Skip to main content Accessibility help

Human milk: maternal dietary lipids and infant development

  • Sheila M. Innis (a1)

Human milk provides all the dietary essential fatty acids, linoleic acid (LA; 18:2n-6) and α-linolenic acid (18:3n-3), as well as their longer-chain more-unsaturated metabolites, including arachidonic acid (20:4n-6) and DHA (22:6n-3) to support the growth and development of the breast-fed infant. Human milk levels of LA have increased in Westernized nations from mean levels (g/100 g total fatty acids) of 6 to 12–16 over the last century, paralleling the increase in dietary intake of LA-rich vegetable oils. DHA levels (g/100 g total milk fatty acids) vary from <0·1 to >1% and are lowest in countries in which the intake of DHA from fish and other animal tissue lipids is low. The role of DHA in infant nutrition is of particular importance because DHA is accumulated specifically in the membrane lipids of the brain and retina, where it is important to visual and neural function. An important question is the extent to which many human diets that contain low amounts of n-3 fatty acids may compromise human development. The present paper reviews current knowledge on maternal diet and human milk fatty acids, the implications of maternal diet as the only source of essential fatty acids for infant development both before and after birth, and recent studies addressing the maternal intakes and milk DHA levels associated with risk of low infant neural system maturation.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the or variations. ‘’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Human milk: maternal dietary lipids and infant development
      Available formats
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Human milk: maternal dietary lipids and infant development
      Available formats
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Human milk: maternal dietary lipids and infant development
      Available formats
Corresponding author
Corresponding author: Dr Sheila M. Innis, fax +1 604 875 3597, email
Hide All
Bazan, NG (2006) Cell survival matters: docosahexaenoic acid signaling, neuroprotection and photoreceptors. Trends in Neurosciences 29, 263271.
Birch, EE, Garfield, S, Hoffman, DR, Uauy, R & Birch, DC (2000) A randomized controlled trial of early dietary supply of long-chain polyunsaturated fatty acids and mental development in term infants. Developmental Medicine and Child Neurology 42, 174181.
Birch, EE, Hoffman, DR, Uauy, R, Birch, DG & Prestidge, C (1998) Visual acuity and the essentiality of docosahexaenoic acid and arachidonic acid in the diet of term infants. Pediatric Research 44, 201209.
Calder, PC (2006) Polyunsaturated fatty acids and inflammation. Prostaglandins, Leukotrienes, and Essential Fatty Acids 75, 197202.
Calder, PC, Krauss-Etschmann, S, de Jong, EC, Dupont, C, Frick, JS, Frokiaer, H et al. (2006) Early nutrition and immunity: progress and perspectives. British Journal of Nutrition 96, 774790.
Carlson, SE, Ford, AJ, Werkman, SH, Peeples, JM & Koo, WW (1996) Visual acuity and fatty acid status of term infants fed human milk and formulas with and without docosahexaenoate and arachidonate from egg yolk lecithin. Pediatric Research 39, 882888.
Clandinin, MT, Chappell, JE, Helm, T, Swyer, PR & Chance, GW (1981) Fatty acid utilization in perinatal de novo synthesis of tissues. Early Human Development 5, 355366.
Fewtrell, MS (2006) Long-chain polyunsaturated fatty acids in early life: effects on multiple health outcomes. A critical review of current status, gaps and knowledge. Nestlé Nutrition Workshop Series. Paediatric Programme 57, 203214.
Fidler, N, Sauerwald, T, Pohl, A, Demmelmair, H & Koletzko, B (2000) Docosahexaenoic acid transfer into human milk after dietary supplementation a randomized clinical trial. Journal of Lipid Research 41, 13761383.
Friesen, RW & Innis, SM (2006) Trans fatty acids in human milk in Canada: a decline with the introduction of trans fat food labeling. Journal of Nutrition 136, 14.
Gibson, RA, Neuman, MA & Makrides, M (1997) Effect of increasing breast milk docosahexaenoic acid on plasma and erythrocyte phospholipids fatty acids and neural indices of exclusively breast fed infants. European Journal of Clinical Nutrition 51, 578584.
Hachey, DC, Silber, GH, Wong, WW & Garza, C (1989) Human lactation. II: Endogenous fatty acid synthesis by the mammary gland. Pediatric Research 25, 6368.
Heird, WC & Lapillonne, A (2005) The role of essential fatty acids in development. Annual Review of Nutrition 25, 549571.
Helland, IB, Saugstad, OD, Smith, L, Saarem, K, Solvoll, K, Ganes, T & Drevon, CA (2001) Similar effects on infants of n-3 and n-6 fatty acids supplementation to pregnant and lactating women. Pediatrics 108, e82e91.
Helland, IB, Smith, L, Saarem, K, Saugstad, OD & Drevon, CA (2003) Maternal supplementation with very-long-chain n-3 fatty acids during pregnancy and lactation augments children's IQ at 4 years of age. Pediatrics 111, e39e44.
Henderson, RA, Jenson, RG, Lammi-Keefe, CJ, Ferris, AM & Dardick, KR (1992) Effect of fish oil on the fatty acid composition of human milk and maternal and infant erythrocytes. Lipids 27, 863869.
Hoffman, DR, Birch, EE, Castaneda, YS, Fawcett, SL, Wheaton, DH, Birch, DG & Uauy, R (2003) Journal of Pediatrics 142, 669677.
Innis, SM (1991) Essential fatty acids in growth and development. Progress in Lipid Research 30, 39103.
Innis, SM (1992) Human milk and formula fatty acids. Journal of Pediatrics 120, S56S61.
Innis, SM (2003) Perinatal biochemistry and physiology of long-chain polyunsaturated fatty acids. Journal of Pediatrics 143, Suppl. 4, S1S8.
Innis, SM (2004) Polyunsaturated fatty acids in human milk: an essential role in infant development. Advances in Experimental Medicine and Biology 554, 2743.
Innis, SM (2006) Trans fatty intakes during pregnancy, infancy and early childhood. Atherosclerosis Supplements 7, 1720.
Innis, SM (2007) Dietary n-3 fatty acids and brain development. Journal of Nutrition (In the Press).
Innis, SM, Auestad, N & Siegman, JS (1996) Blood lipid docosahexaenoic and arachidonic acid in term gestation infants fed formulas with high docosahexaenoic acid and low eicosapentaenoic acid fish oil. Lipids 31, 617626.
Innis, SM, Dyer, R & Nelson, CM (1994) Evidence that palmitic acid is absorbed as sn-2 monoacylglycerol from human milk by breast-fed infants. Lipids 29, 541545.
Innis, SM, Gilley, J & Werker, J (2001) Are human milk long-chain polyunsaturated fatty acids related to visual and neural development in breast-fed term infants? Journal of Pediatrics 139, 532538.
Innis, SM & King, DJ (1999) Trans fatty acids in human milk are inversely associated with levels of essential all-cis n-6 and n-3 fatty acids, and determine trans, but not n-6 and n-3, fatty acids in plasma of breast-fed infants. American Journal of Clinical Nutrition 70, 383390.
Innis, SM, Pinsk, V & Jacobson, K (2006) Dietary lipids and intestinal inflammatory disease. Journal of Pediatrics 149, S89S96.
Insull, W, Hirsch, J, James, J & Ahrens, EH (1959) The fatty acids of human milk II alterations produced by manipulation of calorie balance and exchange of dietary fats. Journal of Clinical Investigation 38, 443450.
Jensen, CL, Maude, M, Anderson, RE & Heird, WC (2000) Effect of docosahexaenoic acid supplementation of lactating women on the fatty acid composition of breast milk lipids and maternal and infant plasma phospholipids. American Journal of Clinical Nutrition 71, 292S299S.
Jensen, CL, Voigt, RG, Prager, TC, Zou, YL, Fraley, JK, Rozelle, JC, Turcich, MR, Llorente, AM, Anderson, RE & Heird, WC (2005) Effects of maternal docosahexaenoic acid intake on visual function and neurodevelopment in breastfed term infants. American Journal of Clinical Nutrition 82, 125132.
Jensen, RG (1999) Lipids in human milk. Lipids 34, 12431271.
Jensen, RG, Ferris, AM, Lammi-Keefe, CJ & Henderson, RA (1990) Lipids of bovine and human milks: a comparison. Journal of Dairy Science 73, 223240.
Jorgensen, MH, Hernell, O, Hughes, EL & Michaelsen, KF (2001) Is there a relation between docosahexaenoic acid concentration in mothers' milk and visual development in term infants? Journal of Pediatric Gastroenterology and Nutrition 32, 293296.
Kennedy, K, Fewtrell, MS, Morely, R, Abbott, R, Quinlan, PT, Wells, JC, Bindels, JG & Lucas, A (1999) Double-blind, randomized trial of a synthetic triacylglycerol in formula-fed term infants: effects on stool biochemistry, stool characteristics, and bone mineralization. American Journal of Clinical Nutrition 70, 920927.
Kris-Etherton, PM, Taylor, DS, Yu-Poh, S, Huth, P, Moriarty, K, Fishell, V, Hargrove, R, Zhoa, G & Etherton, T (2000) Polyunsaturated fatty acids in the food chain in the United States. American Journal of Clinical Nutrition 71, 179S188S.
Lauritzen, L, Hansen, HS, Jorgensen, MH & Michaelsen, KF (2001) The essentiality of long chain n-3 fatty acids in relation to development and function of the brain and retina. Progress in Lipid Research 40, 194.
Lauritzen, L, Jorgensen, MH, Mikkelsen, TB, Skovgaard, M, Straarup, EM, Olsen, SF, Hoy, CE & Michaelsen, KF (2004) Maternal fish oil supplementation in lactation: effect on visual acuity and n-3 fatty acid content of infant erythrocytes. Lipids 39, 195206.
Makrides, M, Neumann, MA, Simmer, K & Gibson, RA (1995) Erythrocyte fatty acids of term infants fed either breast milk, standard formula, or formula supplemented with long-chain polyunsaturates. Lipids 30, 941948.
Martinez, M (1992) Tissue levels of polyunsaturated fatty acids during early human development. Journal of Pediatrics 120, S129S138.
Neville, MC (2001) Anatomy and physiology of lactation. Pediatric Clinics of North America 48, 1334.
Niu, SL, Mitchell, DC, Lim, SY, Wen, ZM, Kim, HY, Salmen, N Jr & Litman, BJ (2004) Reduced G protein-coupled efficiency in retinal rod outer segments in response to n-3 fatty acid deficiency. Journal of Biological Chemistry 279, 3109831104.
Ponder, DL, Innis, SM, Benson, JD & Siegman, JS (1992) Docosahexaenoic acid status of term infants fed breast milk or infant formula containing soy oil or corn oil. Pediatric Research 32, 683688.
Rodriguez-Cruz, M, Tovar, AR, Palacios-Gonzalez, B, del Prado, M & Torres, N (2006) Synthesis of long-chain polyunsaturated fatty acids in lactating mammary gland: role of delta 5 and delta 6 desaturases, SREBP-1, PPAR alpha, and PGC-1. Journal of Lipid Research 47, 553560.
Sanders, TAB & Reddy, S (1992) The influence of vegetarian diet on the fatty acid composition of human milk and essential fatty acid status of the infant. Journal of Pediatrics 120, 71S77S.
SanGiovanni, JP, Berkey, CS, Dwyer, JT & Colditz, GA (2000) Dietary essential fatty acids, long-chain polyunsaturated fatty acids, and visual resolution acuity in healthy full-term infants: a systematic review. Early Human Development 57, 165188.
Simopoulos, AP (1999) Evolutionary aspects of omega-3 fatty acids in the food supply. Prostaglandins, Leukotrienes, and Essential Fatty Acids 60, 421429.
Soubias, O, Teaque, WE & Gawrish, K (2006) Evidence for specificity in lipid-rhodopsin interactions. Journal of Biological Chemistry 281, 3323333241.
Sprecher, H (1999) An update on the pathways of polyunsaturated fatty acid metabolism. Current Opinion in Clinical Nutrition and Metabolic Care 2, 135138.
Tomarelli, RM, Myer, BJ, Weaber, JR & Bernhart, FW (1968) Effect of positional distribution on the absorption of the fatty acids of human milk and infant formulas. Journal of Nutrition 95, 583590.
Uauy, R & Dangour, AD (2006) Nutrition in brain development and aging role of essential fatty acids. Nutrition Reviews 64, S24S33.
Williams, CM & Burdge, G (2006) Long-chain n-3PUFA plant v marine sources. Proceedings of the Nutrition Society 65, 4250.
Yukas, R, Pramul, K & Lien, EL (2006) Human milk fatty acid composition from nine countries varies most in DHA. Lipids 42, 851858.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Proceedings of the Nutrition Society
  • ISSN: 0029-6651
  • EISSN: 1475-2719
  • URL: /core/journals/proceedings-of-the-nutrition-society
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed