Randomized trials with polyunsaturated fatty acid interventions in preterm and term infants: functional and clinical outcomes

Abstract

The role of polyunsaturated fatty acids (PUFA) in infant nutrition has now been well studied through many randomized controlled trials (RCT) that provide us with high-quality evidence, particularly in relation to efficacy. As a result of a systematic search of the literature for RCT of supplementation of formulas of term and preterm infants with long-chain polyunsaturated fatty acids (LC-PUFA), we have identified 21 studies that have physiological responses or growth as outcomes. There have been 11 RCT involving preterm infants, and many of these claim a beneficial effect on visual, neural, or developmental outcomes. There are some reports of negative effects on growth in relation to the addition of n-3 LC-PUFA to preterm formulas but not when AA is added with n-3 LC-PUFA. Small studies have shown no differences in prostanoid formation or peroxidative stress between n-3 LC-PUFA-supplemented and unsupplemented infants. There have been 10 RCT involving term infants; whereas some studies report an effect on visual/neural/developmental outcomes, an equal number report no effect. There have been no reports of negative effects of n-3 LC-PUFA on growth in term infants. In summary, there appear to be few safety concerns relating to the use of LC-PUFA in infant nutrition. The potential medium- and long-term effects of including these compounds in the early diet of infants remain to be assessed.