Traditionally, May is the time of year when we celebrate moms. But since August is National Breastfeeding Month, here at OmegaQuant it gives us another opportunity to focus on moms right now.
Last week’s blog was all about breastfeeding—the reasons for choosing to breastfeed, the health benefits of omega-3 DHA in breast milk and how women can ensure they have enough DHA in their breast milk.
This week, let’s talk about options: what choices do women have—especially nursing moms—to be sure they’re getting the right amount of omega-3 DHA into their—and their babies’—diets; and how they can ensure their children are getting enough DHA to help those babies get off to a good start in life.
Why is DHA Important for Breastfeeding Moms and Their Babies?
In 1978, ground-breaking research in Greenland Eskimos published in The Lancet prompted a re-thinking of “fats” which then catapulted omega-3s into the spotlight and put them on the medical and scientific map.
Now, there’s an extensive research library covering the benefits of omega-3 fish oil, with literally thousands of studies on the role of, and the need for, DHA during pregnancy and after birth. Some of the best health benefits of DHA for pregnant and nursing moms—as well as for their babies—are found in the areas of brain health, eye health, behavior development and mental health.
Think of DHA as the building blocks to those four areas of a child’s development.
Babies need omega-3s, and in particular, DHA, because that nutrient is central to the brain’s growth, structure and development. The brain and the retina both need DHA in order to properly form and function. DHA is pulled from the mother’s blood stores and placenta during pregnancy. Once the baby is born, DHA is transferred through a nursing mother’s breast milk to the baby.
More About the Science of Omega-3 for Breastfeeding Moms
Omega-3s have been proven to be vital to brain and eye development, during both pregnancy and infancy. One study published by The National Center for Biotechnology Information found that “improving maternal DHA nutrition decreases the risk of poor infant and child visual and neural development.” In addition, the study confirmed that “maternal fatty acid nutrition is important to DHA transfer to the infant before and after birth, with short and long-term implications for neural function.”
Another study published in the American Journal of Clinical Nutrition found that infant girls whose mothers received DHA supplements from their fourth month of pregnancy until delivery were less likely to have below-average visual acuity at 2 months of age compared to infant girls whose mothers did not receive the omega-3 supplements.
Studies also show that getting enough DHA during pregnancy can impact behavior, attention, and learning in children. According to researchers at the University of Kansas, infants born to mothers with higher blood levels of DHA at delivery had advanced attention spans (which are considered early indictors of intelligence) well into their second year of life. During the first 6 months, these infants were 2 months ahead of babies whose mothers had lower DHA levels.
Because of the role they play in gene expression, neuronal survival, dopamine, and serotonin transmission, neuron growth, membrane fluidity, neuron growth, and transcription, omega-3 fatty acids are important for brain health and other deficiencies that contribute to the development of mental health issues.
Now that we’ve teased you with some of the science, how does a woman of childbearing age, a pregnant woman, or a mom get enough DHA in her diet?
Here’s How to Get More of a Good Thing—Omega-3 DHA
While many experts consider breastfeeding the gold standard for infant nutrition, the fact is that not every woman is able to successfully breastfeed, and others may choose not to try. In those cases, there are other ways for an infant to obtain adequate DHA.
Similarly, the best source for getting omega-3 fish oils EPA and DHA are through diet, specifically fatty fish; however, the fact is some women just don’t enjoy the taste of fish or have concerns about mercury levels. (By the way, experts say the benefits outweigh the risks when it comes to fish and mercury levels, but some fish choices are better than others. We’re getting to that.)
As importantly, you don’t want too much of a good thing of anything ever. When it comes to knowing how much omega-3 EPA and DHA you need, the best place to start is to figure out how much you already have—whether it’s in the blood, or in the case of nursing women, in the breast milk. OmegaQuant offers a number of simple and safe self-testing options and you can learn more about them here.
3 Ways of Getting Your Omega-3 Dosage While Breastfeeding
- Go Fish!
When it comes to sources for omega-3 fatty acids, consider fish first. Oily fish (also ironically also known as fatty fish) is low in both saturated fat and calories and high in protein, omega-3s and vitamin D. It’s no wonder that the U.S. Food and Drug Administration (FDA) considers it an excellent source of nutrition for a developing baby and a mother-to-be.
The FDA recommends that pregnant or nursing women consume 8 to 12 ounces a week of a variety of seafood that’s low in methylmercury but also high in omega-3s. Consistently safe and beneficial options like salmon, trout and herring can be eaten 2-3 times per week as they are not only low in mercury but also high in omega-3s, which are shown to be especially important for a baby’s cognitive development.
One large Danish study, for example, showed children whose mothers ate the most fish during pregnancy had better motor and cognitive skills at 6 months and at 18 months compared to those whose mothers ate little fish. And those whose mothers ate the least amount of fish had the lowest developmental scores.
But not all fish is considered equal.
White or albacore canned tuna, while also a good source of DHA, should only be eaten once per week due to a slightly higher mercury content.
While many fish prove to be an excellent source of DHA, the FDA advises women of childbearing age steer clear of high-mercury species like swordfish, shark, king mackerel and tilefish, which, according to the Environmental Protection Agency (EPA) can be detrimental to a baby’s brain development, vision, cognition and motor skills.
To help with your decisions, the FDA offers a helpful guide to choosing low-mercury fish, but be aware that not all fish are rich in DHA. The Prenatal DHA Test report includes a list of fish that is both high in DHA and low in mercury, the ideal combination.
If you’re a vegetarian, you’ll still want to be sure you’re getting enough DHA. One of the few plant groups that contain DHA and EPA are algae and seaweed. Walnuts and flaxseed oil convert omega-3 alpha-linolenic acid (ALA) into DHA (and EPA), but not all that efficiently. So dietary supplements are a strong option to consider if you’re not getting enough DHA into your diet from food alone.
- Supplement with Supplements to Boost Your Omega-3 DHA
If you just can’t eat enough fish to get all the DHA you need, you’re probably not alone. Fortunately, there are a good number of fish oil supplements on the market to help.
One advantage of taking a supplement is that you’re readily able to look on the label to see how much omega-3 fish oil EPA and DHA you’re getting in a serving. For breastfeeding women concerned about getting enough DHA to satisfy her own and her baby’s needs, it’s important to look at the label for actual amount of DHA (rather than just the general “omega-3s”) to determine what the supplement actually contains. For example, many supplements offer 1000 mg of fish oil, but may only contain 120 mg of DHA. Also take note of whether the amount of DHA is listed per serving, or per capsule, in case those are different. The number to shoot for is 200 mg of omega-3 DHA per day.
For vegetarians and vegans, instead of a fish oil supplement, look for a plant-based omega-3 supplement—algal-oil—in which the omega-3 DHA is produced by algae. As it turns out, fish don’t naturally produce omega-3s EPA and DHA—it’s their algae-rich diet that’s responsible.
One study had 32 healthy adults consume either algal oil capsules or cooked salmon with an equivalent amount of DHA each day for two weeks. By the end of the trial both groups showed comparable increases in their blood levels of DHA, leading researchers to conclude that “algal-oil DHA capsules and cooked salmon appear to be bioequivalent in providing DHA to plasma and red blood cells.”
Another 2014 scientific review similarly found that algal oil serves as an effective alternative source of DHA. Algal oil is also a safe option when it comes to protecting the environment. Overfishing occurs when fish are caught at higher rates than they can reproduce, which negatively affects ocean food chains, increases global food insecurity, and destroys coral reefs. Algae-based DHA supplements, often harvested from ponds, represents a much more sustainable choice. Plus, algae don’t contain any heavy metals or toxins so there’s no risk of ocean-borne contaminants.
- Choose Infant Formula Fortified with Omega-3 DHA
While adding an infant formula to the mix won’t help the mother get the DHA she needs, infant formulas fortified with omega-3 DHA should ensure her child does.
Almost all brands of infant formula sold in the U.S. are now fortified with DHA (and also arachidonic acid), synthesized versions of the essential fatty acids that are naturally found in breast milk.
That’s because in 2002, as a result of evaluating studies from the 1990s that found infants fed with formula had lower levels of brain DHA compared to breast-fed infants, FDA approved the addition of DHA to infant formulas.
An article from the New York Times stated that “despite decades of research, it’s still not clear that DHA in formula boosts brain health in babies…” The author cited a 2017 Cochrane Collection systematic review that concluded there was no clear evidence that formula supplementation with DHA, or DHA itself, improved infant brain development.
However, that same Cochrane Review also found no harm from adding the nutrient. And, as already discussed in this blog, there is a large amount of research that has found benefit for mothers and babies from omega-3 DHA.
The New York Times piece also noted that many experts do believe there is value in including DHA in formula. Dr. Steve Abrams, a professor of pediatrics at at the University of Texas, Austin, was quoted about the value of including DHA in formula, stating “Even if you can’t easily prove it, because it’s hard to prove developmental outcomes, it makes sense to use it. It’s probably a good idea to keep it [DHA] in there, and it’s certainly safe.”
And infant formula is certainly popular. It safely provides the option of convenience for a new mom along with appropriate levels of DHA. According to an Allied Market Research report, the global baby infant formula market size is projected to reach $45.3 million by 2025, registering a compound annual growth rate (CAGR) of 9.5% from 2018 to 2025.
Infant formula is available in three forms: ready-to-use formula, concentrated liquid formula and powdered formula. The best choice in delivery method, as well as which brand to choose, depends on a mother’s budget and personal preference. This is a decision which could also be made in consultation with a pediatrician.
Infant formula is also used by many women in combination with breast milk. The combination feeding method can provide convenience for working moms and may also be used out of necessity (e.g., low breast milk supply) or simply as a personal choice. There may also be some medical reasons why a doctor would suggest combination feedings.
It is also possible to combine breast milk with expressed formula, in one bottle, however La Leche League, a proponent of breastfeeding, advises this can result in breast milk being wasted if the baby does not finish the milk, since formula would need to be discarded.
Especially for moms who choose, or are unable, to breastfeed, or those who want the convenience of a combination method of feeding, infant formula certainly makes sense.
Just remember to double check that the infant formula is, in fact, fortified with DHA. If you’re not sure how much DHA should be in the infant formula, if you’re buying from a reputable brand, you won’t need to worry.
That’s because FDA’s nutrient specifications for infant formulas are set at levels to meet the nutritional needs of infants. Manufacturers may set levels for their label claims that are generally above the FDA minimum specifications because they add nutrients at levels that will ensure their formulas meet their label claims over the entire shelf-life of the product. Infants fed infant formulas do not need additional nutrients unless a low-iron formula is being fed.