Should Vegan Women Supplement with DHA during Pregnancy?

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I recommend all pregnant and breastfeeding women follow the consensus guidelines to get about 200mg of preformed DHA from a pollutant-free source.

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A systematic review of randomized controlled trials of DHA supplementation of pregnant and breast-feeding women failed to find any clear and consistent short or long-term benefit for psychomotor, mental, visual, or physical development.

Maybe DHA supplementation during pregnancy had no effect because the body isn’t stupid and 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 maybe women with very low intakes would benefit. Well first, it’s interesting to note that even by 1978 researchers were suggesting plant-based diets as the diets of choice in the treatment of our number one killer, but babies breastfed by vegan moms had significantly less DHA in their bloodstreams, presumably because they had significantly less DHA in their breastmilk.

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

It would be interesting to compare the function of babies getting vegan breast milk levels versus general population levels. You can see vegans had 14,  vegetarians 30, and omnivores 37. This study compared zero to 32, 64, and 96, and 32 worked better than zero, but 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 down at that level show no advantage over zero, though one study found a benefit supplementing at as low as 5, but that doesn’t help us.

Now, 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 these new data suggest that some infants may not be getting enough and could benefit from their moms supplementing; and so, I recommend pregnant and breast-feeding women on plant-based diets do 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 see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Katie Schloer.

Please consider volunteering to help out on the site.

Images thanks to Bollepret via pixabay. Image has been modified.

A systematic review of randomized controlled trials of DHA supplementation of pregnant and breast-feeding women failed to find any clear and consistent short or long-term benefit for psychomotor, mental, visual, or physical development.

Maybe DHA supplementation during pregnancy had no effect because the body isn’t stupid and 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 maybe women with very low intakes would benefit. Well first, it’s interesting to note that even by 1978 researchers were suggesting plant-based diets as the diets of choice in the treatment of our number one killer, but babies breastfed by vegan moms had significantly less DHA in their bloodstreams, presumably because they had significantly less DHA in their breastmilk.

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

It would be interesting to compare the function of babies getting vegan breast milk levels versus general population levels. You can see vegans had 14,  vegetarians 30, and omnivores 37. This study compared zero to 32, 64, and 96, and 32 worked better than zero, but 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 down at that level show no advantage over zero, though one study found a benefit supplementing at as low as 5, but that doesn’t help us.

Now, 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 these new data suggest that some infants may not be getting enough and could benefit from their moms supplementing; and so, I recommend pregnant and breast-feeding women on plant-based diets do 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 see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Katie Schloer.

Please consider volunteering to help out on the site.

Images thanks to Bollepret via pixabay. Image has been modified.

Doctor's Note

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.

What about taking long-chain omega-3s to protect our heart? See:

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

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