Is it prudent to add n-3 long-chain polyunsaturated fatty acids to paediatric enteral tube feeding?

SummaryNutritional support, as complete enteral tube feeding, is needed by many paediatric patients and must provide sufficient nutrients for normal growth and development. Enteral feeds contain the parent essential fatty acids, linoleic acid and α-linolenic acid, but often do not contain n-3 long-chain polyunsaturated fatty acids. Available data suggest that biosynthesis of eicosapentaenoic acid and docosahexaenoic acid from α-linolenic acid is low in humans and varies between individuals. Long-term enteral feeding with formulae devoid of eicosapentaenoic acid and docosahexaenoic acid may result in low levels in plasma and tissues, potentially affecting immune and neurological function. Currently there is insufficient evidence to define the quantitative eicosapentaenoic acid and docosahexaenoic acid requirements for healthy children, or those with various disease states. Nevertheless, it appears prudent to supply children on long-term enteral nutrition with a dietary source of eicosapentaenoic acid and docosahexaenoic acid. A reasonable approach would be to provide amounts matching intakes of healthy children complying with the advice to consume 1–2 portions of oily fish per week. Further studies are needed to investigate the effects of different amounts of eicosapentaenoic acid and/or docosahexaenoic acid in enteral nutrition on polyunsaturated fatty acid status and the functional and clinical consequences in children.