VISUAL-ACUITY AND FATTY-ACID STATUS OF TERM INFANTS FED HUMAN-MILK AND FORMULAS WITH AND WITHOUT DOCOSAHEXAENOATE AND ARACHIDONATE FROM EGG-YOLK LECITHIN

Preterm infants fed formulas with docosahexaenoic acid (DHA, 22:6n-3) during the interval equivalent to the last intra-uterine trimester and beyond have higher circulating DHA and transiently higher visual acui ty compared with infants fed formulas containing linolenic acid. In te rm infants several nonrandomized studies of infants receiving DHA from human milk suggest a relationship between DHA status and acuity, but the evidence for a cause-and-effect relationship is mixed. In the pres ent study, term infants were randomly assigned to a standard term form ula (n = 20) or the same formula with egg yolk lecithin to provide DHA (0.1%) and arachidonic acid (AA, 20:4n-6, 0.43%) (n = 19) at levels r eported in milk of American women. A third group of infants was breast fed for greater than or equal to 3 mo (n = 19). Grating visual acuity (Teller Acuity Card procedure) and plasma and red blood cell (RBC) ph osphatidylcholine (PC) and phosphatidylethanolamine (PE) DHA and AA we re determined at corrected ages of 2, 4, 6, 9 (acuity only), and 12 mo past term = 40 wk postmenstrual age (PMA). At 2 mo breast-fed infants and infants fed the supplemented formula had higher grating acuity th an term infants fed standard formula. As in preterm infants, the incre ase was transient. Plasma PC DHA and AA and RBC PE AA increased by 2 m o in supplemented infants, but RBC PE DHA in supplemented infants was not higher than in controls until 4 mo and beyond. Despite normal intr auterine accumulation of DHA and AA, infants fed formula with 2% linol enic acid and 0.1% DHA had better 2-mo visual acuity than infants fed formula with 2% linolenic acid.