DHA will be available to meet the high DHA needs for the brain development and growth. Research Grant from the Sick Kids Foundation. Mead Johnson Nutrition provided DHA.
E-PAS20101355.6
Date: Saturday, May 1, 2010
Poster Symposium Session: Human Milk or Breastfeeding (10:15 AM - 12:15 PM)
Presentation Time: 10:15 AM
Room: 118 - Vancouver Convention Centre
Board Number: 6
Course Number: 1355
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