This study tested the hypothesis that balanced addition of long-chain polyunsaturated fatty acid (LCPUFA) to preterm formula during the first weeks of life would confer long-term neurodevelopmental advantage. The participants were 195 formula-fed preterm infants (birth weight <1750 g, gestation <37 weeks) from 2 UK neonatal units and 88 breast milk-fed infants. There were no significant differences in developmental scores between randomized groups but LCPUFA-supplemented infants were shorter than control infants at 18 months. Breastfed infants had significantly higher developmental scores at 9 and 18 months than both formula groups and were significantly heavier and longer at 18 months than LCPUFA-supplemented but not control infants. The authors concluded that efficacy of the LCPUFA used was not demonstrated and that additional follow-up of this cohort should be undertaken at an age when more specific tests of cognitive function are possible. They state that the surprising effect of LCPUFA-supplemented formula on growth 18 months beyond the intervention period needs to be confirmed in other studies using similar supplementation strategies.