Randomized, double-blind trial of long-chain polyunsaturated fatty acid supplementation with fish oil and borage oil in preterm infants☆
Section snippets
Protocol
Preterm infants with birth weight ≤2000 g were recruited from 5 UK neonatal intensive care units in Glasgow between April 1995 and July 1997. All had a gestational age <35 weeks and were free from congenital malformations known to affect growth or neurodevelopment. Infants were eligible if they received at least some of their enteral feeds as formula milk during their hospital stay. They were randomly assigned and commenced the trial diet when the attending pediatrician decided that infant
Randomized trial
Formula-fed infants (n = 238) were randomly assigned, 116 to the control group and 122 to the LCPUFA-supplemented group. By 9-month follow-up, 25 control infants and 9 LCPUFA-supplemented infants had stopped using the trial formula. In 2 LCPFA-supplemented infants, this change was temporary, lasting 4 weeks and 5 weeks. The change was initiated by the parents in 18 control and all 7 LCPUFA-supplemented infants and by the health visitor (n = 3), family practitioner (n = 1), or pediatrician (n = 3) in
Discussion
In this trial, we showed that the strategy of supplementing infant formula with LCPUFA, using fish oil to provide DHA and borage oil to provide GLA as a precursor of AA, was moderately effective and safe. Outcome data showed benefits for growth and for neurodevelopment in boys.
We found no difference in neurocognitive outcome at 9 or 18 months after term in preterm infants who received LCPUFA-supplemented formula until 9 months after term compared with those fed unsupplemented formula. However,
Acknowledgements
We thank the parents for allowing their infants to participate; Marion McCartney, Barbara Fitzsimmons, Bernadette McGarry, Martina Stones, and Maureen McElroy for collecting data for the study; and H. J. Heinz Company Ltd, for their financial contribution and for supplying the formulas.
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Maternal and neonatal polyunsaturated fatty acid intake and risk of neurodevelopmental impairment in premature infants
2023, Diet and Nutrition in Neurological DisordersA Randomized Trial of Parenteral Nutrition Using a Mixed Lipid Emulsion Containing Fish Oil in Infants of Extremely Low Birth Weight: Neurodevelopmental Outcome at 12 and 24 Months Corrected Age, A Secondary Outcome Analysis
2020, Journal of PediatricsCitation Excerpt :Clinical trials on LC-PUFA enriched infant formula for preterm infants has inconsistently demonstrated a benefit for neurodevelopmental outcome.32,39-43 Studies that found a significant influence did so only after subgrouping: Fewtrell et al found higher mental developmental indices in boys and Makrides et al reported on a similar benefit for girls.39,40 An analysis of infants of this trial showed higher Bayley-III scores in girls, but no sex-specific neurodevelopmental advantage using the mixed lipid emulsion.
The role of long chain polyunsaturated fatty acids in perinatal nutrition
2019, Seminars in PerinatologyCitation Excerpt :On meta-analysis infants receiving omega-3 LCPUFA supplemented formula had improved weight and length at two months post-term (five trials), no effect on growth at 12 months (4 trials) or 18 months (2 trials).7 At 10 years of age, where 45% of infants from Fewtrell et al.,19 were followed up, no difference in growth or body composition were reported.27 However, girls who received omega-3 LCPUFA supplemented formula had significantly greater weight, height, head circumference and skin fold thickness compared with girls who received control formula.
Can Fish Oil Reduce the Incidence of Necrotizing Enterocolitis by Altering the Inflammatory Response?
2019, Clinics in Perinatology
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Supported by a grant from H. J. Heinz Company, Ltd, Hayes, Middlesex (UK), who also provided the trial formulas.