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Updated: May 5, 2026

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DHA: Nutritional Programming During the First 1000 Days of Life.

Laura Maria Sollena1, Maurizio Carta2, Vincenzo Insinga2

  • 1Neonatal Intensive Care Unit, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G. D'Alessandro", University of Palermo, 90127 Palermo, Italy.

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Summary

Docosahexaenoic acid (DHA) is crucial for infant development during the first 1000 days. While DHA supplementation impacts biochemical status, clinical benefits vary, with the DHA and arachidonic acid (ARA) balance being key.

Keywords:
DHALCPUFAdocosahexaenoic acidfirst 1000 days of lifeimmune systemlactationn-3 fatty acidneurodevelopmentnewbornpregnancypreterm infant

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Area of Science:

  • Nutrition Science
  • Developmental Pediatrics
  • Neuroscience

Background:

  • The first 1000 days (conception to 2 years) are critical for neurodevelopment and immune maturation.
  • Docosahexaenoic acid (DHA) is a vital omega-3 fatty acid for brain and retinal development, with significant fetal accumulation.
  • Maternal and infant nutrition profoundly influences long-term health and susceptibility to prematurity-related issues.

Purpose of the Study:

  • To review the role of DHA supplementation during pregnancy, lactation, infancy, and early childhood on development.
  • To synthesize evidence on DHA's impact on neurodevelopment, visual acuity, and prematurity-related morbidities.
  • To evaluate the influence of DHA and arachidonic acid (ARA) balance on clinical outcomes.

Main Methods:

  • Narrative review of studies from March 2015 to December 2025.
  • Inclusion of randomized controlled trials, follow-up studies, and systematic reviews/meta-analyses.
  • Focus on DHA supplementation and its effects on child development.

Main Results:

  • DHA supplementation improves biochemical status, especially in those with low baseline levels.
  • Pregnancy supplementation shows some cognitive/behavioral benefits, but effects on global cognition are often null.
  • Visual acuity may improve; DHA+ARA in preterm infants shows potential for reduced NEC risk but not BPD or ROP.
  • Neuroimaging suggests enhanced white matter maturation with DHA+ARA, but developmental scores show mixed results.

Conclusions:

  • DHA is essential in early life, but clinical impact hinges on timing, dose, and context.
  • The DHA:ARA balance is more critical than DHA alone for efficacy.
  • Precision nutrition strategies are recommended for optimizing early-life development.