Abstract
It takes more than 20 years before the human brain obtains its complex, adult configuration. Most dramatic developmental changes occur prenatally and early postnatally. During development, long-chain polyunsaturated fatty acids (LCPUFA) such as doxosahexaenoic acid (DHA) and arachidonic acid (AA) are accreted in the brain. Since breastfeeding is associated with a better developmental outcome than formula feeding, and human milk in contrast to traditional standard formula contains LCPUFA, the question arose whether LCPUFA supplementation of infant formula may promote the neurodevelopmental outcome. The current paper reviews the evidence available in full-term infants. It concludes that postnatal supplementation of formula with LCPUFA is associated with a beneficial effect on short-term neurodevelopmental outcome. However, no evidence is available that LCPUFA supplementation enhances neurodevelopmental outcome in full-term infants beyond the age of four months. Nevertheless, it should be realized that very limited information is available on the effect of LCPUFA supplementation on neurodevelopmental outcome at school age or later. It is conceivable that effects of LCPUFA supplementation first emerge or re-emerge at school age when more complex neural functions are expressed.
Highlights
Breastfeeding is Associated with Better Developmental OutcomeMore than 80 years ago, it had already been noted that breastfed infants had a better developmental outcome than infants fed other types of milk [1]
The present paper aims at reviewing the effect of long-chain polyunsaturated fatty acids (LCPUFA) supplementation on neurodevelopmental outcome in full-term infants
Uauy et al [35] suggested that the effect of postnatal LCPUFA supplementation in term infants on early visual development may be dependent on doxosahexaenoic acid (DHA) dosage
Summary
More than 80 years ago, it had already been noted that breastfed infants had a better developmental outcome than infants fed other types of milk [1]. The finding that prolongation of the duration of breastfeeding – as a result of a cluster-randomized trial to promote breastfeeding – was associated with a better cognitive outcome at six years [7], suggests that the composition of human milk plays a role in the positive association between breastfeeding and outcome. One of the differences between human milk and standard commercially available formulas was the presence of long-chain polyunsaturated fatty acids (LCPUFA) in human milk [8]. This fact inspired research on the effect of LCPUFA supplementation of formula in pre-term and full-term infants. The paragraphs reviewing the studies on the effect of LCPUFA supplementation are preceded by sections summarizing the ontogeny of the human brain and fatty acid accretion in the central nervous system
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