[Fish oil in prolonged parenteral nutrition in children--omega-3-fatty acids have a beneficial effect on the liver].

Neonates with intestinal failure are dependent on total parenteral nutrition (TPN) and therefore at risk for developing parenteral nutrition associated liver disease (PNALD). In this clinical lesson we report the treatment of PNALD in 3 infants with short bowel syndrome. Conventional omega-6 fat emulsion was substituted by omega-3 fish oil as the sole source of fat in TPN. The described patients were diagnosed as having multiple intestinal atresias, necrotizing enterocolitis and midgut volvulus, respectively, and all patients suffered from short bowel syndrome and were TPN-dependent. When persistent or progressive cholestasis occurred, omega-6 fat emulsion was replaced by omega-3 fish oil. In all 3 cases complete reversal of cholestasis was seen within months after the fish oil-fat emulsion switch. No negative side-effects were reported. These first experiences with the use of fish oil in children in the Netherlands confirm earlier suggested beneficial effects of omega-3 fatty acids in the treatment of PNALD in children with short bowel syndrome.