Omega-3 during pregnancy and breastfeeding – dosage - Blog

In 1984, it was demonstrated that increasing the amount of omega-3 fatty acids in the diet of breastfeeding women altered the fatty acid profile of their milk. It was found at the time that the docosahexaenoic acid (DHA) content in breast milk may be influenced by the mother’s diet. Subsequent studies confirmed that DHA is transferred to the baby both via the placenta during pregnancy and through breast milk during lactation. Currently, there are separate recommendations regarding the intake of long-chain omega-3 fatty acids for the periods of pregnancy and breastfeeding.

pregnant woman – omega-3 fatty acids

The importance of omega-3 fatty acids during pregnancy and breastfeeding
Recommended sources of omega-3 for expectant mothers
Safe omega-3 intake during pregnancy and breastfeeding
Frequently asked questions about omega-3 during pregnancy
FAQ – Frequently Asked Questions

The importance of omega-3 fatty acids during pregnancy and breastfeeding

During pregnancy, DHA is transported from the mother’s body via the placenta and incorporated, amongst other things, into the lipids of the foetal nervous tissue and retina. After birth, breast milk becomes one of the sources of DHA for a breastfed baby, and its content depends in part on the supply of this acid in the mother’s diet. Eicosapentaenoic acid (EPA) also belongs to the group of long-chain omega-3 fatty acids; however, in recommendations concerning pregnancy and lactation, particular attention has been paid to DHA.

In the European Union, a health claim has been authorised stating that DHA contributes to the maintenance of normal brain function. It is also permitted to state that DHA contributes to the maintenance of normal vision. For both claims, the beneficial effect is obtained with a daily intake of 250 mg of DHA. In accordance with the conditions of use, the product must simultaneously provide at least 40 mg of DHA per 100 g and per 100 kcal.

Recommended sources of omega-3 for expectant mothers

omega 3

EPA and DHA can be obtained primarily from fish and seafood. During pregnancy, however, it is not only the omega-3 content that is important, but also the level of contaminants, particularly methylmercury. Species listed in Polish literature as having lower levels of mercury compounds include, amongst others, Atlantic mackerel, sardines, pollock, trout, hake, plaice and farmed Norwegian salmon. Greater caution is advised with regard to large predatory fish. During pregnancy, fish and seafood should be thoroughly cooked.

DHA can also be obtained from microalgae oil, which is particularly important in fish-free diets. Among plant-based products, linseed oil, rapeseed oil, walnuts, chia seeds and linseed can provide significant amounts of ALA. However, they are not direct sources of comparable amounts of DHA, as ALA must first be converted within the body.

Safe omega-3 intake during pregnancy and breastfeeding

The European Food Safety Authority (EFSA) has set an adequate intake for adults at 250 mg per day for the combined total of EPA and DHA. During pregnancy and breastfeeding, an additional 100–200 mg of DHA per day is recommended on top of this amount. If fish and seafood intake is lower than recommended, a higher dose of DHA should be considered.

When choosing an omega-3 supplement instead of fish, check the amount of EPA and DHA per actual serving, as the weight of fish oil does not correspond to the weight of the omega-3 fatty acids themselves. When taking several supplements at the same time, their combined composition must be taken into account. Preparations containing fish liver oil require particular attention, as, in addition to EPA and DHA, they may provide vitamins A and D. During pregnancy, it is particularly important to avoid an excess of vitamin A in the form of retinol. During breastfeeding, EFSA recommendations provide for an additional 100–200 mg of DHA on top of the basic intake of EPA and DHA.

Table

Period	EPA + DHA	DHA
Pregnancy	250 mg/day plus	plus 100–200 mg/day
Breastfeeding	250 mg/day plus	plus 100–200 mg/day

Frequently asked questions about omega-3 during pregnancy

omega 3

If you eat fish regularly, do you still need a DHA supplement? The amount of omega-3 fatty acids provided by your diet depends on the types of fish you choose, the portion sizes and how often you eat them. Is DHA from microalgae different from DHA obtained from fish? Chemically speaking, it is the same fatty acid, but ready-made preparations may differ in their content of other omega-3 fatty acids. Microalgae oils often provide DHA in greater quantities than EPA, so the amount of EPA should be checked separately on the label.

Are cod liver oil and fish oil the same product? No, cod liver oil is obtained from the livers of fish in the cod family and may also contain vitamins A and D. Does a higher amount of DHA mean a stronger effect? Authorised claims regarding normal brain function and vision do not suggest that exceeding the recommended intake enhances these effects.

"During pregnancy and whilst breastfeeding, DHA is particularly important, as it is passed to the baby via the placenta and later also through breast milk. According to the EFSA, in addition to the basic intake of 250 mg of EPA and DHA per day during these periods, an extra 100–200 mg of DHA is recommended. When choosing a supplement, it is worth looking first and foremost at the actual amount of DHA and EPA in the daily dose, rather than just the number of milligrams of fish oil.” Anna Zięba – Dietitian

FAQ – Frequently Asked Questions

How much omega-3 is recommended during pregnancy?

According to the EFSA’s recommendations, the basic adequate intake is 250 mg of EPA and DHA per day, and an additional 100–200 mg of DHA per day is recommended during pregnancy.

How much DHA is recommended whilst breastfeeding?

During breastfeeding, an additional 100–200 mg of DHA per day is also recommended on top of the basic intake of 250 mg of EPA and DHA.

Why is DHA particularly important during pregnancy?

DHA is transported across the placenta and incorporated, amongst other things, into the lipids of the nervous tissue and the retina of the developing baby. After birth, a breastfed baby also receives DHA from their mother’s milk.

Can eating fish provide the necessary omega-3s?

Yes. Fish and seafood are natural sources of EPA and DHA. During pregnancy, however, it is important to choose the right species in terms of contaminant levels, particularly methylmercury, and to ensure they are cooked properly.

Is DHA from microalgae a good alternative to fish oil?

Yes, DHA from microalgae is, chemically speaking, the same fatty acid. However, supplements may differ in the proportions of DHA and EPA, so you should check their exact content on the label.

Can linseed and walnuts replace DHA from fish?

They are not a direct equivalent. They primarily provide ALA, which can be converted in the body into long-chain omega-3 fatty acids; however, this process is limited.

Does 1,000 mg of fish oil equal 1,000 mg of omega-3?

No. The weight of fish oil does not correspond to the amount of EPA and DHA. When choosing a supplement, you should check exactly how much EPA and DHA is contained in the actual daily dose you are taking.

Is cod liver oil a good source of omega-3 during pregnancy?

Cod liver oil contains omega-3, but it may also provide vitamins A and D. During pregnancy, it is particularly important to avoid excessive intake of vitamin A in the form of retinol; therefore, you must check the full composition of the product you are using and any other supplements.

Does more DHA mean greater benefits?

The principle of "the more, the better" does not apply here. The health claims and recommendations cited do not suggest that exceeding the recommended intake of DHA provides proportionally greater benefits.

Sources:

Carlson S. E. (2009). Docosahexaenoic acid supplementation in pregnancy and lactation. The American journal of clinical nutrition, 89(2), 678S–84S. https://doi.org/10.3945/ajcn.2008.26811E
Taylor, C. M., Emmett, P. M., Emond, A. M., & Golding, J. (2018). A review of guidance on fish consumption in pregnancy: is it fit for purpose?. Public health nutrition, 21(11), 2149–2159. https://doi.org/10.1017/S1368980018000599
Jensen, C. L., & Lapillonne, A. (2009). Docosahexaenoic acid and lactation. Prostaglandins, leukotrienes, and essential fatty acids, 81(2-3), 175–178. https://doi.org/10.1016/j.plefa.2009.05.006