title: Early docosahexaenoic and arachidonic acid supplementation in extremely-low-birth-weight infants.
abstract: Extremely-low-birth-weight (ELBW) infants accrue large deficits in docosahexaenoic acid (DHA) and arachidonic acid (ARA) and require improved supplementation strategies. We hypothesized that once daily DHA+ARA drops applied to buccal mucosa will increase blood levels.
  
  
  
  Thirty ELBW infants were randomized to receive DHA 20 mg/kg/d + ARA 40 or 60 mg/kg/d + ARA 120 mg/kg/d or placebo within 72 h of age for 8 wk duration. Red blood cell phospholipid levels of DHA (primary) and ARA (secondary) were measured at 2 and 8 wk of age.
  
  
  
  Twenty-eight survivors with a median birth weight of 806 g completed dosing and sampling. Red blood cell levels were similar between the three groups at 2 wk (DHA: 4.62 wt% (interquartile range (IQR) 4.1-5.5) for all, P = 0.29 between groups; ARA: 21.1 wt% (IQR 18.78-22.6) for all, P = 0.41 between groups) and 8 wk (DHA: 6.0 wt% (IQR 5.1-7.1) for all, P = 0.57 between groups; ARA: 20.1 wt% (IQR 18.3-23.1) for all, P = 0.63 between groups). DHA in all infants showed a median increase of 31% from 2 to 8 wk (P < 0.04). ARA levels did not significantly change over time (P > 0.6).
  
  
  
  Daily buccal DHA and ARA supplements did not affect fatty acid levels in ELBW infants.
authors.affiliation: Ann & Robert H. Lurie Children's Hospital of Chicago and Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
authors.forename: Daniel T
authors.initials: DT
authors.lastname: Robinson
authors.affiliation: Department of Pediatrics, NorthShore University HealthSystem, Pritzker School of Medicine, University of Chicago, Evanston, Illinois.
authors.forename: Michael
authors.initials: M
authors.lastname: Caplan
authors.affiliation: Department of Dietetics and Nutrition, University of Kansas Medical Center, Kansas City, Kansas.
authors.forename: Susan E
authors.initials: SE
authors.lastname: Carlson
authors.affiliation: Department of Dietetics and Nutrition, University of Kansas Medical Center, Kansas City, Kansas.
authors.forename: Rachel
authors.initials: R
authors.lastname: Yoder
authors.affiliation: Ann & Robert H. Lurie Children's Hospital of Chicago and Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
authors.forename: Karna
authors.initials: K
authors.lastname: Murthy
authors.affiliation: Department of Pediatrics, NorthShore University HealthSystem, Pritzker School of Medicine, University of Chicago, Evanston, Illinois.
authors.forename: Brandy
authors.initials: B
authors.lastname: Frost
mesh_terms: D016718:Arachidonic Acid / Q000008:administration & dosage*; D001724:Birth Weight; D019587:Dietary Supplements; D004281:Docosahexaenoic Acids / Q000008:administration & dosage*; D004912:Erythrocytes / Q000378:metabolism; D005260:Female; D006801:Humans; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D009061:Mouth Mucosa; D010743:Phospholipids / Q000097:blood* / Q000378:metabolism; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D010743:Phospholipids; D004281:Docosahexaenoic Acids; D016718:Arachidonic Acid