Pregnancy, lactation, and omega-3 fatty acids

It’s something I’ve not talked about much over the years, but it is truly a major factor in long-term health: obtaining healthy intakes of omega-3 fatty acids, EPA and DHA, during pregnancy and lactation, as well as when babies are formula-fed. While there’s plenty of chatter about adequate intakes of omega-3 for preservation of cognitive health as we age, reduction of cardiovascular risk, and reduction of triglycerides and fatty liver, there is not much talk about obtaining omega-3s during what is likely the most crucial periods of all: while a baby is in utero and over the first two years after birth, times of rapid neurological maturation that is especially dependent on intake of DHA.

The average American female of childbearing age obtains a woeful 100 mg of omega-3 fatty acids per day, given modern lifestyles that tend to not include much fish and seafood, certainly not brains (very rich in DHA). Compare that to what I would regard as an ideal intake of omega-3s for health benefits: 3000-3600 mg EPA + DHA per day.

The ideal intake for a pregnant or lactating mother has not been fully worked out (but is likely to be at least the same, perhaps greater, than everyone else). But note that the baby in utero or breastfeeding essentially cannabilizes omega-3s from the mom, making the deficient mom even more deficient while providing only a meager flow of omega-3s to the child. In one study, 600 mg per day of DHA taken during the last half of pregnancy yielded children with larger head circumferences, better growth, and were less likely to be born prematurely. Another study involved supplementation of DHA 2200 mg per day, EPA 1100 mg per day starting in mid-pregnancy that was associated with improved hand and eye coordination in children when measured at age 2 1/2 years with no adverse effects on mother or child. A number of studies of lactating moms who supplemented omega-3s have children with greater cognitive ability and vocabulary, better visual acuity and coordination, better memory. One study in which pregnant, then lactating, moms supplemented 1600 mg EPA, 1100 mg DHA per day showed only modest benefits in reducing some allergic phenomenon, but this higher dose also showed no adverse effects. Of course, mothers who are vegan or vegetarian can never hope to even come close to an ideal omega-3 intake; linolenic acid intake will not raise blood levels of EPA + DHA to any substantial degree.

As I discussed in the section I called “Formula For Failure” in my Super Gut book, synthetic formula is a poor replacement for human breastmilk, as it does not fully mimic the composition of breastmilk and has been associated with increased risk for various infections, colic, disrupted sleep, increased risk for asthma, and lower intelligence. Besides not coming with the probiotic microbes passed onto the child via breastmilk, formulas are typically low-fat (compared to 4-5% fat of human breastmilk, similar to whole milk from cows), contain no immunoglobulins or other immune-active components, often contain unhealthy additives, and don’t contain the full complement of human milk oligosaccharides that are crucial for normal childhood growth and neurological development. (Some manufacturers have managed to synthesize a few–of the 200+ that occur naturally–that are now added to some brands.) (Super Gut readers will also recognize that the full benefit of human milk oligosaccharides develop only if the child is colonized with the microbe, Bifidobacteria infantis, that the majority of modern children lack.) Only recently have formula manufacturers added omega-3s, but only enough to mimic the omega-3 content of breastmilk from omega-3 deficient mothers. For these reasons, an increasing number of mothers are turning to European organic brands or making their own formulas. (Please do not follow the recipes for homemade formula using rice milk, as they contain toxic levels of arsenic.)

Bottom line: While many of us supplement omega-3 fatty acids later in life for their cognitive, cardiovascular, and metabolic benefits, the most important time of life to ensure adequate or optimal intake of omega-3 fatty acids is during pregnancy, lactation, and early childhood. Even if you have no plans for pregnancy or lactation, you should pass this information onto your children, grandchildren, or anyone else contemplating pregnancy and breastfeeding.