A dose-response relationship between fish consumption and human milk DHA content among Filipino women in Cebu City, Philippines

Aims: Human milk is the primary source of docosahexaenoic acid (DHA) for most infants, an important fatty acid for neurological development. Milk DHA is largely incorporated from the maternal diet. Little is known about whether milk DHA varies within populations with differences in maternal fish consumption. Here, we investigate this association in a sample of marginally nourished Filipino women. Methods: Milk samples were collected during in-home interviews with 117 lactating Filipino mothers from Cebu City, Philippines, nursing infants <24 months of age. Anthropometric data and dietary recalls were also collected. Samples were analysed for total fatty acid composition using gas chromatography. Multivariate regression was used to test the association between fish consumption and milk DHA. Results: Milk DHA showed a positive, dose-response relationship with maternal fish consumption (p < 0.011, r ²=0.21). Milk DHA was also positively related to protein intake, likely reflecting the association between fish and protein intake (p < 0.009). Unlike prior studies, parity predicted increased milk DHA (p = 0.03). Conclusions: Increasing fish consumption during lactation may be a cost-effective means of maximizing DHA delivery to infants particularly in populations with marginal energy intakes during lactation. However, this must be weighed against the potential dangers of increasing exposure to fish-based pollutants.