FORMULA SUPPLEMENTATION WITH LONG-CHAIN POLYUNSATURATED FATTY-ACIDS -ARE THERE DEVELOPMENTAL BENEFITS

Objective. To evaluate the developmental outcomes of children who part icipated in an augmented randomized clinical trial of supplementing a standard infant formula with long-chain polyunsaturated fatty acids. D esign. Randomized clinical trial, augmented with a nonrandomized human milk comparison group. There were three randomized formula groups: st andard formula, standard formula containing docosahexaenoic acid (DHA) , and standard formula containing DHA and arachidonic acid. Setting. T hree clinical sites serving diverse populations: Kansas City, MO; Port land, OR; and Seattle, WA. Participants. A total of 274 healthy full-t erm infants were enrolled in the infant-feeding protocol; of these, 19 7 (72%) participated in assessments of developmental outcome. Formula Supplements. In the randomized trial, one group received a standard fo rmula, another group received a formula that had been supplemented wit h DHA from fish oil, and a third group received a formula supplemented with both DHA and arachidonic acid from an egg phospholipid. Outcome Measures. Mental and Motor Scales of the Bayley Scales of Infant Devel opment at 12 months of age; vocabulary and gesture communication score s from the MacArthur Communicative Development Inventories at 14 month s of age. Results. There were no statistically significant differences for either the Bayley Mental Scale or the Bayley Motor Scale, neither when the analysis was restricted to the three randomized formula grou ps nor when the analysis included all four groups. However, the DHA fo rmula group had significantly lower scores on two of the MacArthur sca les: the DHA group scored lower than the nonrandomized human milk comp arison group on the Vocabulary Comprehension Scale, and the DHA group scored lower than the randomized control formula group on the Vocabula ry Production Scale. Moreover, additional analyses both in the formula groups and in the human milk comparison group found significant negat ive correlations between DHA levels and vocabulary outcomes. Conclusio n. We believe that additional research should be undertaken before the introduction of these supplements into standard infant formulas.