Enrichment of infant formula with long‐chain polyunsaturated fatty acids and risk of infection and allergy in the nationwide ELFE birth cohort

Abstract Background The new European regulations require the enrichment of formulas with docosahexaenoic acid (DHA) because of the positive effects of long‐chain polyunsaturated fatty acids (LCPUFAs) on neurodevelopment and visual acuity. In this observational study, we aimed to evaluate whether the consumption of LCPUFA‐enriched formula was associated with the risk of infection and allergy in early childhood. Methods Analyses involved data from 8389 formula‐fed infants from the ELFE birth cohort. Formula enrichment was identified from the list of ingredients of the formula consumed at 2 months. Infections (gastrointestinal, lower respiratory tract [LRTI], upper respiratory tract) and allergies (wheezing, itchy rash, asthma medication, food allergy) from age 2 months to 5.5 years were reported by parents during follow‐up surveys. Multivariable logistic regression models were used to assess associations between the consumption of LCPUFA‐enriched formula and the risk of infection and allergy. Results Among formula‐fed infants at 2 months, 36% consumed formula enriched with DHA and arachidonic acid (ARA), and 11% consumed formula additionally enriched with eicosapentaenoic acid (EPA). Enriched formula consumption was not associated with infection or allergy, except for an association between consumption of DHA/ARA/EPA‐enriched formula and lower use of asthma medications. Furthermore, as compared with non‐DHA/ARA/EPA‐enriched formula, consumption of formula with high EPA content (≥3.2 mg/100 kcal) was related to lower risk of LRTI and lower use of asthma medications. Conclusion This study suggests that consumption of DHA/ARA/EPA‐enriched formula (especially those with high EPA content) is associated with a lower risk of LRTI and lower use of asthma medications.