Long-chain (LC) polyunsaturated fatty acids (PUFA) (LCP) are considered conditionally essential nutrients for low birth weight infants (LBWI). Therefore, enrichment of LBWI formulae with metabolites both linoleic (omega-6) and alpha-linolenic (omega-3) acids at levels typical for human milk has been recommended. However, previous feeding trials with LCP-enriched formulae evaluated only a dietary supplementation with omega-3 LCP from fish oils alone or with both omega-3 and omega-6 LCP at levels considerably lower than usual human milk contents. We studied the effects of an LBWI formula providing the major omega-3 and omega-6 LCP, docosahexaenoic and arachidonic acids, in amounts similar to those in average human milk. Twenty-seven LBWIs were enrolled in this study when they tolerated full enteral feeding (> or = 130 ml milk/kg/day). Infants either received their own mother's milk (n = 8, birthweight 1218 +/- 146 g, gestational age 30.2 +/- 1.5 weeks, mean +/- SD) fortified with protein and minerals (FM-85, Nestle Ag, Munchen, Germany; dosage 5 g/100 ml milk) or were randomly assigned to blinded batches of an LBWI formula (Prematil, Milupa AG, Friedrichsdorf, Germany) without LCP (n = 10, 1280 +/- 229 g, 31.1 +/- 3.1 weeks) or with LCP (n = 9, 1253 +/- 334 g, 30.4 +/- 3.3 wks.). During the study period of 21 days, the three feeding groups did not differ in growth and feeding tolerances as assessed by occurrence of gastric residuals, spitting, or abdominal distention; however, firms stools were noted more frequently in the two formula groups.(ABSTRACT TRUNCATED AT 250 WORDS)