The use of low-EPA fish oil for long-chain polyunsaturated fatty acid supplementation of preterm infants

Because docosahexaenoic acid (DHA) may be an essential nutrient for the vis ual and early cognitive development of preterm infants, DHA enrichment of p reterm formulas has been recommended. This randomized trial was designed to study the n-6 and n-3 fatty acid status of healthy preterm infants fed a f ormula enriched with a low eicosapentaenoic-fish oil until 4 mo corrected a ge compared with that of infants fed a standard formula. A reference group of breast-fed infants was studied concurrently. The fatty acid content of r ed blood cell (RBC) phospholipid was assessed at enrollment, hospital disch arge, expected term,and 3 and 6 mo postterm. The DHA content of RBC phospho lipid was higher in infants fed the enriched versus the standard formula at hospital discharge, expected term, and 3 and 6 mo postterm. However, compa red with infants fed the standard formula, infants fed the enriched formula had also higher RBC phospholipid eicosapentaenoic content (0.69 +/- 0.15% versus 0.25 +/- 0.12%, p < 0.001), and lower RBC phospholipid arachidonic a cid content (15.1 + 0.93% versus 18.8 + 0.89%; p < 0.001). We conclude that supplementing preterm infants with low-eicosapentaenoic fish oil is effect ive in improving DHA status, but results in worsening of n-6 fatty acid sta tus. We speculate that preterm infants may require a dietary supply of arac hidonic acid as well as DHA if the same fatty acid status as that of breast -fed infants is to be achieved.