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Children's Mercy research at center of infant formula debate
KANSAS CITY, Mo. -- Researchers at Children's Mercy have found no advantage to including long-chain fatty acids in infant formula, despite their being essential components of brain and retinal tissue. The federal Food and Drug Administration takes up the debate this spring.
The research, conducted jointly at Children's Mercy in Kansas City, the University of Washington and the Oregon Health Sciences University, is being presented this week to the Pediatrics Societies' Annual Meeting sponsored by the American Pediatric Society, the Society for Pediatric Research and the Ambulatory Pediatric Association.
The research is the first large-scale study to consider cognitive and language assessment of 3-1/4 year-old children fed formula containing long-chain fatty acid during the first year of life. About 300 children were tested.
"The bottom line is that we don't think adding long-chain fatty acids to formula is necessary for the development of full-term babies," says Dr. Robert T. Hall, one of the researchers and chief of the division of Human Development at children's Mercy. "The good news is that it shows we are feeding babies formula that produces normal children."
One of the reasons the research is controversial -- and significant -- is that long-chain fatty acids are present in breast milk and are known to be an important constituent of the retina and the brain. If fatty acids in formula could be linked to greater brain development and are allowed by the FDA, formula manufacturers could begin marketing a product closer in composition to breast milk, which is the "gold standard" of infant nutrition.
Children's Mercy researchers caution, however, that just duplicating the ingredients of breast milk will not produce a formula as beneficial as breast milk. Furthermore, the exact duplication of the long-chain fatty acids in breast milk is not possible with present technology.
Breast milk remains the preferred method of feeding among health professionals. It is known that children who are breast fed have greater measures of infant intelligence than those who are formula fed. However, it is not certain that it is the breast milk alone which accounts for the higher intelligence. There are other factors involved in the complex intelligence equations, including maternal/infant interaction, maternal educational level and IQ, socioeconomic status and environment.
"We did notice that the breast fed babies performed better in some measures of development," Hall says. "And it has long been shown that breast fed babies do better on IQ tests than formula-fed babies. But we believe the reason is not the long-chain fatty acids or other ingredients, but a variety of other influences, such as maternal interaction."
Infants who received long-chain fatty acids in formula did not perform better than infants who received regular infant formula.
There are a great many differences between breast milk and infant formula beyond fatty acids. Researchers like Dr. Hall are urging caution and more study on the issue. The researchers are already working on a fatty-acid study with pre-term infants.
Human infants can make the controversial fatty acids from another essential fatty acid already present in infant formula. But there is a question about the ability of newborns, especially pre-term babies, to make the conversion in sufficient quantity. There is a period of time when these fatty acids are provided to the infants from the mothers through the placenta. If infants are born prematurely, they are presumed more vulnerable to fatty acid deficiency.
Hall and his colleagues are urging the FDA and others to proceed cautiously on the issue. After all, current formula seems to be sufficiently meeting the needs of full-term infants.
The Pediatrics Societies' Annual Meeting is the largest gathering of pediatricians and pediatric researchers in the United States. More than 4,000 participants are expected this year. Topics include managed care, emergency medicine, immunology, asthma, suicide and childhood obesity.
The meeting winds up May 6 at the Washington, D.C. Convention Center.
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