Routine supplementation of full-term infant milk formula with LCPUFA cannot be recommended

Objectives:
Is supplementation of formula milk with LCPUFA (long-chain polyunsaturated fatty acids) both safe and beneficial for full-term infants, while focusing on effects on visual function, neurodevelopment and physical growth?

Study design:
This review article included 15 RCTs (n = 1889).
9 studies assessed visual acuity, 6 of which used visual evoked potentials (VEP), 2 Teller cards and 1 both. 4 studies reported beneficial effects and the remaining 5 did not.
GRADE analysis of the outcomes indicated that the overall quality of evidence was low.

Results and conclusions:
The investigators found a meta-analysis of 3 RCTs (n = 244) showed significant benefit for sweep VEP acuity at 12 months (log of the minimum angle of resolution) [MD = -0.15, 95% CI = -0.17 to -0.13, I2 = 0%, low-quality of evidence].
However, the meta-analysis of 3 other RCTs (n = 256) showed no benefit for visual acuity measured with Teller cards at 12 months (cycles/degree) [MD = -0.01, 95% CI = -0.12 to 0.11, I2 = 0%, low-quality of evidence].

The investigators found meta-analysis of 4 RCTs (n = 661) revealed no significant differences between LCPUFA and placebo groups in BSID Mental Developmental Index scores at 18 months [MD = 0.06, 95% CI = -2.01 to 2.14, I2 = 75%, low-quality of evidence] and no significant differences in BSID Psychomotor Development Index scores at 18 months [MD = 0.69, 95% CI = -0.78 to 2.16, I2 = 61%, low-quality of evidence].

There were also no significant differences between the two groups in BSID-II scores at one year and two years of age.

The investigators found meta-analysis of 5 RCTs (n = 521) showed that the supplemented group had lower weight (z scores) at one year of age [MD = -0.23, 95% CI = -0.40 to -0.06, I2 = 83%, low-quality of evidence] and that the two groups showed no significant differences with respect to length and head circumference (z scores).

The investigators found meta-analysis at 18 months and at two years revealed no significant differences between the two groups with respect to weight (kg), length (cm) and head circumference (cm).

The investigators concluded there are no beneficial effects or harms of LCPUFA supplementation on neurodevelopmental outcomes of formula-fed full-term infants and no consistent beneficial effects on visual acuity. Therefore, routine supplementation of full-term infant milk formula with LCPUFA cannot be recommended at this time.

Original title:
Long chain polyunsaturated fatty acid supplementation in infants born at term by Jasani B, Simmer K, […], Rao SC.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/28281303

Additional information of El Mondo:
Find more information/studies on pregnancy and LCPUFA right here.