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Positive results in breastfeeding studies are seriously eroded by adjustment for multiple covariates, and residual positive effects cannot be attributed to renal LCPUFAs because of other potentially active constituents in breast milk. Nevertheless, it is of interest that these studies consistently showed a positive renal association between breastfeeding and performance across a wide range of different tests, even after adjustment for at least some potential confounders. Clearly, the experiments most capable of providing definitive evidence that is directly relevant to human exposure conditions are RCTs in humans. As reviewed above, these trials have often not shown renal an effect of LCPUFA supplementation on cognitive or behavioral performance, and some reviewers have considered that, overall, the evidence was insufficient to conclude that LCPUFA supplementation benefited development (73, 74).
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