Common Omega-Fatty Acid Supplement Shows No Benefit for Cognitive Development in Toddlers Born Preterm

October 23, 2018
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Premature birth can affect children’s early brain development, such that children born preterm sometimes struggle in school or with behavior problems. Docosahexaenoic acid (DHA) is an omega-3 fatty act that plays important roles in early brain development. Early evidence has suggested that DHA supplementation can improve global developmental outcomes in preterm infants when started soon after birth.

In a study published in JAMA Pediatrics, researchers from Nationwide Children’s Hospital provide evidence that answers the question of whether DHA supplementation should continue into toddlerhood for children born preterm.

“As infants transition from breastmilk or formula – which both have DHA – to cow’s milk or other beverages, they may enter a period of DHA deficiency,” says Sarah Keim, PhD, principal investigator in the Center for Biobehavioral Health in The Research Institute at Nationwide Children’s and lead author of the publication. “We wanted to see if DHA supplementation could improve developmental outcomes among toddlers born preterm.”

A large, socio-economically diverse group of children who had been born at less than 35 weeks’ gestation and were now 10-16 months old were recruited into the study. Those in the treatment group consumed a DHA (200 mg) with arachidonic acid (AA; 200 mg) supplement once daily. A control group received a placebo preparation of corn oil (400 mg). The trial period lasted 180 days. In all, 377 children were enrolled.

Neither the children, parents nor researchers knew who was in which group. The supplements were packaged identically and given to the children’s caregivers by a research pharmacy at Nationwide Children’s.

A test of skills and abilities for toddlers called the Bayley-III was selected as the primary outcome measure, while parents reported on their child’s activity level and ability to focus and be patient during daily activities as secondary outcomes.

The supplement did not improve cognitive development compared to the placebo. The study data also hinted that some subgroups of children who received DHA may have had lower scores on some of the secondary outcomes, but the study was too small to confirm that and it may have been a chance finding.

“Based on this study, it does not seem warranted to offer DHA supplements to toddlers who were born preterm. It is possible that supplementation has other benefits that this study did not examine, however,” says Dr. Keim.



Keim SA, Boone KM, Klebanoff MA, Turner AN, Rausch J, Nelin MA, Rogers LK, Yeates KO, Nelin L, Sheppard KW. Effect of docosahexaenoic acid supplementation on developmental outcomes of toddlers born preterm: the Omega Tots Randomized Clinical Trial. JAMA Pediatrics. 2018 Oct 22. [Epub ahead of print.]

Image credit: Nationwide Children’s