title: Infant nutrition and stereoacuity at age 4-6 y.
abstract: BACKGROUND
  Breastfeeding has been reported to benefit visual development in children. A higher concentration of docosahexaneoic acid (DHA) in breast milk than in formula has been proposed as one explanation for this association and as a rationale for adding DHA to infant formula, but few long-term data support this possibility.
  
  
  OBJECTIVE
  The objectives of the study were, first, to test the hypothesis that breastfeeding benefits stereoscopic visual maturation and, second, if that benefit is shown, to ascertain whether it is mediated by the dietary intake of DHA.
  
  
  METHODS
  Stereoacuity was measured by using the random dot E test (primary outcome), and visual acuity was measured by using the Sonksen-Silver acuity system (secondary outcome) in previously breastfed (n = 78) or formula-fed (n = 184) children aged 4-6 y who had been followed prospectively from birth. In the formula-fed group, children were randomly assigned to receive formula with either DHA or arachidonic acid (n = 94) or a control formula (n = 90) for the first 6 mo.
  
  
  RESULTS
  Breastfed children had a significantly (P = 0.001) greater likelihood of foveal stereoacuity (high-grade or < 100 s/arc) than did formula-fed children (odds ratio: 2.5; 95% CI: 1.4, 4.5) independent of potential confounding (P = 0.005). Stereoacuity did not differ significantly between children randomly assigned to DHA-supplemented or control formula. None of the groups differed in Sonksen-Silver visual acuity.
  
  
  CONCLUSIONS
  These findings support the hypothesis that breastfeeding benefits long-term stereoscopic development. An effect of DHA cannot be excluded, but the lack of difference in stereoacuity between infants randomly assigned to DHA-containing and those assigned to control formula raises the hypothesis that factors in breast milk other than DHA account for the observed benefits.
authors.affiliation: Medical Research Council Childhood Nutrition Research Center, Institute of Child Health, London, United Kingdom. a.singhal@ich.ucl.ac.uk
authors.forename: Atul
authors.initials: A
authors.lastname: Singhal
authors.forename: Ruth
authors.initials: R
authors.lastname: Morley
authors.forename: Tim J
authors.initials: TJ
authors.lastname: Cole
authors.forename: Kathy
authors.initials: K
authors.lastname: Kennedy
authors.forename: Patricia
authors.initials: P
authors.lastname: Sonksen
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Isaacs
authors.forename: Mary
authors.initials: M
authors.lastname: Fewtrell
authors.forename: Alun
authors.initials: A
authors.lastname: Elias-Jones
authors.forename: Terence
authors.initials: T
authors.lastname: Stephenson
authors.forename: Alan
authors.initials: A
authors.lastname: Lucas
mesh_terms: D001942:Breast Feeding; D002648:Child; D002675:Child, Preschool; D004042:Dietary Fats, Unsaturated / Q000008:administration & dosage* / Q000032:analysis / Q000378:metabolism; D004281:Docosahexaenoic Acids / Q000008:administration & dosage / Q000032:analysis / Q000378:metabolism; D005260:Female; D005527:Food, Fortified; D006801:Humans; D007223:Infant; D041943:Infant Formula / Q000737:chemistry*; D007227:Infant Nutritional Physiological Phenomena; D008137:Longitudinal Studies; D008297:Male; D008895:Milk, Human / Q000737:chemistry*; D011446:Prospective Studies; D014792:Visual Acuity / Q000187:drug effects* / Q000502:physiology
chemical_list: D004042:Dietary Fats, Unsaturated; D004281:Docosahexaenoic Acids