Fish intake reflects on DHA level in breast milk among lactating women in Latvia

Background: Docosahexaenoic acid (DHA) is an essential fatty acid required for proper growth and development. DHA levels in breast milk vary worldwide. Higher levels are observed among coastal populations and are associated with marine food consumption. Latvia is located in Northern Europe, on the eastern shore of the Baltic Sea. Nevertheless, fish consumption among women of reproductive age is low. The aim of this study was to determine DHA levels in breast milk among lactating women in Latvia. Methods: Invitation to participate in the study was posted on a social media member group for breastfeeding mothers. In total, 71 women were enrolled from November 2016 until December 2017. DHA levels (% of total fatty acids) in breast milk were measured by gas chromatography. Information about food consumed during the three consecutive days prior to the milk sampling was obtained and a food frequency questionnaire (FFQ) was completed. Information about maternal and infant characteristics, current breastfeeding pattern and milk expression method was also collected. Results: The mean age of participants was 31 +/- 4 years and the mean BMI was 22.1 +/- 3.2. 27 participants were primiparas. The average age and birth weight for infants (34 males, 33 females) was 6 +/- 4 months and 3.46 +/- 0. 55 kg, respectively. The median DHA level in breast milk (n = 60) was 0.30 +/- 0.18% of total fatty acids and it was not influenced by any of the maternal or infant's characteristics nor current breastfeeding pattern or milk expression manner (p > 0.05). Fish intake was a positive predictor for DHA levels in breast milk (r = 0318, p = 0.013). Average maternal DHA intake was 136 +/- 26, 137 +/- 33 and 178 +/- 49 (SEM - standard error of the mean) mg, for the third, second and last day prior to sampling day, respectively. Conclusions: DHA levels in breast milk among lactating women in Latvia correspond to the suggested target DHA value in breast milk (030%). Fish consumption is a significant positive predictor for DHA levels in breast milk, however, daily DHA intake among the participants was lower than recommended (200 mg).