Omega-3 Foods & Fish Oil During Pregnancy - What To Expect

Omega-3 fats should be a part of everyone's diet: They fight inflammation, lower blood fats (aka triglycerides), reduce blood pressure, increase HDL cholesterol (the good kind), and may lower both LDL cholesterol (the bad kind) and blood pressure.

And for pregnant women and babies, these healthy fats are especially critical. Here's what moms-to-be need to know about omega-3 fatty acids, including how to get enough in your diet and whether it makes sense to take a fish oil supplement.

Key Takeaways:

• Omega-3s are extra-important in pregnancy. They support baby's brain and eye development, may help prevent preterm birth, and could ease depressive symptoms for some moms.
• Food first is a smart strategy. Choose low-mercury fish two to three times a week (think salmon, sardines, herring, or oysters) and round it out with other sources like walnuts, tofu, leafy greens, and fortified foods.
• Supplements can help — but check with your provider first. Many prenatals already include DHA; if you don't eat fish, consider algae or krill oil and skip cod-liver oil, which can be too high in vitamin A during pregnancy.

Why are omega-3 fatty acids important during pregnancy?

Omega-3s may offer a number of benefits during pregnancy, including supporting brain and eye development in babies and helping to prevent preterm birth, studies show. Omega-3s may even help reduce depressive symptoms in women with perinatal depression, some research suggests.

Pregnant women should aim to get around 1.4 milligrams a day of omega-3s. The good news: Your diet is probably already rich in the three different types of omega-3 fats.

For example, plant foods such as vegetable oils, walnuts, chia seeds, and flaxseeds contain alpha-linolenic acid (ALA), while fatty fish, fish oils, and other marine sources are rich in eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Your prenatal supplement may also contain omega-3 fatty acids.

Should you take fish oil during pregnancy?

Omega-3 supplements are sometimes recommended, especially if your diet doesn't include fish. Ask your practitioner about pregnancy-safe, mercury-free DHA supplements, and check to see whether your prenatal vitamin already contains them. Many prenatal vitamins have 200 to 300 milligrams of DHA already, so it's especially important to speak with your practitioner before adding additional supplements to the mix.

If you're not a fan of the fishy aftertaste, you can look for a vegetarian or vegan alternative. Krill oil, from tiny shrimp-like sea creatures, and algae oil, considered a vegetarian source, can supply what you need just as well as fish oil. Avoid cod-liver oil as a source of omega-3s, because it may contain too much vitamin A for pregnant women.

As with all vitamins and supplements in pregnancy, you should never take anything without first discussing it with your practitioner.

Best foods that are high in omega-3 fatty acids

EPA and DHA (the kinds of omega-3s from fish sources) provide the strongest benefits, but your body can convert plant-based ALA into EPA or DHA too. By getting a variety of omega-3 fatty acids in your daily diet before, during and after pregnancy, you'll have enough for yourself and your baby.

Here are a few foods that are high in omega-3s, along with tasty ways to eat them.

Cold-water fish

Omega-3 fats EPA and DHA are found in fatty fish, but not all fatty fish should be on the menu if you're pregnant or nursing. Some are too low in omega-3s to be beneficial, while others are potentially too high in toxins like mercury and dioxin.

Safer fish options during pregnancy include wild salmon, sardines, herring, and farmed oysters, which are all rich in omega-3s, lower in toxins, and readily available. The American College of Obstetrician & Gynecologists (ACOG) and the American Academy of Pediatrics (AAP) both recommend that pregnant women aim for two to three servings (8 to 12 ounces total) a week of a variety of low-mercury fish. If you're not sure whether a particular fish is safe to consume, talk to your health care provider or check out the Environmental Working Group's Safe Fish List.

How to prepare it: Whether it's grilled, steamed, poached, or roasted, make sure fish is cooked through when you're pregnant. Fatty fish tastes great warm or cold, but stick to simple recipes to let the flavor of the fish be the star. Balance the oiliness of fatty fish with acidic ingredients such as fresh lemon or lime juice, salsa, and seasoned vinegar. Add whatever herbs you love — tarragon, oregano, cilantro, and dill all work beautifully.

"I like to air fry salmon; put Dijon mustard, brown sugar, paprika, garlic powder, pepper, salt, and dill; and rub it into a paste. Air fry for around 10-12 minutes and it comes out so perfect and a little crunchy on the edges," says What to Expect Community mom njcb22.

Walnuts

While most nuts contribute healthy fats to your diet, only walnuts and walnut oil contribute omega-3 fatty acids.

How to prepare them: A handful of walnuts makes a quick and satisfying snack, but there are plenty of other ways to increase your intake: For breakfast, stir chopped walnuts into oatmeal, add to granola or other cold cereals, or sprinkle over yogurt and sliced fresh fruit. Stir finely chopped walnuts into muffins, quick breads, and pancake batters; use them to boost crunch and flavor in green salads; or add finely ground walnuts to bread crumb mixtures when you're coating chicken and fish. Walnut oil is not generally used for cooking, but it's fabulous in salad dressings or drizzled over grilled or roasted fish, beef, or vegetables. If you like its nutty flavor, substitute walnut oil for some (or all) of the vegetable oil or butter called for in baked goods.

Tofu

Soybean products such as tofu, enriched soy milk, and edamame can be a good source of omega-3 fatty acids. Just make sure any low-fat varieties of soy products you choose have been enriched with additional omega-3s, since taking the fat out of a food means that the omega-3s — which are a type of fat — get cut too.

How to prepare it: Tofu is known for its neutral taste, but the beauty of that blandness is that it allows tofu to take on the flavors of other ingredients. That's why it's a high protein (and vegetarian) staple in stir-fries, soups, and stews. You can bake or broil slabs of tofu with teriyaki sauce, soy sauce, miso, ginger, sesame, or curry. Other tasty options: Scramble tofu as you would eggs with veggies and cheese; add tofu to burritos, tacos, or chili; or coat a slab with ground walnuts and sauté in canola oil for an omega-3 triple threat. Tofu is also perfect for thickening fruit smoothies and shakes.

Leafy green vegetables

Dark green and leafy veggies like Brussels sprouts, kale, spinach, and watercress contain varying amounts of omega-3s, as do parsley and some other fresh herbs.

How to prepare them: To prepare fresh Brussels sprouts, trim the stem ends, toss with canola or olive oil, add salt and pepper, then arrange in a baking pan large enough to hold the sprouts in a single layer. Roast in a hot (about 400 degrees Fahrenheit) oven for 20 minutes or until lightly browned and just tender. You can also trim and halve the Brussels sprouts and steam or sauté them in canola oil until tender. Spinach and kale taste great steamed or sautéed with garlic and a squeeze of lemon juice, or use raw leaves in salads or as the base in a super-omega-3 smoothie.

DHA-fortified or enriched foods

The definition of a fortified product is one that has been supplemented with a particular nutrient — one that doesn't naturally occur in that type of food. An enriched food, however, just gets a boost of a nutrient that it already contains.

DHA-fortified and enriched varieties of milk, yogurt, orange juice, eggs, peanut butter, and even tortillas are readily available in most large supermarkets and health food stores, and they make good additions to your pantry and fridge.

How to prepare them: Try a combo of fortified peanut butter spread on a fortified tortilla with a glass of fortified milk or juice. Or combine fortified yogurt, milk, and peanut butter in a blender with a ripe banana for a luscious omega-3 smoothie. If you have special dietary concerns like a fish or nut allergy, check the source of omega-3 in the products you use to be sure it's safe for you. Keep in mind, if you're already getting your dose of omega-3s naturally, you don't have to go out of your way to buy fortified or enriched products.

Want more tips on what and how to eat when you're pregnant? Get trimester-by-trimester nutrition advice and meal and snack ideas in the What to Expect app.

Other omega-3 fatty acid food sources

In addition to those above, omega-3 fatty acids like DHA can be found found in other foods you probably already eat, including:

• Brazil nuts
• Chia seeds
• Flaxseeds
• Seaweed
• Grass-fed beef, buffalo, and lamb
• Crab and shrimp
• Pasture-raised or omega-3 chicken

Getting your omega-3s is worth it when you're pregnant — both for your growing baby and you. And with so many options to choose from, filling up can be easy and tasty.