The Food and Drug Administration has recently cleared the way to allow two important fatty acids to be added to infant formula. Studies have shown that formulas fortified with these nutrients--called DHA and AA--can enhance a baby's cognitive and visual development. DHA stands for docosahexaenoic acid and AA stands for arachidonic acid.
Barbara Levine, PhD, is a registered nutritionist and the codirector of the Human Nutrition Program at Rockefeller University in New York. She spoke with the Early Show about the significance of the new baby formulas.
DHA and AA are among the health-promoting omega-3 fatty acids found in fish and other foods. People's bodies manufacture DHA and AA after they eat various fats. Newborns can't manufacture all the DHA and AA needed for optimal development.
Studies show that infants fed formula enriched with the two fatty acids score higher on baby IQ scales than babies fed current formulas. Mental development among 18-month-olds who were fed enriched formula for 4 months was increased by about 7 IQ points over babies fed regular formula. Studies also show that supplemented formula can enhance visual acuity in young babies. The fatty acids seem to be most important for premature infants, who miss absorbing them from their mothers during the last trimester of pregnancy. The last trimester is when a lot of brain growth occurs.
Most experts still believe breast milk is preferable for other reasons besides nutrient content. Breast milk protects babies from infection, lowers risk of some chronic diseases, and seems to foster brain development. The American Academy of Pediatrics recommends that most babies be breast-fed exclusively for 6 months and that mothers try to continue until babies are a year old. But since not all mothers can or will breast-feed, the FDA makes sure that formula contains the nutrients essential for a baby's development.
Controversy remains over how significant the advantage of the new additives will be and whether it's worth the anticipated 10 to 20% price increase. DHA-supplemented infant formula has long been sold in much of Europe and Asia. The FDA debated for 5 years whether to let DHA and AA be added to US formula.
There were disputes over how much should be added and over which sources of the fatty acids should be used. DHA amounts in each woman's breast milk differ according to diet, and initial sources of DHA from fish oil turned out to contain other fats that actually hindered babies' physical growth. There is also controversy over whether the enhanced development effect is a lasting difference or if babies fed regular formula catch up as they grow. Most agree the fatty acids can't hurt.
Earlier this year the FDA approved DHA and AA purified from algae and fungal sources. Formula makers that want to add the ingredients must formally notify the FDA, which has 90 days to object before the product can be sold. The agency also requires that maker track enriched formula to ensure the ingredients cause no unsuspected side effects. Enriched brands are expected on the shelves by year's end.
Levine says that hopefully by the end of the year, baby formulas fortified with DHA and AA fatty acids will be available on store shelves here in the US. Five to 7 years ago, the World Health Organization recommended that all infant formulas throughout the world be fortified with these ingredients. The US and Canada are behind other countries in doing this.
"It's happening in 61 countries for premies and at least 20 or so countries in the world for full-term babies, and much of the infant formula is made by US companies. These two very important essential fatty acids are in breast milk and are crucial for cognitive function and visual acuity. The bottom line is, we are DHA deficient and we have to get good sources of it," says Levine.
She says that it's incorrect to say that the FDA has actually approved DHA and AA for baby frmulas, but they have been given "a favorable review," which is a major step toward incorporating them into formulas. She said that DHA deficiency is not just an issue for babies. It's been associated with postpartum depression for moms with multiple births, and at Rockefeller University, researchers are looking at how a DHA deficiency may be linked to heart disease. She said that in Japan, DHA is used to fortify Coca-Cola and that parents give it to their children as brain boosters before they take an exam.
According to Levine, adding these fatty acids to baby formula doesn't have a downside. "There is no known toxicity," she says. These nutrients will be added to soy milk for babies who are allergic to regular milk.
Levine says that fortified formulas will not be a substitute for breast-feeding. She says breast-feeding is best because there are other important substances in breast milk that are important for babies.
However, when these formulas are available in the US, it will give a new option to mothers who can only breast-feed for a few months or who can't breast-feed at all. "Let's take the guilt away from mothers who can't or choose not to breast-feed," says Levine.
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