DHA Intake During Pregnancy and Breastfeeding

by Beth Vincent, MHS

When I was six months pregnant with my third child I noticed the letters "DHA" popping up on infant formula labels in the grocery stores. Then I noticed it on egg cartons and began to wonder, "What is DHA and why is it being added to these foods?" This is an important question to ask -- and the answer is noteworthy, especially for pregnant women. DHA (short for docosahexaenoic acid, an omega-3 long chain polyunsaturated fatty acid) is found in every cell in our bodies. It is critical for brain, eye and central nervous system development and functioning.

During pregnancy, developing babies rely on their mothers to get needed DHA. Since DHA is derived from the foods we eat, the content of DHA in a mother's diet determines the amount of DHA passed on to her developing baby. Unfortunately, the majority of pregnant women in the U.S. fail to get the recommended amount of DHA in their diets and DHA is not found in most prenatal vitamins. The good news is leaders in maternal health are beginning to educate women about the importance of DHA and some food manufacturers are starting to come up with creative ways to help people -- pregnant and non-pregnant -- get the DHA they need.

Current research suggests adequate levels of DHA may help increase a developing baby's cognitive functioning, reduce the risk of pre-term labor and decrease the risk of postpartum depression. Consider the following:

  • A 2003 study published in the journal Pediatrics showed children whose mothers took a DHA supplement during pregnancy scored higher on intelligence tests at four years of age than children of mothers not taking DHA supplements.
  • A 2004 study published in Child Development found that babies whose mothers had high blood levels of DHA at delivery had advanced attention spans into their second year of life. During the first six months of life these infants were two months ahead of babies whose mothers had lower DHA levels.
  • Other research studies suggest breastfed babies have IQs of six to 10 points higher than formula-fed babies. Medical and nutritional experts attribute this difference to the DHA infants receive while nursing.
  • In a trial of women receiving DHA supplementation during the third trimester, the average length of gestation increased six days (Obstetrics & Gynecology, 2003).
  • Research has found low levels of DHA in mother's milk and in the red blood cells of women with postpartum depression. (Journal of Affective Disorders, 2002). Some scientists believe increasing levels of maternal DHA may reduce the risk of postpartum depression.

Renowned figures speak out about DHA

Research findings such as these have led pregnancy and child health experts to spread the word about the importance of DHA during pregnancy. Dr. William Sears, one of the nation's leading experts on child health and development and longtime advocate of DHA, states "DHA is the most important brain-building nutrient at all ages, especially during pregnancy and the pre-school years when the child's brain is growing the fastest." Dr. Sears hosts DHADOC.com, a web site providing information on the importance of DHA in infant and maternal nutrition. In light of research findings and what he calls "common sense," Dr. Sears recommends on his web site that pregnant and lactating women supplement their normal diet with 200 milligrams of DHA a day.

In what many consider the modern day pregnancy bible, What to Expect When You are Expecting, Heidi Murkoff, et.al., devotes a section to the importance of adequate DHA in the pregnancy diet chapter of her book. She explains that DHA is important during pregnancy, "especially during the last three months, when your baby's brain grows at a rapid pace and lactation (the DHA content of a baby's brain triples during the first three months of life)." Another maternity expert, Rebecca Matthias, president of Mothers Work, Inc., the nation's leading maternity retailer touts the benefits of DHA in her latest book, 51 Secrets of Motherhood. She celebrates DHA as "the new wonder supplement that actually increases your baby's growth."

DHA is hard to get in your diet

Why do pregnant and lactating women, who so critically need DHA, find it difficult to get the recommended amount of this crucial nutrient in their diets? There are two primary reasons. First, during pregnancy the daily requirements of DHA increase from 220 mg to somewhere between 300 and 1,000 mg (depending on which expert you consult). Second, DHA isn't easy to get in your diet -- especially when you are pregnant. Significant amounts of DHA are found in animal organ meats and fatty fish.

Not the typical menu for most pregnant women! Liver does not hold mass appeal and we're told to limit our intake of fish due to concerns over toxins. No wonder a recent study of 112 pregnant or lactating women found that fewer than 2 percent met the FDA's current guidelines for adequate daily DHA consumption.

So what should pregnant women do to safely increase the DHA in their diets? A friend of mine began grinding flax seed onto her cereal every morning. Unfortunately putting flax seed on your cereal is probably a waste of time. Despite popular belief DHA is not found in flax seed, Flax seed (and green leafy vegetables) are sources of alpha-linolenic acid which may convert to DHA, but the process is inefficient and according to some experts may not happen at all.

Alternatively you might choose to eat some of the "safer" fish choices such as pollock, haddock and cod. But according to Dr. Barbara Levine, associate professor of nutrition in medicine at Weill Medical College of Cornell University, "the purest source of DHA is not the fish itself, but rather what fish consume: the ocean's vegetarian plant algae. Taking DHA supplements produced from marine algae is therefore a safe way for pregnant women to boost their fatty acid stores," Levine says.

Martek Biosciences owns the technology that allows DHA to be manufactured from algae. DHA supplements made with Martek DHA are now available in health food and drug stores, as well as some maternity stores. If you don't want to take yet another pill, look for other foods fortified with Martek DHA.

As leaders in all areas of maternal and child health continue to speak out about the importance of DHA for pregnant women, we can expect to see more food manufacturers offering products fortified with DHA. It takes time, but the word gets out. As Dr. Levine states, "It took forever to get the message across about the importance of folic acid early in pregnancy, but now it is in our products and most women get what they need. Now we are trying to get the message out about DHA."

Thanks to perinatal health education efforts and thoughtful manufacturing today's mothers-to-be and new moms can ensure their babies get the DHA they need to thrive. DHA is critical for developing babies during pregnancy and lactation - the benefits of this fatty acid last forever.

Beth Vincent is CEO and co-founder of Vincent Foods LLC. Beth holds a Masters degree from Johns Hopkins School of Public Health in Health Policy and Management. She has extensive knowledge in public health and maternal and child health having worked as a health care consultant specializing in maternal and child health and as a birthing doula prior to starting her company. Beth is a mother of three and lives in Baltimore, Maryland.

Copyright © Beth Vincent. Permission to reprint granted to Pregnancy.org, LLC.