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Clinical Trial ARTICLE Provisionally accepted The full-text will be published soon. Notify me

Front. Pediatr. | doi: 10.3389/fped.2018.00407

Maternal supplementation with krill oil during breastfeeding and long-chain polyunsaturated fatty acids (LCPUFAs) composition of human milk: a feasibility study

 Anna Giulia Cimatti1, 2,  Silvia Martini1, 2*, Alessandra Munarini2, 3,  Maximiliano Zioutas1, Francesca Vitali1, 2,  Arianna Aceti1, 2, Vilma Mantovani2, 3, Giacomo Faldella1, 2 and  Luigi Corvaglia1, 2
  • 1Neonatal Intensive Care Unit, Policlinico S.Orsola Malpighi, Italy
  • 2Department of Medical and Surgical Sciences, University of Bologna, Italy
  • 3Centro Unificato di Ricerca Biomedica Applicata CRBA, Policlinico S. Orsola Malpighi, Italy

Background
Docosahexaenoic acid (DHA) is a major constituent of neuronal and retinal membranes and plays a crucial role in brain and visual development within the first months of life. Dietary intakes are fundamental to provide neonates with adequate DHA supply; hence, maternal supplementation might represent a useful strategy to implement DHA contents in breast milk (BM), with possible benefits on neonatal neurodevelopment.
Antarctic krill is a small crustacean rich in highly available phospholipid-bound DHA. This pilot study aimed to evaluate whether maternal supplementation with krill oil during breastfeeding increases long-chain polyunsaturated fatty acids (LCPUFAs) BM contents.

Methods
Mothers of infants admitted to the Neonatal Intensive Care Unit were enrolled in this open, randomized-controlled study between 4 and 6 weeks after delivery and randomly allocated in 2 groups. Group 1 received an oral krill oil-based supplement providing 250 mg/day of DHA and 70 mg/day of eicosapentaenoic acid (EPA) for 30 days; group 2 served as control. BM samples from both groups were collected at baseline (T0) and day 30 (T1) and underwent a qualitative analysis of LCPUFAs composition by gas chromatography/mass spectrometry.

Results
Sixteen breastfeeding women were included. Of these, 8 received krill-oil supplementation and 8 were randomized to the control group. Baseline percentage values of DHA (%DHA), arachidonic acid (%AA) and EPA (%EPA) did not differ between groups. A significant increase in %DHA (T0: median 0.23% [IQR 0.19;0.38], T1:0.42% [0.32;0.49], p 0.012) and %EPA (T0: median 0.10% [IQR 0.04;0.11], T1:0.11% [0.04;0.15], p 0.036) and a significant reduction in %AA (T0: median 0.48% [IQR 0.42;0.75], T1:0.43% [0.38;0.61], p 0.017) between T0 and T1 were shown in Group 1, whereas no difference was observed in Group 2.
Consistently, a significant between-group difference was observed in percentage changes from baseline of DHA (∆%DHA, group 1: median 64.2% [IQR 27.5;134.6], group 2: -7.8% [-12.1;-3.13], p 0.025) and EPA (∆%EPA, group 1: median 39% [IQR 15.7;73.4]; group 2: -25.62% [-32.7;-3.4], p 0.035).

Conclusions
Oral krill oil supplementation effectively increases DHA and EPA contents in BM. Potential benefits of this strategy on brain and visual development in breastfed preterm neonates deserves further evaluation in targeted studies.

Keywords: LCPUFA, LCPUFA supplementation, arachidic acid (AA), Docosabexaenoic acid (DHA), Eicosapentadienoic acid (EPA), Krill (Euphausia superba), breastfeeding, human milk

Received: 07 Jul 2018; Accepted: 07 Dec 2018.

Edited by:

Sertac Arslanoglu, Istanbul Medeniyet University, Turkey

Reviewed by:

MaryAnn Volpe, Tufts University School of Medicine, United States
Salvatore Andrea Mastrolia, Ospedale dei Bambini Vittore Buzzi, Italy  

Copyright: © 2018 Cimatti, Martini, Munarini, Zioutas, Vitali, Aceti, Mantovani, Faldella and Corvaglia. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: MD. Silvia Martini, Policlinico S.Orsola Malpighi, Neonatal Intensive Care Unit, Bologna, 40138, Emilia-Romagna, Italy, silvia.martini4@gmail.com