Unlabelled: Fatty acids of plasma and red cells of preterm babies, gestational age 28-33 weeks, weighing less than 2200 g were studied between birth and the expected date of delivery (EDD). Babies were fed either mothers' breast milk, or if they were unable, or chose not to breast-feed, randomly assigned to milk formula A or B. Milk B had 26% oleic acid, 0.5% docosahexaenoic acid (DHA) and 0.12% arachidonic (AA); A had 13% oleic acid, less than 0.05% AA and no DHA. The proportions of gamma linoleic and the other fatty acids, and the ratio of linoleic acid (LA)/alpha linolenic acid (ALA) were comparable in the two formulae. Diet and/or physiological adaptation seemed to be responsible for the significant changes in the proportions of certain fatty acids between birth and EDD. Incorporation of DHA in formula B increased its concentration in plasma and red cells, and reduced the conversion of LA to AA. With respect to maintenance of DHA status, milk B was superior to milk A but did not match breast milk.
Conclusion: Fortification of formula with DHA without concomitant incorporation of AA may precipitate AA insufficiency and may have developmental implications.
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