PPD and Taking fish oil?

[KBecks]

Would anyone enlighten me about taking fish oil? I am considering taking it or trying it because it may help prevent PPD. So I would be taking it pregnant.

I will ask my OB but doubt that he'll have much to say about it. I think I had either bad baby blues or mild PPD with Alek and especially John. So I want to do what I can to help ease the transition with baby #3. We're hiring a post partum doula which should be awesome, and then I heard about fish oil. I could just eat more fish too, but I'll need to check on what kinds are safest for pregnant women to eat.

I don't think I'm going to want or need depression drugs after pregnancy, although I'm open to it depending on how things go. With John, I was a mess for about a week, then my pediatrician told me to have DH take care of John more so I could get real sleep, and that helped, but it was still very emotionally challenging for the first couple months.

Thanks!

[billysmommy]

There is a wonderful ultra-pure fish oil that has come out ~ made by Pharmax. I took it while pg with Benj and had no issues. I've been taking 6 capsules a day now and it has totally cleared up my psoriasis :)

The Nordic Naturals brand is great too ~ we have the kids one that Billy takes every day.

ETA: to correct name

[linsei]

You could also check into a plant-based dha supplement. I know enfamil makes one intended for use while pregnant/nursing. I'm going out on a limb, but guessing your concern is with mercury? Iirc, I think the mercury exposure is reduced or eliiminated if obtained from plants vs. fish. I'm sure there are other plant based ones that might be more economical, but I don't know of any specifically. Maybe someone else might know of a brand?

I did not have ppd, but started taking dha for dry eyes. It could be my imagination, but I think my "emotional well being" has improved. Totally worth trying, imo.

[supercalifragilous]

I took flaxseed oil while I was PG & nursing, then switched to fish oil. Then my doctor told me that the fish oil was exacerbating my dry eyes. He said to stick to vegetable-based oils, saying flaxseed was the best.

He said the freshest one was made by Barlean's, found in the refrigerated section of a natural/health food store. Pay attention to the "pressed on" date so you get the freshest one. The only drawback is it's not a capsule so you have to mix it in something (like yogurt, salad dressing). The taste isn't bad, though. I get the one with the lignans so I get fiber too. Might as well if I'm taking it like that.

Bummer, too - since I found a really great Omega Complex capsule @ Sam's Club - it has:
800 mg of fish oil (EPA 180 mg, DHA 120 mg)
50 mg of borage seed oil (GLA 11 mg, LA 18 mg, OA 7 mg)
150 mg of flaxseed oil (ALA 75 mg, LA 18 mg, OA 21 mg)
200 mg of safflower oil (CLA 140 mg, OA 15 mg)

Ingredients:
Fish oil (anchovy, bonito, clupea, salmon, sardine, and sprat), gelatin, safflower oil, flaxseed oil, glycerin, borage seed oil, d-alpha tocopherol (soy). Gluten free.

[ThreeofUs]

I have been thinking about this, too, and looked up the research on it. Apparently, plant-based Omega 3's are harder to metabolize than those from fish oil. So taking fish oil makes the dha/epa, etc., more available to you and your baby.

Frankly, I'm taking both fish oil and flax seed oil. ;) But the Omega complex mentioned by a pp sounds great.

Here's one link to a summary of the research:
http://findarticles.com/p/articles/mi_m0ISW/is_279/ai_n16865300

[brittone2]

In terms of mercury, the amount of mercury in cod liver oil is quite low. Consumer Reports (I don't always love them, but sharing anyway....) did an investigation and found the majority of those tested were very low in mercury.

I'd stick with something that has high standards for purity and tests for nasty stuff. Some companies add synthetic vits back in and there is quite a bit of debate about how healthy that is...

Carlson's and Nordic Naturals are two well respected brands. Radiant Life is another.

Our whole family takes CLO and I personally know of several moms that have been helped by taking a good supplement post partum. I wouldn't hesitate to watch yourself and ask for a RX med if necessary (if you want to go that route), but I do believe CLO can help (specifically the vitamin D in it).

eta: I've always heard it recommended that you take the stuff that has to be refrigerated once open. The quality and stability of the shelf-stable capsules may or may not be that hot, kwim?

[m448]

Yup I give the boys Carlson's and before that we used Nordic Naturals. I also mix their probiotic powder into it and they chug it down like champs. Hubby takes it in capsules I take it in either form. I've found even when not PP or pregnant that the CLO definitely makes a difference in my outlook and mood.

Recently I've added a B complex and of course I take my calmag at night along with an enzyme (I have no gallbladder and without the enzyme my absorption of the EFAs in the CLO would be low).

[brittone2]

Yup I give the boys Carlson's and before that we used Nordic Naturals. I also mix their probiotic powder into it and they chug it down like champs. Hubby takes it in capsules I take it in either form. I've found even when not PP or pregnant that the CLO definitely makes a difference in my outlook and mood.

Recently I've added a B complex and of course I take my calmag at night along with an enzyme (I have no gallbladder and without the enzyme my absorption of the EFAs in the CLO would be low).


Yeah, in our house the kids get mad that they can only have their dose and no more. I have no idea why, as DH and I don't *love* the stuff (but we love what it does for us). Both kids love the lemon flavored oil and my 18 mo. old cries and says "mo...mo" while signing (for "more, more!"). Oddly they adore the stuff.

[m448]

isn't it odd? People always ask me how I get the kids to take it and honestly all I did was pull out the bottle (our favorite is lemon too) when my oldest was around 2, I told him mommy was taking something new and did he want to try. I give them their doses in those little shot glass measuring cups so it's easy to dose and for them to drink.

#2 was even easier to convince to take it because heaven forbid I give his older brother something without him getting it too. ;)

[shilo]

ok, here's the discussion i had with my ob about it... maybe you can ask yours what he/she thinks? i'm not very familiar with the specific research on PPD and the relation to the fish oil. is it the EPA, DHA, vit. D or some other component that is thought to help? anyway, here is what info i've gathered, maybe you can combine it with yours to help you reach an answer that's best for you...

at my last annual before conception, she said that one of the recommendations that had changed from my last pregnancy to this planned one was adding an omega 3 supplement that provided at least 300mg of omega 3's. we didn't really discuss _which_ omega 3's, so since i was already taking the previously mentioned nordic naturals omega 3 (fish oil derived EPA/DHA), i just continued on that.

at my first OB appointment, we discussed it again, and she said it was fine to continue taking the NN omega-3 (EPA/DHA), but that if i wanted i could also switch to an omega supplement that was just DHA or more DHA than EPA, since the main studies here that this new recommendation are based on was looking mostly at the effects of maternal DHA. but she went on to say that there have been many studies (mostly european countries) looking at EPA as well and there 'are no reasons' for her to discourage me from taking one, and possibly, there may be some added benefits of the EPA as well (mostly with reducing premature births).

some say that too much EPA out of balance with the DHA isn't good for developing brains in young children because the EPA can compete with the DHA for a place in the brain (nerve) cell membranes. but her feeling and from what i've read in the primary literature sources, is that the additional EPA (many of the european studies were looking at 8 or 9 times the levels recommended here) did seem to have the positive benefits of reducing prematurity while not having negative outcomes/actually improving test scores on brain development out to at least 4 years (i think there was at least one study that's out to 8 years now IIRC). so while it would appear that a DHA only supplement seems to be the most commonly recommended one for the kiddo once it's born, while still in utero, it appears that a combined supplement may have additional benefits to the pregnancy without negative consequences? i'm sure this probably varies from ob to ob, pedi to pedi, so see what yours thinks?

so other things in my reading, that might be of interest to you:
-many of the DHA only supplements on the market are marine algal derived which is supposed to be a very good source of high quality omega 3's without the mercury concern of fish oil and without the metabolism availability issues of plant derived (like flax seed). you can get a mostly DHA supplement derived from fish oil (NN does make a "prenatal DHA" which is fish oil derived and still has a little bit of EPA too), but the ones that are solely DHA are mostly marine algae which is supposed to be well metabolized and available from what i've read.

-besides the mercury concern (which source after source site as beth (brittone) does - that as long as you are buying a quality brand, this shouldn't be an issue), one other concern with the pure fish oil in pregnant/lactating women seems to be too much vitamin A and D (esp. the A while pregnant). i'm not sure what the numbers are for how much fish oil you'd be taking to help with the PPD??? you could avoid most of the A & D issue by making sure your fish oil isn't liver derived (ie. cod liver oil). or you could also avoid this alltogether by taking an EPA/DHA supplement that has already been extracted out of the fish oil. just read your labels while you _are pregnant_ to make sure you aren't consuming too much additional A in particular, on top of your prenatal and any other supplements or fortified foods you're eating (apparently the betacarotene in the normal food pyramid fruit/veggie recommendations aren't an issue here, just the purified vitamin A in supplements or fortified foods). vitamin A may also be listed as retinol, so add up all your A #'s and make sure you're well under the 10,000 IU's cut off during pregnancy. if the fish oil dose for the PPD does put you over, then maybe you take one of the alternatives above while pregnant and then switch to the fish oil after delivery if you are having PPD issues, if it is supposed to be the best for the actual PPD???

-if you want to stay plant based, you can do the flaxseed oil as a pp recommended. supposedly one T of flaxseed oil contains enough ALA (the precursor of EPA and then DHA) for a normal woman's body to convert it into 1400mg EPA and another 600mg DHA. but then with this route, there is some debate in the literature if the typical american diet provides enough of the right amino acids to make the enzymes needed to properly convert the ALA to EPA and then to DHA day after day and there is also additional concerns for some pregnant women about additional estrogens in the flaxseed oil. i have read that if you decide to go this route, you should clear it with your OB based on your own estrogen #'s.

so this is just my filtered version. i'd love to see more about the PPD benefits and which part of the fish oil it's attributed to. anyone have more links to the primary lit?

hth, lori

[KBecks]

Thanks so much for the detailed information! Nutrition and supplement information really can make my head spin, I want to know enough that I'm doing it "right" or at least acceptably with minimal risk. At the same time I want to get started as it sounds like it may be useful, wow on those long term studies and effects in kids!

[brittone2]

In terms of CLO and vit A/D, the research I've been following states that the RDA for D is drastically low for most people. I *personally* am very comfortable with quite a bit of D in my diet. Vitamin A is a little more confusing. Some of the CLO supplements (I believe Carlson's) have lower A amounts of that's something that worries you (so you can take a dose that gives you a nice dose of D without getting a huge amount of A). Again, based on my own comfort level and research into the topic, I'm worried about high levels of synthetic A. Naturally occurring A doesn't bother me as much.

I know many docs are concerned with CLO's vit A and D levels. I looked into it and was comfortable with it for *myself*.

eta:
One paper on vitamin A:
Myhre, et al., "Water-miscible, emulsified, and solid forms of retinol supplements are more toxic than oil-based preparations," Am J Clin Nutr, 78 (2003) 1152-9.
http://www.ncbi.nlm.nih.gov/pubmed/14668278?dopt=Abstract

Lorien, this isn't a primary source but you can look it up from this article's reference if you are interested (Regarding depression)

http://news.bbc.co.uk/1/hi/health/6747623.stm

If you are taking a prenatal with a lot of vitamin A, I'd be more cautious about the A in the CLO. There are a lot of schools of thought on this, so you'll want to look into it a bit more for yourself

jumping toddler in lap...

one more linky:
here's a link to Nordic Naturals CLO with D:
http://www.nordicnaturals.com/en/Products/Product_Details/98/?ProdID=1440#

Vitamin A content is 650-1500 IU, and that is naturally occurring vs. synthetic (many in the natural foods community believe that a lot of the research on vitamin A toxicity has been affected by using synthetic forms of A vs. naturally occurring).

Carlson's CLO contains 700-1200 IU of vitamin A per dose

Personally I feel that those levels can be safely incorporated, but that's a decision you'll want to look into for yourself, obviously.

The good companies test and are free of mercury and PCBs.

[ThreeofUs]

Wow! This thread is SO helpful!

I'm taking Carlson Super Omega 3 Fish Oil concentrate. (Omega 3's present as 300/200/100 EPA/DHA/other from "fish body oils" - ewwww :) .) The label says nothing about vitamins A or D. I specifically chose this one because I didn't want more vitamin A or D in my diet, as I already supplement for these.

ETA: This may be info overkill, but here is the best list I've found of the (sometimes conflicting) research. There does appear to be some difference of opinion as to the benefits of ALA, and whether both EPA and DHA are beneficial. Most researchers who mentioned vitamins A and D (as in CLO) were warning against them as possibly harmful to the fetus.
http://answers.google.com/answers/threadview?id=743097

[DrSally]

My OB wouldn't let me take fish oil, I think b/c of lack of data on safety. Better safe than sorry I guess. It is good for mild depression though.

ETA: one tin of sardines (low mercury) has 2 grams of Omega 3's

[KBecks]

Just an update - I called the OB's office and the nurse I spoke with was extremely positive about using fish oil or a DHA supplement and was familiar with the brain development research, so I'm going to go ahead and order something today and give it a try.

I'm also interested now in doing it with my kids but one thing at a time to start.

Thanks again for all the great information, I appreciate it so much!