The Role of Docosahexaenoic Acid (DHA) and Arachidonic Acid (ARA) in Eye Development and Health for Neonates
The Importance of Docosahexaenoic Acid (DHA) and Arachidonic Acid (ARA) in Eye Development for Preterm Infants.
Lendy Black, MS, RDN, IBCLC
Docosahexaenoic acid (DHA) and arachidonic acid (ARA) are essential fatty acids crucial for eye development, particularly in infants born prematurely. These long-chain polyunsaturated fatty acids play a significant role in the growth and function of the retina, which is vital for vision. Understanding their importance in neonatal development, especially for preterm infants, is key to ensuring optimal eye health and overall well-being.
The Role of DHA and ARA in Eye Development
DHA is a major structural component of the retina, accounting for up to 60% of the total fatty acids in the retina's photoreceptor cells. These photoreceptors are responsible for converting light into signals that the brain interprets as vision. DHA contributes to the fluidity and flexibility of cell membranes, essential for the function of these photoreceptors. It also plays a role in the regeneration of the visual pigment rhodopsin, necessary for vision in low-light conditions.
ARA, on the other hand, is a precursor to signaling molecules known as eicosanoids. These molecules are involved in inflammatory responses and immune function, crucial for protecting the eyes from injury and infection. Similar to DHA, ARA is also involved in maintaining the structural integrity of cell membranes in the retina and other tissues.
The balance between DHA and ARA is particularly important, as both fatty acids must be available in sufficient quantities to support healthy eye development. An imbalance, where one is deficient, can disrupt normal development and function.
Preterm Infants and the Risk of Deficiency
During the third trimester of pregnancy, DHA and ARA are transferred from the mother to the infant through the placenta. This period is critical for the accumulation of these fatty acids in the developing infant, particularly in the brain and eyes. When preterm infants are born early, they miss out on this crucial transfer, putting them at risk for DHA and ARA deficiencies.
The lack of sufficient DHA and ARA can have significant implications for preterm infants. Studies have shown that preterm infants with low levels of these fatty acids are at an increased risk of visual impairments, including retinopathy of prematurity (ROP), a condition that can lead to blindness. ROP occurs when the blood vessels in the retina grow abnormally, a process that can be influenced by inadequate levels of DHA and ARA.
Ensuring Adequate DHA and ARA Intake
Given the importance of DHA and ARA for eye health, it is essential to ensure that preterm infants receive adequate amounts of these nutrients. Breast milk is a rich source of DHA and ARA, and breastfeeding is strongly recommended for preterm infants, when possible. For infants who cannot be breastfed, infant formulas supplemented with DHA and ARA are available and are crucial for supporting eye development.
Research supports the supplementation of DHA and ARA in infant formula as a way to mimic the natural transfer of these fatty acids that occurs during the last trimester. This supplementation has been associated with improved visual outcomes in preterm infants, highlighting the importance of these nutrients in early life.
Ensuring that preterm infants receive adequate DHA and ARA, either through breast milk or supplemented formula, is essential for promoting healthy vision and preventing long-term visual impairments.
Reference
Hellström A, Pivodic A, Gränse L, et al. Association of Docosahexaenoic Acid and Arachidonic Acid Serum Levels With Retinopathy of Prematurity in Preterm Infants. JAMA Network Open. 2021;4(10):e2128771-e2128771. doi:https://doi.org/10.1001/jamanetworkopen.2021.28771
About the Author
Lendy Black, MS, RDN, IBCLC, has worked in pediatrics and obstetric nutrition as a Registered Dietitian Nutritionist for 8 years, specializing in neonates, lactation, and breast milk management.