Breastfeeding's protection against illness-induced anorexia is mediated partially by docosahexaenoic acid

Eur J Clin Nutr. 2008 Jan;62(1):32-8. doi: 10.1038/sj.ejcn.1602686. Epub 2007 Feb 21.


Objective: To test whether breastfeeding's protection against anorectic responses to infection is mediated by n-3 fatty acids' attenuation of interleukin (IL)-1beta and tumor necrosis factor (TNF)alpha.

Design: Experimental and observational studies.

Setting: A hospital-based study was conducted.

Subjects: Five groups of infants were followed; three in the experimental and two in the observational study.

Methods: Breast-fed- (BF-1), DHA-supplemented formula- (SFF-1), and non-DHA-supplemented formula-fed (FF-1) infants were studied before and after immunization against diphtheria, tetanus, pertussis and haemophilus influenzae type b. Pre- and post-immunization energy intakes (EI) and serum IL-1beta and TNFalpha were measured. The two other groups, breast-fed (BF-2) and formula-fed (FF-2) infants with pneumonia were followed throughout hospitalization. EI, IL-1beta and TNFalpha were measured at admission and discharge. Baseline erythrocyte fatty acid contents were determined.

Results: Both cytokines increased following immunization in all feeding groups. Post-immunization reductions in EI of SFF-1 infants (-11.8+/-5%, CI(95)=-23.3, 1.4%, P=0.07) were intermediate to those observed in BF-1 (-5.2+/-4.2%, CI(95)=-15.2, 5.9%, P=0.27) and FF-1 infants (-18+/-4.4%, CI(95)=-29%, -5.4%, P=0.02). In the observational study, TNFalpha (17.2+/-8.3 vs 3.4+/-3.0 ng/l, P=0.001) and decreases in EI (-31+/-43 vs -15+/-31%, CI(95)=-34%, 0.001%, P=0.056) were greater in FF-2 than in BF-2 infants at admission. Breastfeeding duration was associated positively with docosahexaenoic acid (DHA) erythrocyte contents, and negatively with admission TNFalpha. Decreases in EIs were associated with IL-1beta and TNFalpha concentrations.

Conclusion: Reductions in EI following immunologic or infectious stimuli were associated with increases in IL-1beta and TNFalpha. Those reductions were attenuated by breastfeeding, and mediated in part by tissue DHA.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anorexia
  • Bottle Feeding
  • Breast Feeding*
  • Diphtheria-Tetanus-Pertussis Vaccine
  • Docosahexaenoic Acids / immunology
  • Docosahexaenoic Acids / pharmacology*
  • Energy Intake / immunology*
  • Energy Intake / physiology
  • Erythrocytes / chemistry
  • Female
  • Haemophilus Vaccines
  • Humans
  • Infant
  • Interleukin-1beta / blood
  • Interleukin-1beta / immunology*
  • Interleukin-1beta / physiology
  • Male
  • Milk, Human / immunology*
  • Milk, Human / physiology
  • Pneumonia / immunology
  • Tumor Necrosis Factor-alpha / blood
  • Tumor Necrosis Factor-alpha / immunology*
  • Tumor Necrosis Factor-alpha / physiology


  • Diphtheria-Tetanus-Pertussis Vaccine
  • Haemophilus Vaccines
  • Interleukin-1beta
  • Tumor Necrosis Factor-alpha
  • diphtheria-tetanus-pertussis-haemophilus b conjugate vaccine
  • Docosahexaenoic Acids