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             -- Lane Olinghouse
 

Hand In Hand Pediatrics
725 River Road, Suite 208,     Edgewater, NJ 07020  |  tel: 201.840.8055
(We are located next to Trader Joe's)


                          DHR/ARA 
        and Brain Development
         
By: George Chai, MD FAAP

Over the last couple of years there has been a significant increase in the popularity of supplementing infant formulas with DHA and ARA. Nowadays it is very difficult to find any formula without these supplements. As a result of this supplementation, the overall cost for formula increased by 15-20 percent.

So what are DHA and ARA? What is all the talk about? ARA and DHA are types of fatty acid that are produced from the essential fatty acids (fatty acids we can't produce ourselves and get them through foods): linoleic and linolenic acids. Good sources of essential fatty acid are fish, shellfish, flaxseed, soybean, canola oil, soy oil, pumpkin seeds, sunflower seeds, leafy vegetables, and nuts. In studies comparing breastmilk versus unsupplemented formula, it was found that breastmilk contains higher amounts of these fatty acids. Since it was well known that breastfed babies have better developmental function and improved visual acuity, it was postulated that ARA and DHA contributed to these differences given the fact that these fatty acids are found to be major components of brain and eye tissue. However, the question remains whether these differences in brain and eye development are attributed to these fatty acids or other factors of breastfeeding (more bonding, attachment, immunologic factors).

There are multiple randomized controlled studies (which are the gold standard in testing medications) showing and not showing significant substantial sustained differences in growth of weight and length, neurodevelopment and visual acuity between unsupplemented and supplemented infant formulas. However, most of the studies at this time agree on one thing, that there are no significant adverse effects associated with DHA and ARA supplementation.  At this point, the American Academy of Pediatrics has not decided to take an official stand on whether or not DHA and ARA should be added to formulas. The FDA has approved these fatty acids as safe to be added into infant formula but does not take a stand on the effectiveness.  In general, more testing is needed.

Now where does it leave us in regards to what is best to feed the baby? The tried and true method of breastfeeding. The majority of studies show breastfed babies have better growth, neurodevelopmental and visual outcomes compared to formula babies. After all, looking back at how it all got started, the purpose of supplementing ARA/DHA and infant formula is to simulate breastmilk.

For those unable to breastfeed, if the extra cost is not an unbearable financial burden, unless additional studies show adverse outcomes from supplementing formula with DHA and ARA, it will not hurt to use supplemented formula until further research clearly delineates the role of DHA and ARA in child development.

What do you think? What is your experience with DHA products? Would you go for the more expensive DHA products? We would love your comments. Email comments and questions to handinhandpeds@gmail.com or send us a note via website.

Article written by Dr. George Chai



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