Preterm infant formula supplementation with α linolenic acid and docosahexaenoic acid

Abstract

Objective: To investigate if supplementation of preterm infant formula with a high docosahexaenoic acid/eicosapentaenoic acid (DHA/EPA) ratio together with a-linolenic acid (ALA) was able to maintain plasma and red blood cell DHA levels similar to that obtained with breast milk feeding without altering n-6 fatty acid status. Design and subjects: Preterm infants of mothers who elected not to breast feed (n ¼ 13) were assigned to ALA-and DHAenriched formula (DHA group: DHA/EPA ¼ 5/l). Infants fed breast milk (n ¼ 25) constituted a reference group (BM group). Anthropometric and fatty acid parameters (plasma phospholipids, cholesterol esters, triglycerides and red blood cell phosphatidylethanolamine, PL, CE, TG, RBC-PE, respectively) were obtained after 2 days (D2) and 15 days (D15) of enteral feeding and at the 37th week (W37) of post-conception age and 1 month later (W37+30) in the DHA group. Mean DHA intake ranged between 16.571.6 and 17.972.9 mg/kg/day between D2 and W37+30. Results: At W37, infant weights, heights, and head circumferences were similar in DHA and BM groups. PL DHA was maintained in the DHA group at the same level as in the BM group and the same for DHA in PE at W37. In RBC-PE and at W37, AA status was the same in both groups. In PL, AA levels remained very stable throughout the study; however, in the DHA group AA levels in PL remained in the range observed with standard formulas. Conclusion: The combined 18:3 n-3 and DHA supplementation of infant formula with DHA/EPA ratio 5/l is compatible with growth and n-3 fatty acid metabolism similar to that of preterm infants fed human milk.

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

“…RBC-AA at 1 month of age was also found to be negatively associated with BSID-III receptive language and fine motor abilities at 1 year corrected age, but no associations were observed for DHA. The lack of a significant associations between breast-milk or RBC-DHA and developmental outcome are in line with previous observations [40][41][42], although some studies have demonstrated beneficial effects of DHA on psychomotor development in both term and preterm infants [35,[43][44][45]. A recent Swedish study found significant correlations between breast-milk AA and developmental outcomes at 40 weeks gestational age in preterm infants (born in gestational week 24-36) using the Brazelton Neonatal Behavioral Assesment Scale, which is very similar to the NNNS [16].…”

“…The individual levels of both LA, AA and DHA in the RBC from the infants in the present study tended to be higher than that reported in more preterm populations [35][36][37], but resembled reported levels in RBC from both Danish [25] and American term infants [38,39]. The fatty acid composition of the infant RBC at 1 month of age was found to reflect that a considerable proportion of the infants were to some extent formula fed.…”

“…A few previous studies have found that LC-PUFA composition of breast-milk/formula, maternal RBC and umbilical cord blood was associated with the early QoM in term infants [18][19][20] as well as in preterm infants (born in gestational week [24][25][26][27][28][29][30][31][32][33][34][35][36] [17,35], but the investigated LC-PUFA indices and ratios vary and the results are not very consistent. None of these studies have tested the infants as shortly after delivery as in the present study.…”

A importância dos ácidos graxos poliinsaturados de cadeia longa na gestação e lactação

“…44 Dependendo das quantidades e proporções entre os nutrientes utilizados no enriquecimento, os resultados no desenvolvimento infantil podem se aproximar daqueles obtidos com aleitamento materno exclusivo. 45 A suplementação deve ser vista com cautela, pois dependendo das quantidades e tipos de AGPICL, pode-se inibir a conversão de ω -6 em ácido araquidônico ou o alto teor de EPA pode competir com o AA pela incorporação de fosfolipídios nos tecidos. 5,15,31 Portanto, as fórmulas devem conter, preferencialmente, AA e DHA, sendo que as quantidades devem ser próximas daquelas encontradas no leite materno 1,21 (Tabela 3).…”

Evolution of potential and free furfural compounds in milk-based infant formula during storage

“…One such improvement consists in adding LC-PUFA to IF, since several studies on infant nutrition have addressed their beneWcial eVects on growth and development. Moreover, the addition of docosahexaenoic acid (DHA, C22:6n ¡ 3) to IF has demonstrated improved neurofunctional response in pre-term infants (Cunnane et al, 2000;Gibson, Neumann, & Makrides, 1996;Hornstra, Al, van Houwelingen, & Foreman van Drongelen, 1995;Rodriguez et al, 2003;Valenzuela & Nieto, 2001). One source of DHA is Wsh oil, though it remains very susceptible to oxidation due to high PUFA content.…”