Image Credit: Steve Buissinne / Pixabay. This image has been modified.

Should Plant-Based Women Supplement with DHA During Pregnancy?

A systematic review of randomized controlled trials of DHA supplementation of pregnant and breastfeeding women failed to find any clear and consistent short- or long-term benefit for psychomotor, mental, visual, or physical development. Perhaps DHA supplementation during pregnancy has no effect because the body wisely protects the growth of the baby’s brain by drawing off of maternal stores of DHA, upregulating maternal DHA synthesis, and preferentially shuttling it to the fetus. But what if moms don’t start out with large maternal stores? In other words, maybe DHA failed to help women who were already getting enough, but perhaps women with very low intakes would benefit from DHA supplementation. My video Should Vegan Women Supplement with DHA During Pregnancy? explores the evidence available to date.

It’s interesting to note that, by 1978, researchers already were suggesting a plant-based diet as the diet of choice in the treatment of our number-one killer, heart disease, but babies breastfed by vegan moms had significantly less DHA in their bloodstreams, presumably because the moms had significantly less DHA in their breast milk.

The question is whether these differences are of any consequence. The growth and development of vegan and vegetarian born children are normal as long as they’re getting their B12, and “[t]here is no evidence that neural or intellectual functions are impaired.” In fact, the two studies we have on kids in vegetarian communities showed they had higher IQs, though that may be because their parents tended to be better educated. However, even though the kids seemed fine, that doesn’t rule out the possibility that there may be some “subtle differences…in visual or neural functioning.”

It would be interesting to compare the function of babies getting vegan breast milk levels versus general population levels. In one of the studies I profile in my video, it shows that vegans hit a level of 14, vegetarians 30, and omnivores 37. Another study compared 0 to 32, 64, and 96, and, though 32 worked better than 0, more than 32 didn’t add anything. This could explain why the general population at 37 doesn’t benefit from additional DHA supplementation. But what about down at 14? Most studies at that level show no advantage over 0, though one study found a benefit supplementing at as low as 5, but that doesn’t help us.

Just because babies breastfed by vegan moms have significantly lower DHA levels in the blood, that doesn’t necessarily mean they have lower levels in their brain, which is where it counts. What we need is a randomized, controlled trial in non-fish-eaters of DHA supplementation. Until then, it’s going to remain uncertain. So, what should pregnant and breastfeeding women who avoid fish do in the meanwhile? Low intake of DHA doesn’t “necessarily equate with fetal DHA inadequacy,” but new data suggest that some infants may not be getting enough and could benefit from their moms supplementing. Given this, I recommend pregnant and breastfeeding women on plant-based diets to follow the consensus guidelines to get about 200mg of preformed DHA from an uncontaminated source, like algae oil, which is probably the best combination for all women given the state of our world to minimize exposure to toxic pollutants such as dioxins, PCBs, and mercury. 


To gain a better understanding of why algae oil is better than purified fish oil, I encourage you to watch my video Should Pregnant and Breastfeeding Women Take DHA.

I’ve discussed concerns about pollutants in seafood during pregnancy in a number of my videos:

Finally, for more on taking long-chain omega-3s to protect your heart, see: 

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Discuss

Michael Greger M.D., FACLM

Michael Greger, M.D. FACLM, is a physician, New York Times bestselling author, and internationally recognized professional speaker on a number of important public health issues. Dr. Greger has lectured at the Conference on World Affairs, the National Institutes of Health, and the International Bird Flu Summit, testified before Congress, appeared on The Dr. Oz Show and The Colbert Report, and was invited as an expert witness in defense of Oprah Winfrey at the infamous "meat defamation" trial.


12 responses to “Should Plant-Based Women Supplement with DHA During Pregnancy?

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  1. Wondering if pregnant vegans can have their DHA levels tested?

    Seems like not waiting until they are pregnant to try to up their levels with increased ALA is what I would be thinking of, but increased DHA synthesis might mean the ALA intake might make that part go faster?

    1. I am thinking of it from reading that ALA increases DHA in 10 months which would be a little too late for pregnancy, but which would be perfect for Breast feeding.

      1. Deb 23 weeks:

        My own experience has been that ALA reduced knee pain just as well as DHA.
        I have no idea if that is applicable to fetal brain development.

  2. Oops, it finally did post. My phone got stuck. Sorry for the duplicate comment.

    Happy Thanksgiving to those who celebrate!

    I celebrate every single day. Being thankful is a benefit!

  3. What is DHA? The convention is to write the name followed by abbreviation. I can’t see what DHA is invthe article.
    It sounds like a oRcel delivery service

  4. And what about vegan children? My daughter is 1 year old, drinking plant-based growth milk not fortified with DHA. Should she get DHA supplement like 100 mg of it daily? (she gets enough ALA from food)

    1. The link won’t post because the coment system here is less than optimal (infuriating is the term I prefer) but if you go to veganhealth.org and fund the ‘daily needs’ page, you will find a table setting out the requirements.

      1. LOL!

        Tom, you make me laugh!

        I commend Dr. Greger and his team for having this free-flow commenting system and I thank you for not banning us.

        1. Dr. Greger,

          You have been so kind to us and people have not always given you the proper treatment back.

          I have been buying things on Amazon for Christmas, just so I can give you smile points. I am thinking they probably don’t give much to you, but, sometimes it is the thought, which has to count for a while.

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