Omega-3 Benefits: Omega-3, Pregnancy and Breast-Feeding

Omega-3 Benefits for Women during Pregnancy and Breast-feeding

In humans, the most critical stages in the formation of the brain structure (synaptogenesis and myelination) take place between weeks 32 and 40 of gestation and continue until 2 years after birth. In this period, mother and child are particularly vulnerable to a deficiency or excess of certain nutrients (14) such as long-chain polyunsaturated acids (LC-PUFA) and folic acid, involved in intrauterine growth, post-natal development and childhood diseases.(5,7)

Infant development of the brain and eye and Omega-3

Docosahexaenoic acid (omega-3 DHA) deficiency in the brain during development can cause a deficit in neurogenesis, the metabolism of neurotransmitters and alterations in learning and visual function in animals (4). 
During pregnancy, LC-PUFAs are transferred to the foetus through the placenta, given that, although the foetus and newborn are able to synthesise them from precursors, foetal liver activity is still physiologically immature and omega-3 DHA synthesis from alpha-linolenic acid appears to be insufficient to provide the amount required by the foetus and newborn.(8) 
Therefore the main source of LC-PUFA for the foetus is provided by the mother,(9) both through the placenta and during breastfeeding. Thus, if the mother consumes an adequate amount of PUFA with an adequate Omega-6/Omega-3 ratio, she can provide the foetus, through the placenta, or the newborn, through breast milk, with the LC-PUFAs (especially omega-3 DHA) needed for normal development of the nervous system. 
In premature children, the maternal supply of LC-PUFAs is interrupted early, leading to short- and long-term consequences.(10) 
An inadequate diet in gestating or breast-feeding mothers can lead to a lack of nutrients. Plasma omega-3 DHA levels can drop to 50% after a single pregnancy and not return to normal levels until 26 weeks after birth.(11-15) The greater the number of pregnancies, the greater the drop in maternal, plasma and breast-milk omega-3 DHA levels.(14) In experimental models, when animals were fed on a diet low in Omega-3 LC-PUFA, the omega-3 DHA content of brain phospholipids decreased by approximately 25% after a single reproductive cycle (pregnancy and breastfeeding). (16, 17) This reduction could be reversed through subsequent treatment with DHA (18), but it is not known if the restoration of brain fatty acid composition reverses the neurological changes caused by the loss of omega-3 DHA.

Protection during pregnancy

Ingestion of omega-3 DHA during pregnancy has been related to longer gestation and higher weight at birth, with a lower risk of premature birth, pre-eclampsia and post-natal depression (19).
Various clinical and epidemiological studies suggest that the changes in Omega-3 LC-PUFA levels associated with pregnancy contribute to the development of post-natal depression. A transnational study showed that high fish consumption (leading to higher concentrations of omega-3 DHA in breast milk) was correlated with a lower incidence of post-natal depression.(20) Depression during pregnancy was associated with a diet low in fish and other sources of Omega-3 LC-PUFA. (21,22) Significantly lower plasma and serum concentrations of omega-3 DHA or the DHA-DPA (Omega-6 docosapentaenoic acid) have been observed in women with symptoms of depression during the post-natal period, compared to those with higher levels (23, 24). Also, lower post-natal serum concentrations of omega-3 DHA have been observed in women who subsequently developed depression compared to those who did not.(25) Women with more than one child or periods of less than 24 months between pregnancies had a higher risk of developing post-natal depression,(26, 27) which is consistent with a potentially greater alteration in Omega-3 LC-PUFA levels after several pregnancies or insufficient recovery time between them.

Attention deficit hyperactivity disorder (ADHD) related to learning and behavioural problems and Omega-3

There is evidence that Omega-3 LC-PUFAs can help treat problems related to attention deficit hyperactivity disorder (ADHD), such as lack of attention, hyperactivity and impulsivity, although additional research is required to confirm these findings.(28)



1. Martínez M. Tissue levels of polyunsaturated fatty acids during early human development. J Pediatr 1992;120: S129-S138. // 2. Wauben lP, Wainwright PE. The influence of neonatal nutrition on behavioral development: a critical appraisal. Nutr Rev 1999; 57(2):35-44. // 3. Georgieff MK. Nutrition and the developing brain: nutrient priorities and measurement. Am J Clin Nutr 2007;85(2):614S-620S. // 4. Innis SM. Dietary omega 3 fatty acids and the developing brain. Brain Res 2008;1237:35-43. // 5. McNamara RK, Carlson SE. Role of omega-3 fatty acids in brain development and function: potential implications for the pathogenesis and prevention of psychopathology. Prostaglandins Leukot Essent FattyAcids 2006;75(4-5):329-349. // 6. Krauss-Etschmann S, Hartl D, Rzehak P et al. Nutraceuticals for Healthier Life Study Group. Decreased cord blood IL-4, IL-13 and CCR4 and increased TGF-beta levels after fish oil supplementation of pregnant women. J Allergy Clin Immunol 2008;121(2): 464-470. // 7. Golding J, Steer C, Emmett P et al. High levels of depressive symptoms in pregnancy with low omega-3 fatty acid intake from fish. Epidemiology 2009;20(4):598-603. // 8. Uauy R, Hoffman DR, Peirano P et al. Essential fatty acids in visual and brain development. Lipids 2001;36:885-895. // 9. Marszalek JR, Lodish HF. Docosahexaenoic acid, fatty acid-interacting proteins, and neuronal function: breastmilk and fish are good for you. Annu Rev Cell Dev Biol 2005;21:633-657. // 10. Díaz-Argüelles V. Deficiencia de ácidos grasos esenciales en el feto y en el recién nacido pretérmino. Rev Cubana Pediatr 2001; 73(1):43-50. // 11. Otto SJ, Van Houwelingen AC, Antal M et al. Maternal and neonatal essential fatty acid status in phospholipids: an international comparative study. Eur J Clin Nutr 1997;51(4):232-242. // 12. Holman RT, Johnson SB, Ogburn PL. Deficiency of essential fatty acids and membrane fluidity during pregnancy and lactation. Proceedings of the National Academy of Sciences of the United States of America 1991;88(11):4835-4839. // 13. Al MDM, Van Houwelingen AC, Kester ADM et al. Maternal essential fatty acid patterns during normal pregnancy and their relationship to the neonatal essential fatty acid status. Br J Nutr 1995;74(1):55-68. // 14. Al MDM, Van Houwelingen AC, Hornstra G. Relation between birth order and the maternal and neonatal docosahexaenoic acid status. Eur J Clin Nutr 1997;51(8):548-553. // 15. Van der Ham EC, Van Houwelingen AC, Hornstra G. Evaluation of the relation between n-3 and n-6 fatty acid status and parity in nonpregnant women from the Netherlands. Am J Clin Nutr 2001;73(3):622-627. // 16. Levant B, Ozias MK, Carlson SE. Diet (n-3) polyunsaturated fatty acid content and parity interact to alter maternal rat brain phospholipid fatty acid composition. J Nutr 2006;136(8):2236-2242. // 17. Levant B, Radel JD, Carlson SE. Reduced brain DHA content after a single reproductive cycle in female rats fed a diet deficient in N-3 polyunsaturated fatty acids. Biol Psychiatry 2006;60(9):987-990. // 18. Levant B, Ozias MK, Davis PF et al. Decreased brain docosahexaenoic acid content produces neurobiological effects associated with depression: interactions with reproductive status in female rats. Psychoneuroendocrinology 2008;33(9):1279-1292. // 19. Cetin I, Koletzko B. Long-chain omega-3 fatty acid supply in pregnancy and lactation. Curr Opin Clin Nutr Metab Care 2008; 11(3):297-302. // 20. Hibbeln JR. Seafood consumption, the DHA content of mothers' milk and prevalence rates of postpartum depression: a cross-national, ecological analysis. J Affecte Disord 2002;69(1-3):15-29. // 21. Golding J, Steer C, Emmett P et al. High levels of depressive symptoms in pregnancy with low omega-3 fatty acid intake from fish. Epidemiology 2009;20(4):598-603. // 22. Sontrop J, Avison WR, Evers SE et al. Depressive symptoms during pregnancy in relation to fish consumption and intake of n-3 polyunsaturated fatty acids. Paediatr Perinat Epidemiol 2008;22(4):389-399. // 23. Otto SJ, De Groot RHM, Hornstra G. Increased risk of postpartum depressive symptoms is associated with slower normalization after pregnancy of the functional docosahexaenoic acid status. Prostaglandins Leukot Essent Fatty Acids 2003;69(4):237-243. // 24. Rees AM, Austin MP, Owen C et al. Omega-3 deficiency associated with perinatal depression: case control study. Psychiatr Res 2009;166(2-3):254-259. // 25. De Vriese SR, Christophe AB, Maes M. Lowered serum n-3 polyunsaturated fatty acid (PUFA) levels predict the occurrence of postpartum depression: further evidence that lowered n-PUFAs are related to major depression. Life Sci 2003;73(25):3181-3187. // 26. Berle JØ, Aarre TF, Mykletun A et al. Screening for postnatal depression: validation of the Norwegian version of the Edinburgh Postnatal Depression Scale, and assessment of risk factors for postnatal depression. J Affect Disord 2003;76(1-3):151-156. // 27. Flores DL, Hendrick VC. Etiology and treatment of postpartum depression. Curr Psychiatry Rep 2002;4(6):461-466. // 28. Sinn N, Bryan J. Effect of supplementation with polyunsaturated fatty acids and micronutrients on learning and behavior problems associated with child ADHD. J Dev Behav Pediatr 2007 Apr,28(2).89-91.