Should there be a target level of docosahexaenoic acid in breast milk?

Purpose of reviewThis article examines the evidence for and against establishing a target level of docosahexaenoic acid (DHA) in breast milk.Recent findingsTwo target levels for milk DHA have been recently proposed. One (approximate to 0.3% of milk fatty acids) was based on milk DHA levels achieved in women consuming the amount of DHA recommended by the American Academy of Pediatrics for pregnant and lactating women (at least 200mg DHA/day). Another (approximate to 1.0%) was based on biomarker studies of populations with differing lifelong intakes of fish. Populations or research cohorts with milk DHA levels of 1.0% are associated with intakes that allow both the mother and infant to maintain relatively high DHA levels throughout lactation. Lower milk DHA levels may signal suboptimal maternal stores and possibly suboptimal infant intakes.SummaryBased on the current data, a reasonable milk DHA target appears to be approximately 0.3%, which is about the worldwide average. Although this may not be the optimal' level (which remains to be defined), it is clearly an improvement over the currently low milk DHA levels (approximate to 0.2%) seen in many Western populations.