Maternal-infant health experts call government guidelines overly restrictive, and counterproductive
by Craig Weatherby
Last February, we reported the findings of a study in Britain, which indicated that the benefits of fish to pregnant/nursing women and infants far outweigh the risks of mercury in seafood (See “Findings Verify Safety and Value of Higher Maternal Fish Intake”).
Those findings received strong support last Thursday, when doctors and public health experts announced higher fish-intake recommendations for pregnant/nursing women.
- A major maternal-child health group advises pregnant and nursing mothers to eat more fish than is recommended by US government agencies.
- Group cites evidence of benefit from omega-3s in fish, and no evidence of harm from traces of mercury.
- New advice fits with findings of recent studies and evidence reviews.
- Women who don't like fish can take fish oil instead.
The new advice comes from the Maternal Nutrition Group (MNG)—comprised of leading professors of obstetrics and nutrition—and the Directors of the National Healthy Mothers, Healthy Babies Coalition (HMHB).
The big news was that the intake recommendations for young children and for women who are pregnant or nursing (or are trying to become pregnant) exceed the intake limits advised by the US government.
Advisories issued by the US FDA and EPA in 2004 for mothers and children counseled a maximum of 12 ounces of fish or seafood per week (This is the amount in three normal servings of fish or shellfish).
In contrast, the “Healthy Mothers” guidelines issued last week by maternal health experts recommend a minimum of 12 ounces per week.
The doctors and researchers of the Maternal Nutrition Group concluded that eating fish is the optimal way to gain the benefits of long-chain omega-3 fatty acids (DHA and EPA), which are known to play a key role in brain and eye development.
As they said, “Ocean fish, including salmon, tuna, sardines and mackerel, are natural sources that meet the need for DHA and EPA in pregnancy and provide a lean protein source with important micronutrients like vitamins B, D, zinc, iodine and selenium” (Maternal Nutrition Group 2007).
The HMHB press release included this quote from Maternal Nutrition Group member (and mother) Ashley S. Roman, MD, MPH, assistant professor of Obstetrics & Gynecology at the New York University Medical Center:
“The Group... found a link between ocean fish consumption and advanced cognitive and motor skill development in children. Some data also shows a connection with reduced pre-term labor and post-partum depression in mothers who ate ocean fish when pregnant” (HMHB 2007).
US agencies’ advice yield counterproductive consequences
When the US FDA and EPA advised expectant and nursing mothers to limit fish or seafood intake to three servings per week, the guidance confused or frightened many.
The results of a study conducted this year at the Medical University of South Carolina (MUSC) indicate that awareness of the FDA/EPA advisory caused 56 percent of pregnant women to needlessly lower their fish consumption to levels well below the beneficial minimums.
What is the Healthy Mothers, Healthy Babies Coalition?
The Coalition, founded in 1981, encompasses six mainstream health advocacy and research organizations:
- The American College of Obstetricians and Gynecologists (ACOG)
- The March of Dimes
- The American Academy of Pediatrics (AAP)
- The American Nurses Association (ANA)
- The National Congress of Parents Teachers
- The US Public Health Service.
As the HMHB press release acknowledged: “Any statement that is supported by the HMHB Board in no way implies that it has been endorsed by our member organizations.”
In addition, an HMHB Coalition survey found that 53 percent of women who were pregnant for the first time reported eating less fish because of warnings about mercury.
As Dr. Roman told the media, “We found that the FDA/EPA advisory was scaring a large number of women away from eating any fish. There is scientific evidence that fish leads to better outcomes in babies. Studies have shown that if you eat 12 ounces or more fish per week, you are doing better for your baby than if you eat less than that amount or no fish at all” (Reinberg S 2007).
Mercury fears seen as highly exaggerated
Dr. Roman told The Washington Post that fish intake in pregnancy has never been linked with mercury toxicity in fetuses or newborns (Squires S 2007).
This point was echoed by Gary J. Meyers, M.D. professor of neurology and pediatrics at the University of Rochester Medical Center. As he said, the only time fish-borne mercury has caused detectable harm was the case of extreme industrial contamination of fish in Minimata, Japan (Reinberg S 2007).
Dr. Meyers led a large, well-designed, long-term study of the effects of fish-borne mercury on children. It is still ongoing in the Seychelles Islands where mothers and children eat about 12 times more fish than their American counterparts, and have shown no evidence of harm.
(See “Fight Over Mercury Risks Muddied by Bad Science.”)
Seafood is the richest dietary source of DHA and EPA in Americans’ diets. And the Group also recognized—as we’ve reported—that selenium, an essential mineral abundant in most ocean fish, accumulates in fish consumers and appears to protect against the toxicity from trace amounts of mercury (See “Mercury-Fighting Mineral in Fish Overlooked in Heated Debate”).
Other omega-3 options
Fish oil supplements provide a perfect supplemental or alternative omega-3 source for pregnant and nursing women who don't favor fish.
Earlier this year, the European Commission recommended that pregnant and nursing women get at least 200 mg of DHA every day, using fish oil supplements to ensure the dose. This is the amount provided in three of our certified-pure Salmon Oil capsules.
After fatty fish and fish oil supplements, the best source is eggs from chickens raised on feed high in omega-3 DHA, which usually contain 100 or 200 mg per egg.
Women can and should also get omega-3s from leafy greens, which are broadly healthful as well. However, the short-chain omega-3s in plant foods are not nearly as useful to the body or to developing fetuses and infants, and occur in small amounts, making them poor choices as primary sources of omega-3s. The richest sources of short-chain omega-3s are flaxseed and flaxseed oil.
Why Ocean Fish Consumption is Critical During Pregnancy
The following is an unedited excerpt from the Maternal Nutrition Group’s paper, titled Seafood Recommendations During Pregnancy:
“A critical concern regarding the typical American diet that has a great impact on maternal nutrition is the suboptimal intake of long-chain omega-3 essential fatty acids. Long-chain omega-3 fats cannot be synthesized in adequate amounts during periods of rapid fetal growth and development. “
“Therefore, optimal levels must be maintained through consumption of dietary sources, such as fish, that are rich in EPA and DHA. DHA is concentrated in nerve cell membranes and is essential for development of the fetal nervous system. The majority of DHA accumulates in the fetal brain during late prenatal and early postnatal development.”
“Research studies have concluded that potential benefits from DHA in pregnancy for the developing fetus include improved visual, cognitive, motor and behavioral skills in the newborn that have been shown to last into childhood and may impact lifelong health and mental capacity.”
“Ocean fish is the richest dietary source of EPA and DHA; thus, it is a highly beneficial food during pregnancy and postpartum.”
“Breast milk is the richest source of DHA for the infant and its adequacy is dependent on maternal levels of DHA. As in pregnancy, long-chain omega-3 fats are not synthesized in adequate amounts during the post-partum and breastfeeding period, so a diet rich in DHA is highly desirable. Furthermore, higher DHA intake has been linked to a reduction in preterm birth, as well as the prevention and management of postpartum depression.
- Maternal Nutrition Group. Seafood Recommendations During Pregnancy. Accessed online October 7, 2007 at http://www.brainybabieshealthykids.org/seafood-recommendations-for-pregnancy/
- HMHB (National Healthy Mothers, Healthy Babies Coalition). For Pregnant Women, Benefits of Eating Ocean Fish Outweigh Concerns from Trace Levels of Mercury: Experts in Obstetrics and Nutrition Unveil Seafood Consumption Recommendations During Pregnancy. Accessed online October 7, 2007 at http://www.hmhb.org/oceanfishpr.html
- Reinberg S. Fish Safe for Pregnant Women to Eat. Accessed online October 7, 2007 at http://health.msn.com/pregnancykids/articlepage.aspx?cp-documentid=100171470
- Squires S. Advisory at Odds With FDA Stance. Washington Post. Accessed online October 7, 2007 at http://www.washingtonpost.com/wp-dyn/content/article/2007/10/03/AR2007100301278.html