Prenatal DHA: The Complete Guide

Picture of Pregnancy Vitamins with Algal DHA

Summary

  • Yes, Prenatal Vitamins are extremely important.
  • We recommend taking a separate Omega-3 (DHA) supplement in addition to a multivitamin.
  • Prenatal DHA supplements vary widely in quality. The best are algae-based with low (or zero!) mercury content.
  • Our favorite Prenatal DHA is Diet Standards Prenatal DHA on Amazon

The Full Story on Prenatal DHA

When you just find out you’re pregnant, one of the first things your physician tells you about is the importance of taking prenatal vitamins and other supplements, and how it can help improve the outcome of your pregnancy. Recent studies show prenatal supplements help reduce infant morbidity and mortality as well as a variety of maternal pregnancy complications.

One of the supplements recommended by most doctors is Prenatal DHA, the most abundant fatty acid found in the brain and serves to help develop a child’s brain, nerves, and vision. While the studies on prenatal DHA’s benefits are sound, it is to be noted that not all mothers take prenatal DHA supplements and still have a healthy baby.

Do you need prenatal vitamins? Do you or your child need prenatal DHA? Read on to find out.

What are Prenatal Vitamins?

Prenatal vitamins became a popular trend in the past few years due to solid research showing their potential benefits to both the mother and the baby in her womb. These special vitamins are formulated to reduce the risks and complications of childbearing and are considered essential for both mom and baby. [1] They are well-researched to provide benefits and can be the safest choice for a mother to manage her pregnancy period.

Scientists believe there are certain nutrients needed by the developing baby that can’t be met through diet alone. The science is also greatly supported by stories of mothers who took prenatal supplementation and delivered healthy babies compared to those who only relied on diet. [2]

Recent studies have also shown deprivation of omega-3 fatty acids during gestation is linked with visual and behavioral deficits, both of which cannot be fixed with postnatal supplementation.

How do Prenatal Vitamins Benefit Moms?

Prenatal vitamins are usually made of a carefully blended mix of folic acid, iron, calcium, vitamins A, B, C, D, and other minerals. Some also include DHA.

What separates prenatal vitamins from typical multivitamins are the formulations and what the ingredients are made of. Rigorous standards were created with the developing baby as well as the expecting mother in mind, and as a result, companies are designing their prenatal vitamins in the safest and risk-free way possible.

From avoiding the use of artificial colors and preservatives to investing more in natural ingredients, rest assured reputable prenatal vitamins are safe for you and your baby. Below are some of the nutrients you should consider taking.

1. DHA

Docosahexaenoic acid (DHA) is a type of Omega-3 and the most abundant fatty acid in the brain. DHA is abundant in seafood particularly anchovies, mackerel, salmon, herring, and some species of trout. Studies suggest adequate DHA intake during pregnancy helps prevent preterm labor and postpartum depression. [3, 4]

Higher concentrations of DHA in mothers’ milk and greater seafood consumption both predicted lower prevalence rates of postpartum depression in simple and logarithmic models, respectively.

Consensus guidelines recommend at least 200 mg per day for healthy brain development in the womb. [5]

2. Flaxseed Oil

Many people associate flaxseed oil to have the same Omega-3 as fish. While fish have DHA, what flaxseed offers is a shorter-chain Omega-3 called Alpha-linolenic acid or ALA. ALA cannot be utilized by the body and is therefore converted into EPA (eicosapentaenoic acid) and DHA first. The amount of ALA that’s actually converted to EPA and DHA is rather low at a range of 5-15%. [6, 7]

3. Iron

Iron is among the many “must-haves” of any prenatal vitamin product. It acts as a building block for the baby’s cells and supports the baby’s oxygen and nutrient transport mechanism.

Pregnant mothers also need fifty percent more blood than normal. Iron produces hemoglobin, a primary component of red-blood cells which justifies the need for iron supplementation during pregnancy. Othe benefits include improved anemia and immune system maintenance.

4. Calcium

Calcium is known for its benefits to bones and teeth, but as a prenatal supplement calcium is more about the health of the mother than it is the baby. Not just for maintaining the mom’s bones and muscles, it helps prevent heartburn and even pre-eclampsia, [8] a condition where the mom is hypertensive due to a protein “leak” from the kidneys that flows into the uterus that is dangerous for fetal development.

5. Folic Acid

Perhaps one of the most important supplements a woman, especially a pregnant woman, could ever use. It can improve fertility, support brain development, and prevent neural tube defects.

Other Vitamins and Minerals

  • Vitamin B6 provides relief from nausea and vomiting during the first few days of pregnancy. [9]
  • Vitamin C helps rebuild tissues and repair brittle bones that could have depreciated during fetal expansion.
  • Vitamin D supports fetal bone and teeth development by merging with calcium. Adequate intake also prevents pre-eclampsia. [10]
    • The intended intervention (i.e., prescription of vitamin D) has a protective effect against recurrent preeclampsia. Vitamin D supplementation therapy in pregnancy could help in reducing the incidence of gestational hypertension/preeclampsia.
  • Zinc promotes cell growth and improves the immune system which are both important for the mother and baby. In fact, the mineral is so critical a maternal zinc deficiency can lead to pregnancy complications such as structural birth defects, low birth weight, immunological abnormalities after birth, and even fetal death. [11]

Why DHA is Critical During Pregnancy

As mentioned, DHA is important when it comes to proper fetal brain development as well as prevention of pre term labor and postpartum depression. DHA is mainly sourced from the fats of oily fish and seafood together with EPA.

Benefits of DHA

More than its pregnancy-related benefits, DHA (as a form of Omega 3) reduces risk of allergens as well as many other diseases through its anti-inflammatory properties. It’s also particularly good for overall cardiovascular and neurological health in older adults. [12, 13]

Omega-3 fatty acid consumption has been associated with improved cardiovascular function in terms of antiinflammatory properties, peripheral arterial disease, reduced major coronary events, and improved antiplatelet effects in the face of aspirin resistance or clopidogrel hyporesponsiveness.

Benefits of EPA

Though similar in source, health benefits, and structure, EPA is a whole other form of omega-3.

EPA’s strength lies in its ability to mitigate cellular inflammation. It works by preventing eicosanoid production through arachidonic acid (AA) inhibition. Eicosanoids are produced from AA which is sourced from animal fats. Eicosanoids play a big role in inflammation and fever promotion, two health issues that force us to visit the doctor’s office. So basically, the more EPA you have in your diet, the less AA you produce. The less AA you produce, the lower the risk of inflammation.

On top of inhibiting inflammation (which is already a huge benefit), EPA is also superior to DHA when it comes to treating brain-related issues such as depression, brain trauma, ADHD, and even Alzheimer’s Disease. [14 – 16]

Sources of DHA and EPA in Diet

While flaxseed, soybean, and canola oils technically supply omega-3, we reiterate that the ALA to EPA & DHA conversion is inefficient. To get the best source, you have to focus on fish and seafood sources. Good dietary sources include salmon, tuna, herring, sardines, and mackerel. Farmed fish can also have higher levels of EPA & DHA compared to their wild counterparts, but it entirely depends on the food they are fed. [17, 18]

Below are the top 20 foods high EPA, and DHA according to the USDA. Click here for the full report.

Click to enlarge

The recommended intake of omega 3s (both DHA & EPA) are:

  • 1.1 g for females aged 19 and above;
  • 1.4 g during pregnancy;
  • and 1.3 g during lactation.

“I get what Omega-3 is, but what about Omega-6?”

That’s a really great question. Omega-3 and Omega-6 are essential fatty acids, meaning the body is unable to produce its own and requires dietary intake.

Omega-3s are a type of polyunsaturated fatty acid, which means it contains more than one double bond in its chemical structure. The number “3” refers to the location the first double bond occurs in the structure. The three omega-3s are DHA, EPA, and ALA.

Omega-3s are awesome for your cells and plays a critical role in reducing inflammation which can lead to lower risks of cancers, heart disease, and osteoporosis. Omega-3s also stimulate hair and skin growth which is why it is recommended as a prenatal supplement.

Omega-6s are also a type of polyunsaturated fatty acid that has similar benefits to Omega-3 when it comes to the brain, bone, and reproductive health. It’s been shown to help reduce diabetic neuropathy, rheumatoid arthritis, and even some allergies. [19] It’s also shown to help reduce the risk of heart disease by lowering LDL cholesterol while increasing HDL cholesterol. [20]

So what’s the difference between Omega-3 and Omega-6 aside from their chemical structure?

Just two: Their sources and the amount your body can tolerate.

As mentioned earlier, Omega-3s are mostly sourced from fish and seafood. There are other plausible sources, but the amount of Omega-3 you get from other sources is much, much smaller per serving. Omega-6s, on the other hand, are much more abundant, with a lot of its sources coming in the form of vegetable oils, dairy and eggs, red meat and poultry, and even fast food items such as popcorn, onion rings, and french fries.

Researchers confirm it’s almost impossible to have too much. In fact, most American adults don’t even meet the right amount of Omega-3 their body needs unless they supplement. When it comes to Omega-6, though, it’s entirely too easy to have too much of it. [21]

Too much Omega-6 increases inflammation as well as being linked to depression. This is why supplementing with Omega-3 is recommended for those who eat a typical Western diet as it helps balance the ratio and therefore reduce the side effects. [22]

Increases in the ratio of n-6 : n-3 PUFA, characteristic of the Western diet, could potentiate inflammatory processes and consequently predispose to or exacerbate many inflammatory diseases. The change in ratio and increase in n-6 PUFA consumption changes the production of important mediators and regulators of inflammation and immune responses towards a proinflammatory profile.

Prenatal Multivitamin + Prenatal DHA

Prenatal Multivitamins and Prenatal DHA are good for you, but taking one over the other will not yield the same benefits for you and your baby. A Prenatal Multivitamin contains a lot of vitamins and minerals that benefit you and your baby. However, it may not provide a good amount of DHA hence the necessity of taking prenatal DHA.

How do I take Prenatal DHA?

A prenatal DHA can be taken the same way you take other multivitamins (one capsule before or after a meal, etc.), but your doctor may specify otherwise.

When should I take Prenatal DHA?

High quality prenatal supplementation should begin before and during pregnancy as well as during the breastfeeding stage. Women should allow at least six months before conceiving to build up the necessary DHA. Not to mention multiple pregnancies can deplete the mother’s stored DHA.

How do nutrients get inside the baby while still in the womb?

Nutrients get inside the baby with the help of the mother’s blood circulation, the placenta, the umbilical cord, and the baby’s own circulation. All nutrients must pass through the placenta and all of the unnecessary metabolites are removed through the placenta and the mother’s liver and kidneys. You can say the placenta plays the role of kidney, gut, and liver for the baby.

When it comes to breastfeeding, the mother’s diet has little to do with the quality of the milk than it has on the body of the mother. The magical thing about breast milk is its composition varies according to the baby’s needs, especially during the first month. [23]

What happens when you take too much DHA?

While getting too much DHA is almost impossible with dietary sources alone, supplementation can definitely spike the daily intake. One of the known risks includes blood thinning which could result in excessive bleeding in delivery. Other possible side effects include headaches, nausea, dizziness, and even vomiting although it’s to be noted these are mostly anecdotal.

To date, most physicians recommend at least 300 mg DHA per day although some studies indicate 1000 mg per day is harmless to the child. [24] For reference, the FDA recommends not exceeding 3,000 mg EPA & DHA combined for adults.

The real issue with overdosing on DHA is not DHA itself, but where it’s sourced from and how it was processed. When taking DHA supplements, make sure it’s molecularly distilled or sourced from originatinating algae. If not, your supplement could contain trace amounts of environmental pollutants such as mercury which can adversely affect the child.

Types of Prenatal DHA

Prenatal DHA products may be the same in structure, but not in source. We all know the typical marine source of DHA, but even the fish and seafood are unable to produce their own DHA. So, where does DHA really come from? The answer to that is algae. No, not the algae that make the flaxseed-type of Omega-3, but the microscopic one that is responsible for creating DHA itself.

The DHA food chain goes like this:

  1. We start with algae, which is then consumed by other organisms, such as krill.
  2. Krill are then consumed by a larger fish, like tuna.
  3. Finally, much higher up the food chain are larger fish such as squid, and other apex predators.
  4. By the time you get up the chain to fish, these animals have accrued DHA and EPA stores in their fat due to having directly or indirectly eaten algae.

Okay, so we understand how we source DHA, but what about people who prefer to source their nutrients from plants? Well, for that we go to the source which is the algae and extract what we call algae oil.

Algae Oil: The Vegetarian DHA

Algae oil is the oil derived directly from algae. This type of algae can be farm-raised and provide sustainable vegetarian, kosher, and organic DHA. The algae-derived DHA, or commonly referred to as algae oil, is now added to some of our food make sure we acquire enough omega-3s in our diet in a more sustainable and so much more humane way. [25]

Algae oil is also known to be contaminant-free when raised in a clean farm. This eliminates the possibility of ingesting compounds like mercury unlike when eating fish. How does mercury get into our fish anyway? Below is what we call the Mercury Food Chain.

  1. Methylmercury is pumped into waters through coal plants, mines, and even natural sources such as volcanoes.
  2. All fish absorb some of this mercury, but its levels are still safe for the human body to eat. However, the problems come when a larger fish eats a smaller fish and then that larger fish gets both his and its food’s amount of mercury.
  3. Then comes along a larger predator that then eats that fish and absorbs both of the previous fish’s mercury levels, on top of its own.
  4. This continues up all the way to apex predators like swordfish and shark. Both of those creatures have extreme levels of mercury.

As you can see, the Mercury Food Chain is a lot like the DHA Food Chain except with pollutants in between. Consuming algae oil from farms help prevent this polluted chain from interfering with our health.

Protip: You can check the FDA’s official table on fish and mercury content right here.

Fish oil and Algae oil: Advantages and Disadvantages

Fish oil’s main advantage is its current abundance and popularity in the market. This abundance makes it affordable and easier to manufacture. Its main disadvantage is it spoils, may contain contaminants such as mercury and lead, there is the risk of overfishing, and of course its taste and smell.

Algae oil’s highlights include no moral arguments with regards to its sourcing, can be enjoyed by both omnivores and vegans, much more environmentally sustainable, and has no contaminants when grown in a clean environment. Its primary disadvantage is its rarity which translates to a higher price point.

Choosing the Best DHA Supplement

Before we go over what we recommend as the best DHA supplement, it’s important to note how you should ingest DHA in your system.

  1. Take them with food. All Omega 3 supplements are much more bioavailable if you take them as soon as you’re done eating a fatty meal. This is due to how oils are difficult to break down. Eating a meal, which contains at least a bit of fat, will trigger bile discharge from the gallbladder. This will then help the retention of the Omega 3 fats.
  2. As oil or as a capsule. We got nothing against people who like the rather strong fishy taste, but it’s not easy to get omega-3 oil as oil. Even flaxseed oil is quite unpleasant when taken raw. However, you do get the benefit of absorbing the omega-3 quicker than you would have with a capsule and they’re also way cheaper. The only problem is you’ll have to deal with “fishy reflux” or “fish burps” which aren’t exactly pleasant to both user and the people around them. If you’re a fan of fish oil, but hate the smell or aftertaste, you’re better off with a high quality capsule brand.
  3. Don’t double the dose. Most people think skipping a dose means they have to double up on the next one. When this happens, you should just stick with your regular dosage as doubling it may cause unwanted side effects.

When you’re done with your DHA supplement, make sure to store them in the fridge or at room temperature to make sure they don’t become rancid.

What to look for in a Prenatal DHA

There isn’t one best prenatal DHA. What works best for thousands of people may not work best for you, but you can narrow down the results according to their quality, sourcing, and potency.

  1. Trusted brand name. As with all types of supplements, it’s important to try and search for trusted brands so to have security over the quality of the product. Not only that, but you’re also buying something for a baby so don’t hesitate to spend a bit more for your child.
    • You should also consider brands that guarantee “no fish burps.”
  2. Essential nutrients. A nutritious diet should already provide you with 70-80% of vitamins, minerals, and essential oils you and your baby need. With that said, there are benefits to supplementing as we laid out earlier and it’s important to note not just the nutrients in the supplement, but also their dosage. For DHA, you should opt for a supplement to contain at least 300 mg per serving.
    • It’s worth noting that vegetarians or vegans may have to consult with a physician to determine which nutrients should they be getting more of in a product.
  3. Source of DHA. Fish-derived DHA will always be cheaper than ones from algae, but perhaps even non-vegans should consider algae-sourced DHA due to their purity as well as environmental sustainability.
    • Some non vegan DHA supplements may get their source from fish that contain high levels of mercury. If enough mercury gets in your baby’s system it may cause irreversible brain damage, delays in walking and talking, poor memory and attention span, and sensory problems.

Why is Diet Standards Prenatal DHA better than others?

When it comes to Prenatal DHA, nothing beats Diet Standards Prenatal DHA.

Here are what makes Diet Standards Prenatal DHA superior to the competition:

  • Algae sourced.
  • Vegan softgels
  • Offers 825 mg of Omega-3s per serving
  • One serving contains 450 mg DHA and 225 EPA
  • Zero allergens (fish, egg, gluten, soy, milk, nuts) and zero contaminants
  • They submit to 3rd party lab tests and posts the results on their website.

Got to this link so you can order now.

Summary

  • Yes, Prenatal Vitamins are extremely important.
  • We recommend taking a separate Omega-3 (DHA) supplement in addition to a multivitamin.
  • Prenatal DHA supplements vary widely in quality. The best are algae-based with low (or zero!) mercury content.
  • Our favorite Prenatal DHA is Diet Standards Prenatal DHA on Amazon

References:

  1. Imhoff-Kunsch B, Stein AD, Martorell R, Parra-Cabrera S, Romieu I, Ramakrishnan U. Prenatal Docosahexaenoic Acid Supplementation and Infant Morbidity: Randomized Controlled Trial. Pediatrics. 2011;128(3):e505-e512. doi:10.1542/peds.2010-1386.
  2. Newman V, Lyon RB, Anderson PO. Evaluation of prenatal vitamin-mineral supplements. Clin Pharm. 1987;6(10):770-7.
  3. Hibbeln JR. Seafood consumption, the DHA content of mothers’ milk and prevalence rates of postpartum depression: a cross-national, ecological analysis. J Affect Disord. 2002;69(1-3):15-29.
  4. Sontrop J, Avison WR, Evers SE, Speechley KN, Campbell MK. Depressive symptoms during pregnancy in relation to fish consumption and intake of n-3 polyunsaturated fatty acids. Paediatr Perinat Epidemiol. 2008;22(4):389-99.
  5. Koletzko B, Lien E, Agostoni C, et al. The roles of long-chain polyunsaturated fatty acids in pregnancy, lactation and infancy: review of current knowledge and consensus recommendations. J Perinat Med. 2008;36(1):5-14.
  6. Brenna JT. Efficiency of conversion of alpha-linolenic acid to long chain n-3 fatty acids in man. Curr Opin Clin Nutr Metab Care. 2002;5(2):127-32.
  7. Gerster H. Can adults adequately convert alpha-linolenic acid (18:3n-3) to eicosapentaenoic acid (20:5n-3) and docosahexaenoic acid (22:6n-3)?. Int J Vitam Nutr Res. 1998;68(3):159-73.
  8. Hofmeyr GJ, Roodt A, Atallah AN, Duley L. Calcium supplementation to prevent pre-eclampsia–a systematic review. S Afr Med J. 2003;93(3):224-8.
  9. Babaei AH, Foghaha MH. A randomized comparison of vitamin B6 and dimenhydrinate in the treatment of nausea and vomiting in early pregnancy. Iranian Journal of Nursing and Midwifery Research. 2014;19(2):199-202.
  10. Behjat Sasan S, Zandvakili F, Soufizadeh N, Baybordi E. The Effects of Vitamin D Supplement on Prevention of Recurrence of Preeclampsia in Pregnant Women with a History of Preeclampsia. Obstetrics and Gynecology International. 2017;2017:8249264. doi:10.1155/2017/8249264.
  11. Uriu-adams JY, Keen CL. Zinc and reproduction: effects of zinc deficiency on prenatal and early postnatal development. Birth Defects Res B Dev Reprod Toxicol. 2010;89(4):313-25.
  12. Swanson D, Block R, Mousa SA. Omega-3 Fatty Acids EPA and DHA: Health Benefits Throughout Life. Advances in Nutrition. 2012;3(1):1-7. doi:10.3945/an.111.000893.
  13. Dyall SC, Michael-titus AT. Neurological benefits of omega-3 fatty acids. Neuromolecular Med. 2008;10(4):219-35.
  14. Bloch MH, Qawasmi A. Omega-3 Fatty Acid Supplementation for the Treatment of Children with Attention-Deficit/Hyperactivity Disorder Symptomatology: Systematic Review and Meta-Analysis. Journal of the American Academy of Child and Adolescent Psychiatry. 2011;50(10):991-1000. doi:10.1016/j.jaac.2011.06.008.
  15. Song C, Shieh CH, Wu YS, Kalueff A, Gaikwad S, Su KP. The role of omega-3 polyunsaturated fatty acids eicosapentaenoic and docosahexaenoic acids in the treatment of major depression and Alzheimer’s disease: Acting separately or synergistically?. Prog Lipid Res. 2016;62:41-54.
  16. Martins JG. EPA but not DHA appears to be responsible for the efficacy of omega-3 long chain polyunsaturated fatty acid supplementation in depression: evidence from a meta-analysis of randomized controlled trials. J Am Coll Nutr. 2009;28(5):525-42.
  17. Miller MR, Nichols PD, Carter CG. n-3 Oil sources for use in aquaculture–alternatives to the unsustainable harvest of wild fish. Nutr Res Rev. 2008;21(2):85-96.
  18. Cladis DP, Kleiner AC, Freiser HH, Santerre CR. Fatty acid profiles of commercially available finfish fillets in the United States. Lipids. 2014;49(10):1005-18.
  19. Perez-Matos MC, Morales-Alvarez MC, Mendivil CO. Lipids: A Suitable Therapeutic Target in Diabetic Neuropathy? Journal of Diabetes Research. 2017;2017:6943851. doi:10.1155/2017/6943851.
  20. Sobczak S, Honig A, Christophe A, et al. Lower high-density lipoprotein cholesterol and increased omega-6 polyunsaturated fatty acids in first-degree relatives of bipolar patients. Psychol Med. 2004;34(1):103-12.
  21. Papanikolaou Y, Brooks J, Reider C, Fulgoni VL. U.S. adults are not meeting recommended levels for fish and omega-3 fatty acid intake: results of an analysis using observational data from NHANES 2003–2008. Nutrition Journal. 2014;13:31. doi:10.1186/1475-2891-13-31.
  22. Patterson E, Wall R, Fitzgerald GF, Ross RP, Stanton C. Health Implications of High Dietary Omega-6 Polyunsaturated Fatty Acids. Journal of Nutrition and Metabolism. 2012;2012:539426. doi:10.1155/2012/539426.
  23. Ballard O, Morrow AL. Human Milk Composition: Nutrients and Bioactive Factors. Pediatric clinics of North America. 2013;60(1):49-74. doi:10.1016/j.pcl.2012.10.002.
  24. Kobayashi M, Ogawa K, Morisaki N, Tani Y, Horikawa R, Fujiwara T. Dietary n-3 Polyunsaturated Fatty Acids in Late Pregnancy and Postpartum Depressive Symptom among Japanese Women. Frontiers in Psychiatry. 2017;8:241. doi:10.3389/fpsyt.2017.00241.
  25. Adarme-Vega TC, Lim DKY, Timmins M, Vernen F, Li Y, Schenk PM. Microalgal biofactories: a promising approach towards sustainable omega-3 fatty acid production. Microbial Cell Factories. 2012;11:96. doi:10.1186/1475-2859-11-96.