Enteral supplementation of DHA and ARA effective in very Low Birth Weight Infants
Recent research has brought light to the fact that a combination of docosahexaenoic acid [DHA] and arachidonic acid [ARA] is likely necessary to reduce declines as well as allow increases in whole blood concentrations in the first 8 weeks of life.
The study is published in the Journal of Pediatrics.
Brandy L. Frost and colleagues from the NorthShore University Health System, Evanston conducted this prospective, randomized, double-blind, placebo-controlled trial to determine feasibility of providing a concentrated emulsified long-chain polyunsaturated fatty acids (LCPUFA) supplement to very low birth weight infants, and to evaluate blood LCPUFA concentrations at 2 and 8 weeks of study supplementation.
This trial randomized infants to receive (1) LCPUFA-120 (a supplement of 40 mg/kg/day docosahexaenoic acid [DHA] and 80 mg/kg/day arachidonic acid [ARA]; DHA:ARA at 1:2 ratio), (2) LCPUFA-360 (a supplement of 120 mg/kg/day DHA and 240 mg/kg/day ARA), or (3) sunflower oil (placebo control).
Infants were 28 weeks of gestation (IQR, 27-30 weeks of gestation) and weighed 1040 g (IQR, 910-1245 g).
Infants received supplement daily for 8 weeks or until discharge, whichever came first. Whole blood LCPUFA levels (wt%; g/100 g) were measured at baseline, 2 weeks, and 8 weeks.
The key findings highlighted in this trial include-
- At 2 weeks, the change in blood DHA (wt%) from baseline differed significantly among groups (sunflower oil, n = 6; −0.63 [IQR, −0.96 to −0.55]; LCPUFA-120: n = 12; −0.14 [IQR, −0.72 to −0.26]; LCPUFA-360, n = 12; 0.46 [IQR, 0.17-0.81]; P = .002 across groups).
- Change in blood ARA (wt%) also differed by group (sunflower oil: −2.2 [IQR, −3.9 to −1.7]; LCPUFA-120: 0.1 [IQR, −2.1 to 1.1] vs LCPUFA-360: 2.9 IQR, 1.5 to 4.5]; P = .0002).
- Change from baseline to 8 weeks significantly differed between groups for DHA (P = .02) and ARA (P = .003).
Therefore, the authors concluded that "enteral LCPUFA supplementation supported higher blood DHA by 2 weeks. LCPUFA supplementation at 360 mg of combined DHA and ARA is likely necessary to reduce declines as well as allow increases in whole blood concentrations in the first 8 weeks of life."