Lipids in human milk and infant formulas.

About 50 metabolically important fatty acids can be identified in human milk. The extent of absorption of milk fatty acids varies considerably from infant to infant, particularly in pre-term infants, and requires more study. Human milk provides sufficient vitamins A and E for the term infant, but supplementation with vitamins D and K may be necessary. More research is needed on the amounts of the fat-soluble vitamins in human milk, the efficiency of transfer from mother to infant, the reasons for variation in different women, and the consequences to breast-fed infants of inadequate intake of vitamins D and K. Breast milk contains the PUFA needed by term infants who are able to synthesize the long-chain PUFA soon after birth. Pre-term infants fed formulae need supplementation with n3 and n6 long-chain PUFA, since formulas currently do not contain these acids. More work is needed to determine the requirements for n3 and n6 fatty acids, expressed as weights per kilogram. A larger data base using improved analytical procedures to study the nature and content of lipids in human milk is needed. The impact of maternal genetics and diet on fatty acids in milk should be studied, as well as the effect of maternal diet on eicosanoids secreted by the mammary gland. Information on the structure and function of the milk fat globule and its membrane is needed. Little is known about the effect of milk banking on milk lipids. The reader of this review will no doubt find other gaps in our knowledge of the lipid composition and nutritional value of milk that require additional investigation.