Effects of high-dose fish oil supplementation during early infancy on neurodevelopment and language: a randomised controlled trial

Abstract

n-3 Long-chain PUFA (LC-PUFA) intake during infancy is important for neurodevelopment; however, previous studies of n-3 LC-PUFA supplementation have been inconclusive possibly due to an insufficient dose and limited methods of assessment. The present study aimed to evaluate the effects of direct supplementation with high-dose fish oil (FO) on infant neurodevelopmental outcomes and language. In the present randomised, double-blind, placebo-controlled trial, 420 healthy term infants were assigned to receive a DHA-enriched FO supplement (containing at least 250 mg DHA/d and 60 mg EPA/d) or a placebo (olive oil) from birth to 6 months. Assessment occurred at 18 months via the Bayley Scales of Infant and Toddler Development (3rd edition; BSID-III) and the Child Behavior Checklist. Language assessment occurred at 12 and 18 months via the Macarthur -Bates Communicative Development Inventory. The FO group had significantly higher erythrocyte DHA (P¼0·03) and plasma phospholipid DHA (P¼ 0·01) levels at 6 months of age relative to placebo. In a small subset analysis (about 40 % of the total population), children in the FO group had significantly higher percentile ranks of both later developing gestures at 12 and 18 months (P¼ 0·007; P¼ 0·002, respectively) and the total number of gestures (P¼ 0·023; P¼ 0·006, respectively). There was no significant difference between the groups in the standard or composite scores of the BSID-III. The results suggest that improved postnatal n-3 LC-PUFA intake in the first 6 months of life using high-dose infant FO supplementation was not beneficial to global infant neurodevelopment. However, some indication of benefits to early communicative development was observed.

Long-Chain Polyunsaturated Fatty Acids in Breast-Milk and Erythrocytes and Neurodevelopmental Outcomes in Danish Late-Preterm Infants

“…Another Swedish cohort study [34] of moderately preterm infants found positive associations between both AA and DHA in infant blood and global developmental outcomes at 18 months of age, but negative associations with n-6 PUFA and the n-6/n-3 PUFA ratio. The observed assocition between AA and language skills is in accordance with some previous studies of term infant showing negative associations between LC-PUFA intake or status and language development [26,46], but other studies found no effect [47,48]. The previous studies have primarily focused on the effect of supplementation with fish oil, DHA or DHA+AA.…”

Current Information and Asian Perspectives on Long-Chain Polyunsaturated Fatty Acids in Pregnancy, Lactation, and Infancy: Systematic Review and Practice Recommendations from an Early Nutrition Academy Workshop

“…Studies have evaluated mental development, visual acuity, or motor development during infancy or in young childhood and the results have been mixed: one study providing high-dose fish oil with n-3 LC-PUFA but without AA did not observe beneficial effects on Bayley Scale of Infant Development (BSID) scores [87], one observed a beneficial effect on the mental development index [85], and another study reported beneficial effects on visual acuity [86] when 3 different DHA dosage groups were combined. These data may indicate that effects at younger ages may be too subtle to detect with smaller sample sizes.…”

Gestational Age and the Cord Blood Lipidomic Profile in Late Preterm and Term Infants

“…Moderate to late preterm birth increases the risk of neurodevelopmental problems [21]. Although supplementation of high-dose omega-3 fatty acids has not been shown to improve global development [22], it is plausible that the normal physiological acquisition of omega-3 fatty acids in late gestation is neuroprotective. The role of omega-3 fatty acids in overweight and obese adults is less clear.…”