Human milk polyunsaturated fatty acids are related to neurodevelopmental, anthropometric, and allergic outcomes in early life: a systematic review.
Level 3 - non-randomized controlled study
Systematic review of observational cohort and cross-sectional studies
PubMed 38254254 · doi:10.1017/S2040174423000454
What was done
This systematic review (PROSPERO ID: CRD42023400059) synthesized 21 observational studies published between 2005 and 2020 evaluating healthy term children aged 0 to 5 years. It examined associations between human milk omega-3 fatty acids (DHA, EPA, ALA) and omega-6 fatty acids (AA, LA) and three child health domains: neurodevelopment, body composition/anthropometrics, and allergy, skin, and eczema outcomes. Study quality was evaluated using the NIH Quality Assessment Tool and certainty of evidence was graded using GRADE.
What was found
The abstract reports no numerical effect sizes or confidence intervals. Across the 21 included studies, higher milk concentrations of total omega-3, DHA, EPA, and ALA consistently correlated with better outcomes across neurodevelopment, body composition, and allergy/eczema domains. Conversely, higher concentrations of total omega-6, AA, and LA in human milk were associated with poorer outcomes across the same domains. Evidence certainty was rated as moderate.
Why it matters
These findings suggest that balancing maternal human milk polyunsaturated fatty acid composition toward higher omega-3 and lower omega-6 levels could support infant developmental and allergic health. It highlights the potential utility of maternal dietary guidance and lactation support.
Limits
The abstract provides qualitative directional summaries without specific effect sizes, risk ratios, or confidence intervals. Included studies were observational (cohort and cross-sectional), limiting causal inference. The authors noted significant gaps in controlling for maternal diet influences on milk composition and maternal/infant fatty acid desaturase (FADS) genetic variants.
Cited by
- context A mother's diet directly affects the composition of her breast milk and can impact infant eczema.