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Fish oil for mum-to-be

Infant and Children, Pregnancy | July 13, 2018 | Author: Naturopath

pregnancy, infants

Fish oil for mum-to-be

Fish is a good source of protein, rich in omega-3 fatty acids, vitamins and minerals. Eating fish, or taking a fish oil supplement, is associated with many beneficial health effects such as lowering LDL cholesterol, reducing risk of heart disease and Alzheimer’s, decreasing joint pain and swelling in patients with rheumatoid arthritis, improving depression, and aiding in weight management.

The Australian dietary guidelines recommend that older children and adults should eat around 2 serves of fish per week, where one serve equals 100g cooked fish fillet (about 115g raw) or one small can of fish.

Is it safe for pregnant women to eat fish?

Some species of fish may contain high levels of mercury, which can be toxic to the brain of developing foetus, infants, and young children. Pregnant women and those who are breast-feeding are advised to limit their exposure to fish high in mercury.

Is it safe for pregnant women to eat fish?Food Standards Australia New Zealand recommendations:

1. Eat 2-3 serves per week of any fish and seafood not listed below

2. Eat 1 serve (100g cooked) per fortnight of these fish, and no other fish that fortnight: Shark (Flake) or Billfish (Swordfish, Marlin) OR

3. Eat no more than one serve (100g cooked) per week of these fish, and no other fish that week: Orange roughy (deep sea perch) or catfish.

The benefits of fish oil during pregnancy

Fish is a natural source of Omega-3 fatty acids. There are two main types of omega-3 fatty acids: Docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA). During pregnancy, both DHA and EPA are transferred from the mother to the foetus through the placenta. It is therefore essential that that the mother has sufficient dietary intake of these beneficial oils.

Higher intakes of omega-3 fatty acids from fish and fish oil supplements during pregnancy are associated with health benefits for the offspring and the mother, including:

  • Brain-related health benefits in infants. DHA is essential for the growth and development of the brain in infants. It accumulates in the foetal brain mainly during the last trimester of pregnancy and continues accumulating up to two years of age. Infants of mothers who took DHA supplementation or combined EPA/DHA fish oil supplements during pregnancy have shown enhanced problem-solving skills, hand and eye coordination, and cognitive function.
     
  • Reduced food allergy in infants. A summary of six studies concluded that a fish oil supplement, taken from around 20 weeks of pregnancy through the first 3 to 4 months of lactation, might reduce risk of allergic sensitisation to egg or peanut in the child.
     
  • Reduced asthma. A study of 736 pregnant women in Denmark found that taking high dose fish-oil supplementation during the third trimester of pregnancy and until 1 week after delivery reduced the risk of persistent wheeze and asthma in children during their first 5 years of life.
     
  • Increased length of pregnancy. It has been found that fish oil supplementation during pregnancy increased the length of the pregnancy by 2.5 days, resulting in an average increase of birth weight by 50 g and birth length by 0.5 cm.
     
  • Reduce high anxiety during pregnancy. Examination of dietary patterns of 9,530 pregnant women in southwest England found that women with little or no intake of omega-3 fatty acids from fish had a greater likelihood to have high levels of anxiety, when compared with women with adequate intake. 
     
  • Reduce postnatal depression. More than 1 in 7 new mums experience postnatal depression in the year after giving birth. It has been found that lower maternal omega-3 status in late pregnancy (week 28) was associated with higher levels of postnatal depression.

Are fish oil supplements safe during pregnancy?

Are fish oil supplements safe during pregnancy?In the general population, taking fish oil supplements is considered to be safe. Some minor side effects have been reported such as a fishy aftertaste and heartburn. Additionally, high doses may cause nausea and diarrhoea.

Studies of fish oil supplementation during pregnancy and breast-feeding have not reported any serious adverse effects. 

It is worth noting that although fish oil supplements are free of mercury, evidence-supporting safety are still lacking. The Royal Australian and New Zealand College of Obstetricians and Gynaecologists do not recommend taking fish oil supplements in the first trimester. As for the second and third trimester, the recommendation is as follows:

“Women whose dietary intake of Omega-3 fatty acids is low, for example those who eat very little seafood, should consider a dietary supplementation which may be obtained from fish oil and some commercially available pregnancy supplements”.

Fish oil recommendations

A wide range of fish oil supplements is available on the market, both in capsules form or liquid, and in varying dosages.

  • Dose. Global authorities recommend a dose of 200 mg/day DHA for pregnant or lactating women.
     
  • Read the supplement label. The dose of EPA and DHA is the actual omega-3 content of the supplement, and not the total amount of fish oil, which is the big number that you see on the front label (usually around 1000-2000mg). EPA and DHA content may vary in each of these supplements.
  • Smell and taste. The American Pregnancy Association explains that a high quality fish oil supplement will not smell or taste fishy. Avoid a supplement that smells unpleasant or has really strong or artificial flavours added (because they are most likely trying to hide the fishy flavour).
     
  • Take fish oil with food. Fish oil is absorbed more efficiently with meals. Large doses can be divided into two or three smaller doses throughout the day to decrease the risk of gastrointestinal side effects.
     
  • Avoid cod liver oil. Cod liver oil contains high levels of vitamin A. Too much vitamin A can harm your baby.

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References

American Pregnancy Association 2016. Omega-3 Fish Oil and Pregnancy: Benefits & Proper Dosage. Available at: http://americanpregnancy.org/pregnancy-health/omega-3-fish-oil/

Bisgaard, H. et al., 2016. Fish Oil–Derived Fatty Acids in Pregnancy and Wheeze and Asthma in Offspring. New England Journal of Medicine, 375(26), pp.2530–2539. Available at: http://www.nejm.org/doi/10.1056/NEJMoa1503734  

Foods Authority 2016. Foods to eat or avoid when pregnant. Available at: http://www.foodauthority.nsw.gov.au/foodsafetyandyou/life-events-and-food/pregnancy/foods-to-eat-or-avoid-when-pregnant

FSANZ 2011. Mercury in fish. Available at: http://www.foodstandards.gov.au/consumer/chemicals/mercury/Pages/default.aspx

Garcia-Larsen, V. et al., 2018. Diet during pregnancy and infancy and risk of allergic or autoimmune disease: A systematic review and meta-analysis. PLoS medicine, 15(2), p.e1002507. Available at: http://www.ncbi.nlm.nih.gov/pubmed/29489823

Linus Pauling Institute, 2014. Essential Fatty Acids. Available at: http://lpi.oregonstate.edu/mic/other-nutrients/essential-fatty-acids

Markhus, M.W. et al., 2013. Low Omega-3 Index in Pregnancy Is a Possible Biological Risk Factor for Postpartum Depression M. Mazza, ed. PLoS ONE, 8(7), p.e67617. Available at: http://dx.plos.org/10.1371/journal.pone.0067617 

NHMRC Eat for Health Publications, 2013. Australian Dietary Guidelines. Available at: https://www.eatforhealth.gov.au/sites/default/files/files/the_guidelines/n55a_australian_dietary_guidelines_summary_book.pdf

NHMRC Eat for Health Publications. Healthy Eating During Your Pregnancy. Available at: https://www.nhmrc.gov.au/_files_nhmrc/file/publications/n55h_healthy_eating_during_pregnancy_print.pdf

Swanson, D., Block, R. & Mousa, S.A., 2012. Omega-3 Fatty Acids EPA and DHA: Health Benefits Throughout Life. Advances in Nutrition, 3(1), pp.1–7. Available at: https://academic.oup.com/advances/article/3/1/1/4557081

Vaz, J. dos S. et al., 2013. Dietary patterns, n-3 fatty acids intake from seafood and high levels of anxiety symptoms during pregnancy: findings from the Avon Longitudinal Study of Parents and Children. PloS one, 8(7), p.e67671. Available at: http://www.ncbi.nlm.nih.gov/pubmed/23874437

Weiser, M.J., Butt, C.M. & Mohajeri, M.H., 2016. Docosahexaenoic Acid and Cognition throughout the Lifespan. Nutrients, 8(2), p.99. Available at: http://www.ncbi.nlm.nih.gov/pubmed/26901223

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