Eating and nutrition

• It’s important to eat a healthy diet during pregnancy.
• You also need plenty of vitamins and minerals in your diet.
• Most pregnant women need around 300 extra calories per day.

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It's very important for pregnant moms to eat a healthy diet. During pregnancy, your baby gets many of the nutrients she needs from the foods you eat and the vitamins you take. One of the essential nutrients moms need is omega-3 fatty acids.

Types of omega-3 fatty acids
There are three major omega-3 fatty acids:

• Alpha-linolenic acid (ALA)
• Eicosapentaenoic acid (EPA)
• Docosahexaenoic acid (DHA)

Each omega-3 fatty acid performs different functions. ALA is the parent omega-3 and cannot be produced by the body. It must be gotten through foods such as walnuts and soybeans. Our bodies can convert small amounts of ALA into EPA and then into DHA, but this process is not efficient. Research shows that the body converts only 5 to 10 percent of ALA into EPA and even less into DHA.

The best way to get enough EPA and DHA is to eat foods rich in these important nutrients. But only a few foods contain DHA and EPA. Fatty fish and organ meats (such as calf's liver) are the primary dietary sources.

Benefits of omega-3 fatty acids

Adults
Omega-3 fatty acids can improve a person's health. Studies show that omega-3s, specifically DHA and EPA, lower blood pressure and help us maintain heart health. EPA and DHA also help reduce risk factors for heart disease, such as high cholesterol and clogged arteries. They may reduce the risks of heart attacks and strokes. DHA is also important to brain health throughout life.

During pregnancy and breastfeeding
For pregnant and nursing women, omega-3 fatty acids, particularly DHA, are important for the health of mom and baby. DHA is the most common omega-3 in the brain and eyes. It helps to support a baby's brain and eye development and function. Women should get at least 200 milligrams of DHA every day.

How to get omega-3 fatty acids
DHA and EPA omega-3s can be found in fatty fish, algae oil, fish oil and certain fortified foods such as milk, juice, bread and yogurt. But pregnant moms need to be careful about the kinds of fish they eat. Some fish are high in mercury, which can harm an unborn baby. Other fish are safe when eaten in recommended amounts. ALA can be found in walnuts and vegetable oils like canola, soybean and olive oil.

Fish are sources of DHA because of what they eat in the wild. Farm-raised fish may not contain DHA unless they are fed a diet rich in DHA.

Expecting moms can safely eat up to a total of 12 ounces per week of salmon, herring, sardines or fresh-water trout. These wild fish are good sources of DHA (and EPA) and can help pregnant women get enough DHA. Women can also get DHA from albacore tuna (white tuna), but should limit themselves to just 6 ounces per week of this fish during pregnancy. Women who do not want to eat fish can look for vegetarian sources of DHA, such as fortified foods.

If you're not getting enough DHA from food, another option is to take a supplement containing at least 200 mg of DHA. Several prenatal supplements include DHA, either from fish oil or other sources. As with all supplements, talk to your health provider beforehand to make sure this choice is right for you.

Fish oil products have some health risks. Before taking any of these products, talk to your health care provider.

• Fish oil taken over many months can cause a person to have too little vitamin E. So vitamin E is added to many fish oil products. Prenatal vitamins often also contain vitamin E. Because use of vitamin-E enriched products can lead to high levels of this vitamin, pregnant women should be careful about the amount of vitamin E they consume.
• Omega-3 fatty acids and fish oil increase the risk of bleeding, such as nosebleeds and blood in the urine.
• Fish liver oils, such as cod liver oil, contain vitamins A and D. Taking this oil may lead to dangerously high levels of these vitamins.

Flaxseed is a source of omega-3 fatty acids. But some medical experts recommend that women avoid flaxseed and flaxseed oils during pregnancy or while breastfeeding. Some animal studies have shown that flaxseed can be harmful during pregnancy. Little research has been done in humans. But because we know so little, it's wise to avoid flaxseed if you are pregnant or breastfeeding.

May 2009/March 2010

Funding for this article was provided in part by Martek. The March of Dimes does not endorse specific brands or products.