Randomized trials with polyunsaturated fatty acid interventions in pretermand term infants: Functional and clinical outcomes

The role of polyunsaturated fatty acids (PUFA) in infant nutrition has now been well studied through many randomized controlled trials (RCT) that prov ide us with high-quality evidence, particularly in relation to efficacy. As a result of a systematic search of the literature for RCT of supplementati on of formulas of term and preterm infants with long-chain polyunsaturated fatty acids (LC-PUFA), we have identified 21 studies that have physiologica l responses or growth as outcomes. There have been I I RCT involving preter m infants, and many of these claim a beneficial effect on visual, neural, o r developmental outcomes. There are some reports of negative effects on gro wth 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-suppleme nted and unsupplemented infants. There have been 10 RCT involving term infa nts; whereas some studies report an effect on visual/neural/developmental o utcomes, an equal number report no effect. There have been no reports of ne gative 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 n utrition. The potential medium- and long-term effects of including these co mpounds in the early diet of infants remain to be assessed.