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Authors' responses to letters from Dr J Hoffman and Dr A Lapillone
We completely disagree with Dr Hoffman's statement that ‘caregivers of preterm infants are not well served’1 by our report of a 10-year follow-up of long-chain polyunsaturated fatty acid (LCPUFA) supplementation in preterm infants. Our study2 presents the results of the longest follow-up of a randomised trial of LCPUFA supplementation during infancy to date. We have explicitly acknowledged the shortcomings of the study (mainly cohort attrition) to a much greater extent than is typical in a study of this type, and we have discussed the limitations of our data and the need for further research into these outcomes. Our responses to Dr Hoffman's specific points are detailed in the Appendix.
It is worth noting here that, although the vast majority of infant formulas now contain LCPUFA, the scientific evidence base for their addition is recognised by most investigators and Key Opinion Leaders in the field to be weak; the most recent update of the Cochrane systematic reviews on LCPUFA supplementation of formulas for both preterm and term infants (encompassing 29 trials) concluded that there is no evidence for outcome benefits of the intervention, at least up to 18 months of age.3 4 We contend this field of research has been driven to an extent by enthusiasm and vested interest. As one of the major groups to do outcomes research in this area, we do not hold a fixed position but are open to the scientific evidence, and we have published on both positive and negative effects of supplementation in different trials. Our experience of publishing in this field has consistently been that publications supporting the addition of LCPUFA to infant formula are more readily accepted and less criticised than those which do not support the intervention, or …