Breast-fed babies may have an advantage over bottle-fed infants in development and cognition, but a new study shows it may be possible to close the gap using infant formula fortified with DHA, an omega-3 fatty acid found in breast milk.
MedPage reports that infants nourished by formula containing docosahexaenoic acid (DHA) for 12 months, and those who started it after six weeks of initial breast-feeding, aced a cognitive test compared with babies who received standard formula, according to James R. Drover, PhD, of the Retina Foundation of the Southwest in Dallas.
Drover and colleagues reported their findings in the September/October issue of Child Development.
According to the MedPage report, infants who received the formula with DHA were significantly more likely than control babies to figure out how to retrieve a rattle intentionally placed slightly beyond their reach.
Moreover, babies in both groups also were more likely to solve the rattle-retrieval puzzle in three different iterations of the task: placed just beyond reach, placed at a greater distance, and hidden by cloth when placed beyond reach. Again the differences were statistically significant compared with controls.
The study, which was actually a substudy of a trial investigating the impact of DHA supplements on vision, enrolled 229 infants whose parents were offered a year’s worth of free formula, a $25 gift card for each completed study visit, and a $100 savings bond at the end of the trial.
All babies were full-term infants born in Dallas. All parents were also “informed that the American Academy of Pediatrics recommends breast-feeding for 12 months and that other ongoing studies in our laboratory were available for infants who were breast-fed.”
Since other studies have raised questions about the durability of a DHA effect, the babies underwent testing when they were nine months old, a time when all were still receiving most of their nutrition from formula.
But, according to MedPage, a number of pediatricians have registered concern about the possibility that DHA-fortified formulas, as well as juice drinks that are similarly fortified, might be oversold to new parents.
“The marketing has actually dissuaded mothers from choosing exclusive breast-feeding, which is preferred from all the outcomes that we understand,” Lori Feldman-Winter, MD, a pediatrician with Cooper University Hospital in Camden, NJ, told MedPage.
She noted that simply adding DHA – while it may top other infant formula – does not make an infant formula superior to breast milk.
“There are many other factors in human milk that also support neurocognitive development and visual acuity,” saidFeldman-Winter, whose concerns were echoed by other physicians who responded to an ABC News request for comment on the Drover study.
Miriam Labbok, MD, a professor of public, maternal, and child health at the University of North Carolina at Chapel Hill and director of the Carolina Breast Feeding Institute, expressed some skepticism about the findings to MedPage.
Labbok said that the DHA formula might be a good option for a mother faced with circumstances that force her to stop breast-feeding, but warned that “none of these studies compare to continued breast-feeding.”
Moreover, Labbok said that one “could also get these [nutrients] from other sources if you stop breast-feeding, and there are hundreds, if not thousands, of other components in human milk that cannot be replaced.”
Ruth Lawrence, MD, a neonatologist at the University of Rochester Medical Center and an AAP spokesperson, said that DHA may contribute to better formula, but that won’t replace breast milk.
“The important point is to not let mothers think it’s as good as their milk,” she said.
MedPage tells physicians, “Explain to interested parents that the American Academy of Pediatrics recommends breast-feeding babies for 12 months. The AAP does not recommend the use of infant formula.”
But, if you must use formula, choosing one with DHA now has a sliver of evidence to support it.