LCPs: For and Against the Supplementation of Infant Formula

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The role of long-chain essential polyunsaturated fatty acids (LCPs) such as DHA and AA in the normal development of infants, and consequences of deficiency

Fats are the main component of the brain, up to 60 percent. This is usually a high concentration of fatty acids, which are mainly long-chain polyunsaturated fatty acids (LCPs). The main LCPs in the brain are usually docosahexaenoic acid (DHA) and arachidonic acid (AA). Tissues of the retina of the eye and the brain have DHA as the main structural part. During the early developmental stages of children, DHA is necessary to support the rapid development of the eye and the brain. Any deficiency of DHA can cause children to have poorly developed eye and brain functions.

Arachidonic acid (AA) mainly comes from omega-6 fatty acids. The body cells require AA for the usual transmission of messenger using the nerves. It also enhances the proper function of the memory. Both AA and DHA play vital roles in developing vision, coordination, and learning ability. Some studies conclude “children with learning disorders usually have low amounts of DHA and AA in the red blood cell membranes and their plasma”. ¹

Good consumption of DHA and AA enhance the development of a good brain. This is why during the formative years, omega-3 and omega 6 are crucial. Some of these LPCs are readily available in nutritional diets. However, children do not take most foods, which contain these fatty acids for brain and eye development. Thus, using these fatty acids as supplements can provide solutions to perceived deficiency.

Low level or lack of both AA and AA have other serious health problems in infants and young children cause pediatric conditions such as cystic fibrosis, fetal alcohol syndrome, unipolar depression, attention deficit hyperactivity disorder, congenital metabolic disorders, and aggressive hostility. Some of these conditions have shown that the use of supplements may provide positive changes in infants’ and young children’s conditions. Still, studies on the effectiveness of DHA supplements are ongoing to justify the use of DHA as supplements with infants with such conditions.

An argument supporting the use of LCP-supplemented infant formula over non-supplemented formula in infants

DHA has a fundamental function during the early stages of pregnancy and early childhood in functional brain development. ADH also shows anti-inflammatory properties. This has led some scientists to suggest that DHA can act as a supplement for therapeutic and preventive uses. ⁵

Researchers think that DHA is conditionally necessary for the early growth and functional development of the brain. However, they have not been able to prove this claim apart from some exceptional fish species. A comparison between “plasma and red blood cells of infants with supplemental DHA and those without reveals infants with no supplements can only produce up to 70 percent of the DHA they need”. ⁷ Currently, studies cannot establish that the deficit of 30 percent may cause impairments in infants and young children though some studies suggest it may do so. ²

DHA is predominant in the n-3 fatty acid of the brain with an exceptional turnover rate. According to Henriksen and other authors, “AA presence in the brain occurs in n-6 fatty acid with a stable level probably due to the presence of its precursor, linoleic acid (LA)”. ² According to recent studies, researchers established that “supplementing AA and DHA together may exert additional positive effects on neurotransmission and membrane maturation”. ³

Kramer and other authors note that “both preterm and term infants with a supply of AA and DHA in ratios and amounts as those of the human breast milk show excellent neurofunctional results mainly in short-term duration”. ¹ However, we need further studies to determine medium and long-term outcomes on the persistence use of AA and DHA as supplements. Some of these findings may be different as a result of various study designs that provide different results and subsequent conclusions and recommendations. ⁶

According to Simmer, only a little proof from randomized trials of LCPs supplementation using term infants studies to support supplement claims. ⁴He argues that LCPs show little in terms of benefits to the brain and vision development. Other experts have also concluded “infant formulas for term infants should contain at least 0.2% of total fatty acids like DHA and 0.35% as AA, while formulas for preterm infants should include at least 0.35% DHA and 0.4% AA”. ⁴ These studies show that LCPs supplementations have no known adverse effects.

A majority of health experts believe that preterm infants require a large amount of DHA. This is because these infants miss out on LPCs transfer from their mothers during the late stages of pregnancy. They also argue that changes in the formula compositions may affect infants. ⁸

Several studies indicate that preterm infants who received supplements containing ADHA had better visual functions than those who received non-supplemented formulas. These studies conclude that preterm and term infants benefit more from supplements than full-term babies. Other studies indicated that the effects of formulas were transient and reduced as the infant grew. They conclude that the effects of LPCs supplements are stronger for preterm infants than for full-term infants. The only controversies surrounding these studies are only small samples of infants participated in the study over a relatively short time. ⁹

These experts agree that there is an urgent need to study the long-term effects of using LPCs supplementation in preterm infants. Many preterm infants born early or with low birth find it difficult to develop. Therefore, Fang and other researchers note that “the use supplements in formulas may be the best possible source of nutrition to help such infants increase their chances of living and reduce their exposure to long-term health risks”. ⁹

Experts have also established that “provision of DHA supplements to pregnant women during early developmental stages resulted in improved offspring”. ¹⁰

Summary

Recent studies highlight that providing certain supplements of LPCs fatty acids, such as DHA and AA, to infants and pregnant women may offer preventive and therapeutic benefits, especially concerning the development of the brain and vision. In addition, “supplementing LPCs together in given amounts may enhance their impacts on neurotransmission and membrane development”. ¹⁰ Recently, some groups of health experts concluded “infant formulas for term infants should contain at least 0.2% of total fatty acids like DHA and 0.35% as AA, while formulas for preterm infants should include at least 0.35% DHA and 0.4% AA”. ⁴

At the same time, “all recent studies and recommendations have shown the lack of adverse effects from LPCs supplementations”. ⁵ Furthermore, these experts discovered that “providing supplements of DHA to pregnant women improve the early developmental outcome of the offspring”. ¹However, further studies are necessary to establish the long-term effects of these supplements.

Reference List

Kramer MS, Aboud F, Mironova E, Breastfeeding and child cognitive development: new evidence from a large randomized trial. Archives of General Psychiatry 2008; 65: 578-84.
Henriksen C, Haugholt K, Lindgren M, Improved cognitive development among preterm infants attributable to early supplementation of human milk with docosahexaenoic acid and arachidonic acid. Pediatrics 2008; 121: 1137-45.
Clandinin MT, et al. Growth and development of preterm infants fed infant formulas containing docosahexaenoic acid and arachidonic acid. The Journal of Pediatrics 2005; 146: 461-8.
Simmer K, Schulzke S2, Patole S. Long chain polyunsaturated fatty acid supplementation in preterm infants. Cochrane Database of Systematic Reviews 2008, Issue 1.
Carnielli VP, et al. Synthesis of long-chain polyunsaturated fatty acids in preterm newborns fed formula with long-chain polyunsaturated fatty acids. The American Journal of Clinical Nutrition 2007; 86: 1323-30.
Makrides M, Gibson RA, McPhee AJ. Neurodevelopment outcomes of preterm infants fed high-dose docosahexaenoic acid: a randomized controlled trial. JAMA: The Journal of the American Medical Association 2009; 301: 175-82.
McCann JC, Ames BN. Is docosahexaenoic acid, an n-3 long-chain polyunsaturated fatty acid, required for development of normal brain function? An overview of evidence from cognitive and behavioral tests in humans and animals. American Journal of Clinical Nutrition 2005; 82: 281-95.
Birch EE, et al. Visual maturation of term infants fed long-chain polyunsaturated fatty acid-supplemented or control formula for 12 mo. American Journal of Clinical Nutrition 2005; 81: 871-9.
Fang PC, Kuo HK, Huang CB, Ko TY, Chen CC. The effect of supplementation of docosahexaenoic acid and arachidonic acid on visual acuity and neurodevelopment in larger preterm infants. Chang Gung Medical Journal 2005; 28: 708-15.
Groh-Wargo S, et al. Body composition in preterm infants who are fed long-chain polyunsaturated fatty acids: A prospective, randomized, controlled trial. Pediatric Research 2005; 57: 712-8.

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LCPs: For and Against the Supplementation of Infant Formula

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