Fatty acids play central roles in growth and development through their roles in membrane lipids, as ligands for receptors and transcription factors that regulate gene expression, precursor for eicosanoids, in cellular communication, and through direct interactions with proteins. Adverse fatty acid supplies during fetal and child development alter the fatty acid composition of membrane phospholipids and storage triglycerides with the potential to disrupt cellular environments, and program structure and function. Maternal fatty acid nutrition during pregnancy and lactation determines the transfer of essential n-6 and n-3, and non-essential trans fatty acids via the placenta and through human milk. Poor maternal docosahexaenoic acid (DHA) status increases risk of inadequate DHA to support brain and retinal development, delaying or limiting neural and visual system development. The implications of recent changes in the dietary fatty acids on maternal to infant fatty acid transfer, including the composition of human milk has been insufficiently studied.