DHA and Diarrhea

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DHA and ARA are important fatty acids, present naturally in breast milk and added to many formulas.

I received a letter expressing concern that some babies do not tolerate formula with added DHA/ARA and that parents are not aware of this possibility. DHA and ARA are important fatty acids, present naturally in breast milk and added to many formulas. About 4 million babies are born in the U.S. each year. Over the last several years, there have been at least 98 voluntary reports of babies who had diarrhea, vomiting, or other symptoms that went away when they switched to a non-DHA/ARA formula. While this percentage is very low (much less than 0.0025%), the real number is inevitably higher, because many parents wouldn’t report it. On the other hand, whenever I see a baby with diarrhea lasting longer than a week or so, like most pediatricians, I investigate it until either the cause is found or the diarrhea has gone away. Looking at what kids eat or drink is one of the first steps. If your child has ongoing diarrhea or vomiting and is taking a formula with added DHA / ARA you may want to mention it to your child’s doctor. Even though I’ve been looking, I have yet to see a case of DHA or ARA intolerance myself. Still, I think it is important for parents and physicians to be aware of potential intolerance to make it easier to recognize when it occurs.

Clearly, breast milk is the ideal food for babies. I encourage nursing throughout the first year if possible and as long beyond that as both mom and baby desire. When breast feeding decreases or stops while the brain is rapidly growing, I suggest finding another source for the DHA they are designed to get.

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Anonymous's picture
Submitted by Anonymous on Fri, 2010-04-16 12:22.

my son suffered from this

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Hello Dr Green.
I am a mother from Israel and I'd like to thank you for this post and to confirm this issue.
I have a one year old at home. I got back to work when he was 5 month old and started giving him Similac Advance during the hours I was away. After a short while he started developing all kinds of symptoms. He had accute alergic reactions to different things, one which sent us to the hospital and another in which his whole body was covered in blisters for 3 days and he had to take steroids to get over. He also developed atopic dermatitis (which I understand is also a sort of alergic reaction) and he started vomiting intermitently. It took us a while of trying to change things other than the food (to no avail) to notice two things:
1. a week or so after being opened the formula developed a strong smell of fish
2. the baby was vimiting mostly when he had been eating formula from a box that had been open for over a week (according to specification the formula is good for three weeks once opened).

I decided to investigate on the web. On Israeli sites I did not find any clue, however it was on sites like yours that I found what I was looking for. I imidiately went to the store looking for formula that did not have this newer formula of omega 3 and 6. I went with Similac top (at least that the name in Israel) because it did not have ARA and DHA and because it would be closest in taste to the previous formula he was taking, so he would make the switch easily.
The vomiting stopped almost immediately!
The atopic dermatitis took 2-3 weeks to clear up and there were no alergic reaction from that day on (and hopefully those are behind us).
I, myself, am sure that this was the cause to all our trouble and I am trying to spread the word in Israel through alergy forums and such in hope that it would help others.
I'd like to point out that in our case the problem was in Similac Advance but I understand that this is a problem related not to the manufacturer but to the specific ingredient which is used by other brands as well.
I thank you for your note and hope that it will help others, and I apologize for being lengthy and for any spelling mistakes I may have made :-)
Gavriela Davis,
Israel