Plasma values of polyunsaturated fatty acids in extremely low birth weight (ELBW) infants fed breast milk or formula very early in life.

The influence of very early enteral feedings on plasma fatty acid levels in 29 sick, very premature infants with gestational age < 30 weeks was assessed at age 1, 3 and 7 weeks. Eighteen infants (birthweight 963 +/- 245 g, gestational age 27 +/- 1.3 weeks) received breast milk and 11 infants (829 +/- 159 g and 26 +/- 1.3 weeks) received formula, starting with small amounts on the first day after birth. Plasma phospholipid arachidonic acid (AA) levels decreased in both groups, but only the decline at 3 weeks in the formula-fed group was statistically significant (10.6 +/- 0.5 versus 8.0 +/- 0.4% weight, P < or = 0.05). The plasma phospholipid docosahexaenoic acid (DHA) levels of the formula-fed infants also declined from Week 1 to Week 7 (2.1 +/- 0.1 to 1.7 +/- 0.2 weight %; p < or = 0.05). In contrast, human milk-fed infants maintained their plasma phospholipid DHA levels, which were significantly higher at 7 weeks than those of the formula-fed infants (1.7 +/- 0.2 vs 2.3 +/- 0.2; p < or = 0.05). The decline in plasma DHA levels of our formula-fed very premature infants was of similar magnitude to that previously reported for larger premature infants. On the other hand, it is reassuring that very premature infants are able to maintain plasma DHA levels during the first weeks of life, if they receive even small amounts of breast milk.