Maternal consumption of a DHA-containing functional food benefits infant sleep patterning: An early neurodevelopmental measure Michelle P. Judge a, c, ⁎, Xiaomei Cong a, 1 , Ofer Harel b, 2 , Amber B. Courville c , Carol J. Lammi-Keefe d, e, 3 a University of Connecticut, School of Nursing, 231 Glenbrook Road, U-4017, Storrs, CT 06269-2026, United States b University of Connecticut, Department of Statistics, Storrs, CT 06269, United States c University of Connecticut, Department of Nutritional Sciences, Storrs, CT 06269, United States d Louisiana State University, Division of Human Nutrition and Food, School of Human Ecology, College of Agriculture and Agricultural Center, Baton Rouge, LA 70808, United States e Louisiana State University, Pennington Biomedical Research Center, Baton Rouge, LA 70808, United States abstract article info Article history: Received 1 September 2010 Received in revised form 13 December 2011 Accepted 20 December 2011 Keywords: Long-chain polyunsaturated fatty acids Docosahexaenoic acid DHA DHA functional food Infant sleep Pregnancy Background: Docosahexaenoic acid (DHA; 22:6n -3) is highly important during pregnancy for optimal de- velopment and functioning of fetal neural tissue. Infant ability to organize sleep and wake states following parturition is highly associated with later developmental outcomes. The impact of maternal DHA intake on sleep organization has not been previously investigated. Aims: To examine the effect of a DHA-containing functional food consumed during pregnancy on early neu- robehavioral development as assessed by infant sleep patterning in the first 48 postnatal hours. Study design: A longitudinal, randomized, double-blinded, placebo-controlled design was used. Subjects: Women (18–35 y) with no pregnancy complications consumed a cereal-based functional food (92 kcal) containing 300 mg DHA an average of 5 d/week or placebo bars (n = 27 DHA, n = 21 Placebo). The intervention began at 24 weeks gestation and continued until delivery (38–40 weeks). Outcome measures: Infant sleep/wake states were measured on postnatal days 1 (D1) and 2 (D2) using a pressure sensitive mattress recording respiration and body movements. Results: Using ANCOVA and controlling for ethnic variation, there were significant group differences in arousals in quiet sleep on D1 (P = 0.006) and D2 (P = 0.011) with fewer arousals in the DHA intervention group compared to the placebo group. Similarly, arousals in active sleep on D1 were significantly lower in the DHA-intervention group (P = 0.012) compared to the placebo group. Conclusions: We conclude that increased prenatal supply of dietary DHA has a beneficial impact on infant sleep organization. © 2012 Elsevier Ireland Ltd. All rights reserved. 1. Introduction The essential fatty acid docosahexaenoic acid (DHA, 22:6n -3), found in cold water marine fish, has a central role in regulating the biophysical properties of neural membranes [1]. Based upon animal studies, specific regions of the brain, including the cerebral cortex, synapses and retinal rod photoreceptors, have a particularly high DHA concentration [1,2]. Adequate DHA intake is especially impor- tant during pregnancy, accumulating in fetal tissue at a particularly high rate during the third trimester [3]. Studies conducted in animals provide evidence for disturbances in brain development of offspring relating to DHA deficiency induced during the gestational period [4–8]. Human studies show that maternal DHA dietary intake during the last trimester of pregnancy is related to cord blood DHA status, however its impact on the infant's neurodevelopment has not been extensively investigated [9]. In the U.S. [10–12] and Canada [13] maternal dietary DHA intake during pregnancy has been estimated at 39–99 mg/day which is less than half of the current recommended level of 200 mg/d [14] thus raising concern for the neurodevelopment of infants [13,15–18]. Compounding this concern, the fetal conversion of α-linolenic acid (LNA, 18:3 n -3), the precursor fatty acid to DHA is extremely lim- ited [19]. The placenta compensates in part for this limited conver- sion with a higher preference by the fatty acid binding proteins located in the basal placental membrane for DHA compared to other long chain polyunsaturated fatty acids or their precursors [20–22]. Given the general concern for DHA deficiency in pregnancy and potential alterations in infant development, increased research Early Human Development 88 (2012) 531–537 ⁎ Corresponding author. Tel.: + 1 860 486 1596. E-mail addresses: michelle.judge@uconn.edu (M.P. Judge), xiaomei.cong@uconn.edu (X. Cong), ofer.harel@uconn.edu (O. Harel), amber.courville@yahoo.com (A.B. Courville), CLammi-Keefe@agcenter.lsu.edu (C.J. Lammi-Keefe). 1 Tel.: +1 860 486 2694. 2 Tel.: +1 860 486 6989. 3 Tel.: +1 225 578 1518. 0378-3782/$ – see front matter © 2012 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.earlhumdev.2011.12.016 Contents lists available at SciVerse ScienceDirect Early Human Development journal homepage: www.elsevier.com/locate/earlhumdev