Evidence for the essentiality of arachidonic and docosahexaenoic acid in the postnatal maternal and infant diet for the development of the infant's immune system early in life

Appl Physiol Nutr Metab. 2016 May;41(5):461-75. doi: 10.1139/apnm-2015-0660. Epub 2016 Jan 22.


Long-chain polyunsaturated fatty acids (LCPUFA), especially the balance between arachidonic (AA) and docosahexaenoic (DHA) acids are known to have important immunomodulatory roles during the postnatal period when the immune system is rapidly developing. AA and DHA are required in infant formula in many countries but are optional in North America. The rationale for adding these LCPUFA to full-term formula is based on their presence in breast milk and randomized controlled studies that suggest improved cognitive function in preterm infants, but results are more variable in full-term infants. Recently, the European Food Safety Authority has proposed, based on a lack of functional evidence, that AA is not required in infant formula for full-term infants during the first year of life but DHA should remain mandatory. The purpose of this review is to review the evidence from epidemiological and intervention studies regarding the essentiality of AA and DHA in the postnatal infant and maternal diet (breast-feeding) for the immune system development early in life. Although studies support the essentiality of DHA for the immune system development, more research is needed to rule out the essentiality of AA. Nevertheless, intervention studies have demonstrated improvement in many markers of immune function in infants fed formula supplemented with AA and DHA compared with unsupplemented formula, which appears to consistently result in beneficial health outcomes including reduction in the risk of developing allergic and atopic disease early in life.

Keywords: acide arachidonique; acide docosahexaénoïque; allergie; allergy; arachidonic acid; atopic diseases; breast milk; docosahexaenoic acid; développement initial; early development; immunologie nutritionnelle; infant formula; lait maternel; maladies atopiques; nutritional immunology; postnatal diets; préparation pour nourrissons; régime alimentaire postnatal.

Publication types

  • Review

MeSH terms

  • Arachidonic Acid / physiology*
  • Diet
  • Dietary Supplements
  • Docosahexaenoic Acids / physiology*
  • Female
  • Fish Oils
  • Food, Fortified
  • Humans
  • Immune System*
  • Infant
  • Infant Formula / chemistry
  • Infant Nutritional Physiological Phenomena*
  • Maternal Nutritional Physiological Phenomena
  • Milk, Human / chemistry
  • Postnatal Care*
  • Randomized Controlled Trials as Topic


  • Fish Oils
  • Docosahexaenoic Acids
  • Arachidonic Acid