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Supplementation with long chain polyunsaturated fatty acids (LCPUFA) to breastfeeding mothers for improving child growth and development.

Abstract

BACKGROUND

Long chain polyunsaturated fatty acids (LCPUFA), especially docosahexaenoic acid (DHA), are the most abundant fatty acids in the brain and are necessary for growth and maturation of the brain and retina. LCPUFA are named "essential" because they cannot be synthesised efficiently by the human body and come from maternal diet. It remains controversial whether LCPUFA supplementation to breastfeeding mothers is beneficial for the development of their infants.

OBJECTIVES

To assess the effectiveness and safety of supplementation with LCPUFA in breastfeeding mothers in the cognitive and physical development of their infants as well as safety for the mother and infant.

SEARCH STRATEGY

We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (November 2009), CENTRAL (2009, Issue 2), PubMed (1966 to July 2009), EMBASE (1974 to June 2009), CINAHL (1984 to June 2009), LILACS (1982 to June 2009), Google Scholar (June 2009) and reference lists of published narrative and systematic reviews.

SELECTION CRITERIA

Randomised controlled trials or cluster-randomised controlled trials evaluating the effects of LCPUFA supplementation on breastfeeding mothers and their infants.

DATA COLLECTION AND ANALYSIS

Two review authors independently assessed eligibility and trial quality and performed data extraction.

MAIN RESULTS

We included six randomised controlled trials involving 1280 women. We found no significant difference in children's neurodevelopment: language development (standardised mean difference (SMD) -0.14, 95% confidence interval (CI) -0.49 to 0.20; two trials, 349 participants); intelligence or problem-solving ability (two trials, 817 participants; SMD -0.22, 95% CI -0.23 to 0.66); psychomotor development (SMD 0.34, 95% CI -0.11 to 0.78; two trials, 279 participants); motor development (SMD 0.08, 95% CI -0.13 to 0.29; two trials, 349 participants); in child attention there was a significant difference (SMD 0.50, 95% CI 0.24 to 0.77; one study). For child visual acuity there was no significant difference (SMD -0.06, 95% CI -0.26 to 0.14; three trials, 401 participants). For growth, there were significant differences in length (MD -0.75 cm, 95% CI -1.38 to -0.12; two trials, 834 participants) and head circumference (MD 0.69 cm, 95% CI 0.35 to 1.02; one trial, 244 participants). One study reported a significant difference in infant allergy (risk ratio (RR) 0.12, 95% CI 0.02 to 0.95). We found no significant difference in one trial evaluating postpartum depression (SMD 0.15, 95% CI -0.11 to 0.41).  

AUTHORS' CONCLUSIONS

Based on the limited evidence that we found, LCPUFA supplementation did not appear to improve children's neurodevelopment or visual acuity. In two studies, LCPUFA supplementation was associated with increased head circumference. Currently, there is insufficient evidence to support or refute the practice of giving LCPUFA supplementation to breastfeeding mothers in order to improve infant growth and development.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Departamento de Pediatría, Universidad del Cauca, Popayán, Colombia; Iberoamerican Cochrane Network, Barcelona, Spain.

    ,

    Source

    MeSH

    Breast Feeding
    Child Development
    Fatty Acids, Unsaturated
    Female
    Growth
    Humans
    Infant
    Intelligence
    Language Development
    Problem Solving
    Psychomotor Performance
    Randomized Controlled Trials as Topic
    Visual Acuity

    Pub Type(s)

    Journal Article
    Meta-Analysis
    Review
    Systematic Review

    Language

    eng

    PubMed ID

    21154388

    Citation

    Delgado-Noguera, Mario F., et al. "Supplementation With Long Chain Polyunsaturated Fatty Acids (LCPUFA) to Breastfeeding Mothers for Improving Child Growth and Development." The Cochrane Database of Systematic Reviews, 2010, p. CD007901.
    Delgado-Noguera MF, Calvache JA, Bonfill Cosp X. Supplementation with long chain polyunsaturated fatty acids (LCPUFA) to breastfeeding mothers for improving child growth and development. Cochrane Database Syst Rev. 2010.
    Delgado-Noguera, M. F., Calvache, J. A., & Bonfill Cosp, X. (2010). Supplementation with long chain polyunsaturated fatty acids (LCPUFA) to breastfeeding mothers for improving child growth and development. The Cochrane Database of Systematic Reviews, (12), p. CD007901. doi:10.1002/14651858.CD007901.pub2.
    Delgado-Noguera MF, Calvache JA, Bonfill Cosp X. Supplementation With Long Chain Polyunsaturated Fatty Acids (LCPUFA) to Breastfeeding Mothers for Improving Child Growth and Development. Cochrane Database Syst Rev. 2010 Dec 8;(12)CD007901. PubMed PMID: 21154388.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Supplementation with long chain polyunsaturated fatty acids (LCPUFA) to breastfeeding mothers for improving child growth and development. AU - Delgado-Noguera,Mario F, AU - Calvache,Jose Andres, AU - Bonfill Cosp,Xavier, Y1 - 2010/12/08/ PY - 2010/12/15/entrez PY - 2010/12/15/pubmed PY - 2011/2/11/medline SP - CD007901 EP - CD007901 JF - The Cochrane database of systematic reviews JO - Cochrane Database Syst Rev IS - 12 N2 - BACKGROUND: Long chain polyunsaturated fatty acids (LCPUFA), especially docosahexaenoic acid (DHA), are the most abundant fatty acids in the brain and are necessary for growth and maturation of the brain and retina. LCPUFA are named "essential" because they cannot be synthesised efficiently by the human body and come from maternal diet. It remains controversial whether LCPUFA supplementation to breastfeeding mothers is beneficial for the development of their infants. OBJECTIVES: To assess the effectiveness and safety of supplementation with LCPUFA in breastfeeding mothers in the cognitive and physical development of their infants as well as safety for the mother and infant. SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (November 2009), CENTRAL (2009, Issue 2), PubMed (1966 to July 2009), EMBASE (1974 to June 2009), CINAHL (1984 to June 2009), LILACS (1982 to June 2009), Google Scholar (June 2009) and reference lists of published narrative and systematic reviews. SELECTION CRITERIA: Randomised controlled trials or cluster-randomised controlled trials evaluating the effects of LCPUFA supplementation on breastfeeding mothers and their infants. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed eligibility and trial quality and performed data extraction. MAIN RESULTS: We included six randomised controlled trials involving 1280 women. We found no significant difference in children's neurodevelopment: language development (standardised mean difference (SMD) -0.14, 95% confidence interval (CI) -0.49 to 0.20; two trials, 349 participants); intelligence or problem-solving ability (two trials, 817 participants; SMD -0.22, 95% CI -0.23 to 0.66); psychomotor development (SMD 0.34, 95% CI -0.11 to 0.78; two trials, 279 participants); motor development (SMD 0.08, 95% CI -0.13 to 0.29; two trials, 349 participants); in child attention there was a significant difference (SMD 0.50, 95% CI 0.24 to 0.77; one study). For child visual acuity there was no significant difference (SMD -0.06, 95% CI -0.26 to 0.14; three trials, 401 participants). For growth, there were significant differences in length (MD -0.75 cm, 95% CI -1.38 to -0.12; two trials, 834 participants) and head circumference (MD 0.69 cm, 95% CI 0.35 to 1.02; one trial, 244 participants). One study reported a significant difference in infant allergy (risk ratio (RR) 0.12, 95% CI 0.02 to 0.95). We found no significant difference in one trial evaluating postpartum depression (SMD 0.15, 95% CI -0.11 to 0.41).   AUTHORS' CONCLUSIONS: Based on the limited evidence that we found, LCPUFA supplementation did not appear to improve children's neurodevelopment or visual acuity. In two studies, LCPUFA supplementation was associated with increased head circumference. Currently, there is insufficient evidence to support or refute the practice of giving LCPUFA supplementation to breastfeeding mothers in order to improve infant growth and development. SN - 1469-493X UR - https://www.unboundmedicine.com/medline/citation/21154388/Supplementation_with_long_chain_polyunsaturated_fatty_acids__LCPUFA__to_breastfeeding_mothers_for_improving_child_growth_and_development_ L2 - https://doi.org/10.1002/14651858.CD007901.pub2 DB - PRIME DP - Unbound Medicine ER -