Are human milk long-chain polyunsaturated fatty acids related to visual and neural development in breast-fed term infants?

Objective: To determine whether docosahexaenoic acid (DHA) is related to visual and neural development in term breast-fed infants. Design: A prospective study of 83 infants who were exclusively breast-fed for at least 3 months. We determined red blood cell and plasma fatty acids at 2 months, visual acuity at 2, 4, 6, and 12 months, speech perception and an object search task at 9 months, Bayley's mental development index and psychomotor development index at 6 and 12 months, and novelty preference at 6 and 9 months. Results: The infant red blood cell phosphatidylethanolamine DHA was significantly related to visual acuity at 2 months of age (r = 0.32, P = .01) and 12 months of age (P = 0.30, P = .03). The ability to discriminate normative retroflex and phonetic contrasts at 9 months of age was related to the plasma phospholipid D HA (r = 0.48, P < .02) and red blood cell phosphatidylethanolamine DHA (r = 0.26, P = .02) at 2 months of age after adjusting for covariates. Conclusion: DHA may influence the development of visual acuity and neural pathways associated with the developmental progression of language acquisition in term breast-fed infants. The extent to which our results can be attributed solely to DHA from maternal sources through breast milk or in gestation or other confounding factors remains to be determined.