Long-chain polyunsaturated fatty acids (LC-PUFA) are essential for normal development. Fetal accretion of LC-PUFA occurs during the last trimester of gestation; therefore, premature infants are born with minimal LC-PUFA reserves. Recent studies indicate that the newborn can synthesize LC-PUFA from essential fatty acid precursors; however, the extent of de novo synthesis remains to be established. Postnatally, human milk provides LC-PUFA to the newborn. Maternal LC-PUFA reserves depend upon diet and can be improved by supplementation of docosahexaenoic acid and arachidonic acid during pregnancy and lactation. This in turn affects fetal LC-PUFA accretion and postnatal provision through mother's milk. Supplementation of formula-fed preterm or full-term infants with docosahexaenoic acid and arachidonic acid leads to plasma and red blood cell LC-PUFA levels similar to those of breast-fed infants. The higher blood and presumably tissue levels of LC-PUFA following supplementation lead, however, to only temporary functional benefits.