Objectives: Docosahexaenoic acid (DHA, 22:6 n-3) is a fatty acid, which plays an important role in growth and neurodevelopment. There is wide variability of DHA levels in breast milk based on gestational age, geographical location, and diet. Indian diets contain low levels of DHA, implying lower breast milk DHA levels. However there is dearth of information on the fatty acid profile of the breast milk of Indian mothers.

In this study we compared the fatty acid composition of the breast milk of Indian mothers with term and preterm neonates and determined the relationship of breast milk DHA with dietary intake of DHA.

Study Design: This observational study included postnatal mothers (Days 4-7) from the NICU and postnatal wards of a tertiary care hospital in South India. Expressed breast milk from 23 term and 24 preterm mothers was analyzed for fat composition by gas chromatography. Dietary history was taken by a food record questionnaire. BMI of mothers was noted. The sample size of 48 was calculated with 90% power and α error of 5%.

Results: DHA was significantly higher in term breast milk as compared to preterm breast milk (0.18 ± 0.08 ug % Vs 0.12 ± 0.09 ug % p = 0.025). The levels of arachidonic acid and also overall PUFA were significantly higher in term milk. This difference was seen even though the dietary intake of fatty acids in both groups was similar. Whether this has long term consequences needs to be investigated.

Conclusion: The levels of DHA was significantly lower among preterm infants’ mothers’ breast milk, compared to term infants, despite there being no significant dietary differences between the two groups. Whether supplementation of DHA to pregnant women or preterm infants could improve neurological and retinal outcomes is yet to be studied.