Human milk fatty acid profile across lactational stages after term and preterm delivery: A pooled data analysis

• Published in: Prostaglandins, leukotrienes and essential fatty acids Vol. 156; p. 102023
• Main Authors: Floris, L.M., Stahl, B., Abrahamse-Berkeveld, M., Teller, I.C.
• Format: Journal Article
• Language: English
• Published: Scotland Elsevier Ltd 01.05.2020
• Subjects: Arachidonic Acid - analysis; Data Analysis; Docosahexaenoic Acids - analysis; Fatty acids; Fatty Acids - analysis; Fatty Acids - metabolism; Fatty Acids, Essential - analysis; Female; Gestational Age; Human milk; Humans; Lactation - physiology; Lactational stages; Milk, Human - chemistry; Milk, Human - metabolism; Pooled data; Postpartum Period; Pregnancy; Premature Birth - physiopathology; Preterm; Term; PP; HM; DGLA; Pooled data; Term; Fatty acids; SCFA; Preterm; EFSA; ARA; LCPUFA; DPA; LA; MCFA; ALA; Human milk; Lactational stages; FA; GLA; WLS
• ISSN: 0952-3278; 1532-2823
• DOI: 10.1016/j.plefa.2019.102023

•Interstudy variation were found for some, but remarkably not for all, fatty acids.•Distinct patterns of fluctuations in fatty acid levels were apparent over the course of the 3 lactational stages.•Several LCPUFAs, including ARA and DHA, seemed to decrease over the course of lactation.•The most abundant fatty acids (LA, ALA, palmitic and oleic acid) remained stable, while short- and medium-chain FAs increased.•These patterns seem to be comparable between term and preterm milk. Lipids in human milk (HM) provide the majority of energy for developing infants, as well as crucial essential fatty acids (FA). The FA composition of HM is highly variable and influenced by multiple factors. We sought to increase understanding of the variation in HMFA profiles and their development over the course of lactation, and after term and preterm delivery, using a pooled data analysis. To review the literature and perform a pooled data analysis to qualitatively describe an extensive FA profile (36 FAs) in term and preterm colostrum, transitional - and mature milk up to 60 days postpartum. A Medline search was conducted for HMFA profile data following term or preterm delivery. The search was confined to English language papers published between January 1980 and August 2018. Studies reporting original data, extensive FA profiles in HM from healthy mothers were included. Weighted least squares (WLS) means were calculated from the pooled data using random or fixed effect models. Our pooled data analysis included data from 55 studies worldwide, for a total of 4374 term milk samples and 1017 preterm milk samples, providing WLS means for 36 FAs. Patterns in both term and preterm milk were apparent throughout lactation for some FAs: The most abundant FAs (palmitic, linoleic and oleic acid) remained stable over time, whereas several long-chain polyunsaturated FAs (including ARA and DHA) seemed to decrease and short- and medium-chain FAs increased over time. High heterogeneity between individual studies was observed for the reported levels of some FAs, whereas other FAs were remarkably consistent between studies. Our pooled data suggests that specific FA categories fluctuate according to distinct patterns over the course of lactation; many of these patterns are comparable between term and preterm milk.