Effect of maternal docosahexaenoic acid supplementation during lactation on breast milk DHA concentration and infant neurodevelopment among urban and rural populations of Punjab, India.

Docosahexaenoic acid (DHA) plays a critical role in infant growth and neurodevelopment during early life; however, dietary intake of omega-3 fatty acids among Indian lactating women is often inadequate, potentially compromising maternal DHA status and infant development. The present study evaluated the effects of maternal DHA supplementation during lactation on maternal DHA status, breast milk DHA concentration, infant growth, and neurodevelopment among urban and rural populations in Punjab, India. A community-based randomized supplementation trial was conducted among 60 healthy lactating mothers (1 month postpartum) and their exclusively breastfed infants. Participants were stratified by residence and randomly assigned to urban control (UC), urban supplemented (US), rural control (RC), or rural supplemented (RS) groups (n = 15 per group). Supplemented mothers received DHA capsules daily for 150 days. Maternal dietary intake, erythrocyte DHA concentration, breast milk DHA concentration, infant anthropometric measurements, WHO growth indicators, and neurodevelopmental outcomes assessed using the Developmental Assessment Scale for Indian Infants (DASII) were evaluated. Dietary intake of alpha-linolenic acid and DHA was inadequate in both populations and significantly lower among rural mothers (p < 0.001). Maternal DHA supplementation significantly increased erythrocyte DHA concentration and breast milk DHA concentration in both supplemented groups (p < 0.001). Infants of supplemented mothers demonstrated significantly higher weight, length, and head circumference measurements at 6 months postpartum compared with controls (p < 0.05). Supplemented infants also exhibited more favorable weight-for-age, length-for-age, and weight-for-length Z-scores, together with a lower prevalence of slow weight gain. Furthermore, supplemented infants achieved significantly higher Motor Development Quotient and Mental Development Quotient scores than controls (p < 0.001). Breast milk DHA concentration was positively associated with infant neurodevelopmental outcomes. These findings suggest that maternal DHA supplementation during lactation was associated with improved maternal DHA status, enhanced breast milk DHA concentration, favorable infant growth indicators, and higher neurodevelopmental scores. Maternal DHA supplementation may therefore represent a useful nutritional strategy for improving maternal and infant health outcomes in populations with low habitual omega-3 fatty acid intake.