I received a letter expressing concern that some babies do not tolerate formula with added Docosahexaenoic acid/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.