Swedish national guidelines

In August 2026, the Swedish Neonatal Society published new guidelines on supplementation with the long-chain polyunsaturated fatty acids docosahexaenoic acid (DHA) and arachidonic acid (ARA). Below is a summary of the recommendations. To read the full guideline, please click the link below.

Why supplement ARA and DHA?

ARA and DHA are essential fatty acids that play a critical role in the development of the brain and retina. During fetal development, the accumulation of these fatty acids occurs most rapidly during the third trimester.

Infants born before 28 weeks of gestation are therefore at high risk of developing low serum concentrations of ARA and DHA after birth.

Enteral supplementation is necessary to ensure adequate intake. The Swedish Neonatal Society therefore now recommends DHA and ARA supplementation for extremely preterm infants.

READ MORE ABOUT DHA & ARA HERE

Target Group 
Infants born before 28 weeks of gestation

Initiation of Treatment 
Treatment should be initiated on the first day of life, preferably with the second enteral feed, and no later than 72 hours after birth.

Treatment Duration 
Treatment should be continued at a daily dose of 0.4 mL/kg until 40 weeks’ corrected age or until discharge.

Dosage & Administration 
The recommended daily dose is 50 mg/kg/day of DHA and 100 mg/kg/day of ARA, corresponding to 0,4 ml/kg/day of NeoMega36®. The maximum daily dose is 1 ml.

The supplement is administered once daily with a feed. It can be given either directly by mouth or via a nasogastric tube.

See administration Instructions

1. Oral administration

1. For oral administration, you will require an oral syringe to aspirate.

2. Open the cap and connect an oral syringe* to the bottle. Aspirate the desired volume of the portion (0.4 ml/kg).

3. Give the portion (0.4 ml/kg) in the mouth of the infant.

2. Administration through the nasogastric tube

1. For administration through a nasogastric tube, you will require a feeding syringe and a sampling straw.

2. Open the cap, connect a feeding syringe to a sampling straw**, and put this into the bottle. Aspirate the desired volume of the portion (0.4 ml/kg).

3. Administer the portion (0.4 ml/kg) in the nasogastric feeding tube.

*Oral syringes are specific syringes intended for oral administration. One suitable example is the Exadoral syringe 1 ml provided by B Braun (art nb 4608661) **Sampling straws for Nutrasafe2 and ENFit syringes are available from Vygon (art nb 817.052 and 817.057, respectively)