Aug. 10, 2001 -- Pediatricians generally view breast milk as the best option for a baby, because it provides all the essential nutrients a baby needs to develop properly. But some mothers may not wish to breastfeed or may be unable.
Lots of time and effort have gone into making baby formulas as similar to breast milk as possible. One component that's in breast milk but not in formulas is fatty acid. Pediatricians have debated whether fatty acids need to be added to formulas to ensure normal development for children who are formula fed.
The FDA recently decided that two dietary fatty acids, docosahexaenoic acid, or DHA, and arachidonic acid, or AA, are safe ingredients for baby formulas. But any benefit may be limited to premature infants, according to two new studies in the August Pediatrics.
In the largest study of its kind, more than 400 premature infants were fed formulas fortified with or without DHA and AA for the first 12 months of life. The babies who received the formula with the two fatty acids, particularly the very tiny babies who weighed less than 2.5 pounds at birth, showed signs of improved brain and visual development compared to children who did not receive the fatty acids.
No adverse effects were detected in the infants, Deborah O'Connor, PhD, of the Hospital for Sick Children in Canada and colleagues reported.
In the second study, researchers looked at the effect of DHA and AA-fortified formula on full-term infants. They gave 239 infants formula either with or without the fatty acids for the first year of life.
Unfortunately, no benefit on brain or visual development was found in these infants. This suggests that the addition of the fatty acids to formulas would "pose no demonstrable benefits for infant development," Marc Bornstein, PhD, of the National Institute of Child Health and Human Development, and colleagues write.
But whether the fatty acids improve long-term intelligence of premature or term infants remains unknown, says William C. Heird, MD, a professor of pediatrics and a researcher at USDA/ARS Nutrition Research Center at Baylor College of Medicine in Houston.
Only a long-term study that follows these children until they are 6 or 7 will answer the question of whether adding these fatty acids to formulas is beneficial, Heird says.
Ross Products, which funded both studies and manufactures Similac baby formula, has followed infants as long as three years and has not detected any IQ differences between those who received DHA and AA and those who did not, says Russell Merritt, MD, PhD, the company's medical director in pediatric nutrition. The company may continue to follow them longer if enough children stay enrolled in the study, Merritt tells WebMD.
Martek Biosciences, which manufactures the fatty acids and currently sells them to the majority of baby formula manufacturers, recently received notice from the FDA that they could safely add these ingredients to infant formulas in the U.S.
The fatty acids are already available in baby formulas in virtually every other country except for the U.S. and Canada. But it could be a while before formulas containing the fatty acids are available here.
An FDA source who requested anonymity tells WebMD that the approval is only for Martek and only for term infants, which seem to be the least likely to benefit from the fatty acids.
Other companies wishing to incorporate the ingredients into their baby formulas would have to seek FDA approval and then monitor the babies to make sure they are developing in a normal manner, the source says.
Ross is considering adding the ingredients to its formulas, Merritt tells WebMD. Two other top formula manufacturers, Mead Johnson, which makes the Enfamil line of formulas, and Carnation, tell WebMD that they have not yet made a decision in that regard.