The Basics
What is Marine Oils?
Marine oils have a long list of apparent indications, including prevention of cardiovascular disease and cognitive decline and treatment of inflammatory diseases.
Brand names for Marine Oils
Na
How Marine Oils is classified
Complementary Therapies, Food, Oils, Phytotherapy, Plants, Medicinal
Marine Oils During Pregnancy
Marine Oils pregnancy category
Category N/ANote that the FDA has deprecated the use of pregnancy categories, so for some medications, this information isn’t available. We still think it’s useful to list historical info, however, given what a common proxy this has been in the past.
What we know about taking Marine Oils while pregnant
N/A
Taking Marine Oils While Breastfeeding
What are recommendations for lactation if you're taking Marine Oils?
Marine oils, such as fish oil or algal oil, are a rich source of omega-3 fatty acids, especially the essential fatty acids, docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA). Algal oil is high in DHA and low in EPA, whereas fish oil has more EPA than DHA. DHA and EPA are normal components of breastmilk in which concentrations reflect maternal intake. The DHA level in breastmilk is typically between 0.2% and 0.3% in Western countries.[1] This is usually sufficient to meet the DHA requirements of term breastfed infants, but not the higher requirements of pre-term infants, where additional maternal supplementation is needed.[2] Maternal supplementation increases breastmilk levels of DHA and EPA.[3] Higher milk levels result in higher infant plasma and erythrocyte levels of omega-3 fatty acid-derived phospholipid; one study found that breastmilk DHA was a better predictor of infant erythrocyte DHA than direct supplementation of the infants with fish oil.[4] Current dietary recommendations for nursing mothers is 250 to 375 mg daily of DHA plus EPA.[5] Lactating women require a daily dosage of about 1000 mg DHA plus EPA to reach a milk DHA plus EPA of 1 g/dL at 4 weeks postpartum.[6] Supplementation with omega-3 fatty acids has been studied for reduction of postpartum depression in nursing mothers and for improving various infant outcomes. A meta-analysis of 35 randomized, controlled trials found that women with a diagnosis of severe depression obtained benefit from omega-3 fatty acids, but those with mild depression did not.[7] A meta-analysis of randomized, controlled trials on infant neurodevelopmental outcomes found that maternal supplementation with essential fatty acids during pregnancy and breastfeeding for the first 4 months postpartum did not improve the child’s problem solving ability, intelligence, or psychomotor or motor development. Weak evidence for improved vision and attention was found in one study.[8] Two meta-analyses found that maternal supplementation with omega-3-polyunsaturated fatty acids during lactation had little or no beneficial effect on childhood allergic diseases.[9][10] Another meta-analysis using different selection criteria found that supplementation of the mother with omega-3-fatty acids during pregnancy and/or breastfeeding had no beneficial effect on visual acuity, growth or language development. Some aspects of motor, cardiovascular health, behavior and immunity were found to be differentially affected by supplementation, with the more desired effect occurring more often in breastfed infants than in formula-fed infants.[11] One subsequent study found fewer allergies in the breastfed infants of supplemented mothers, but could not distinguish between supplementation during pregnancy and during breastfeeding.[12] Another study that gave fish oil to women during pregnancy and lactation found no clear benefit or harm of fish oil supplementation on children’s neurodevelopment at 5 years of age.[13] Long-term follow-up of a small group of children whose mothers received fish oil supplements during lactation found that boys had a delayed puberty, shorter average height, and higher systolic blood pressure at age 13 years.[14] Another study found that maternal fish oil supplementation during pregnancy and lactation reduced oxidative stress in their breastfed infants.[15] Fish oil up to 3 grams daily is generally recognized as safe (GRAS) as a food by the U.S. Food and Drug Administration. The most common complaint is burping a fishy taste after ingestion. However, breast milk odor is not changed by maternal fish oil consumption.[16] Rarely, allergic reactions are reported with nut oil-derived omega-3 fatty acids in patients allergic to nuts. Dietary supplements do not require extensive pre-marketing approval from the U.S. Food and Drug Administration. Manufacturers are responsible to ensure the safety, but do not need to prove the safety and effectiveness of dietary supplements before they are marketed. Dietary supplements may contain multiple ingredients, and differences are often found between labeled and actual ingredients or their amounts. A manufacturer may contract with an independent organization to verify the quality of a product or its ingredients, but that does not certify the safety or effectiveness of a product. Because of the above issues, clinical testing results on one product may not be applicable to other products.
Maternal / infant drug levels
Marine oils, such as fish oil or algal oil, are a rich source of omega-3 fatty acids, especially the essential fatty acids, docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA). Algal oil is high in DHA and low in EPA, whereas fish oil has more EPA than DHA. DHA and EPA are normal components of breastmilk in which concentrations reflect maternal intake. The DHA level in breastmilk is typically between 0.2% and 0.3% in Western countries.[1] This is usually sufficient to meet the DHA requirements of term breastfed infants, but not the higher requirements of pre-term infants, where additional maternal supplementation is needed.[2] Maternal supplementation increases breastmilk levels of DHA and EPA.[3] Higher milk levels result in higher infant plasma and erythrocyte levels of omega-3 fatty acid-derived phospholipid; one study found that breastmilk DHA was a better predictor of infant erythrocyte DHA than direct supplementation of the infants with fish oil.[4] Current dietary recommendations for nursing mothers is 250 to 375 mg daily of DHA plus EPA.[5] Lactating women require a daily dosage of about 1000 mg DHA plus EPA to reach a milk DHA plus EPA of 1 g/dL at 4 weeks postpartum.[6] Supplementation with omega-3 fatty acids has been studied for reduction of postpartum depression in nursing mothers and for improving various infant outcomes. A meta-analysis of 35 randomized, controlled trials found that women with a diagnosis of severe depression obtained benefit from omega-3 fatty acids, but those with mild depression did not.[7] A meta-analysis of randomized, controlled trials on infant neurodevelopmental outcomes found that maternal supplementation with essential fatty acids during pregnancy and breastfeeding for the first 4 months postpartum did not improve the child’s problem solving ability, intelligence, or psychomotor or motor development. Weak evidence for improved vision and attention was found in one study.[8] Two meta-analyses found that maternal supplementation with omega-3-polyunsaturated fatty acids during lactation had little or no beneficial effect on childhood allergic diseases.[9][10] Another meta-analysis using different selection criteria found that supplementation of the mother with omega-3-fatty acids during pregnancy and/or breastfeeding had no beneficial effect on visual acuity, growth or language development. Some aspects of motor, cardiovascular health, behavior and immunity were found to be differentially affected by supplementation, with the more desired effect occurring more often in breastfed infants than in formula-fed infants.[11] One subsequent study found fewer allergies in the breastfed infants of supplemented mothers, but could not distinguish between supplementation during pregnancy and during breastfeeding.[12] Another study that gave fish
Possible effects of Marine Oils on milk supply
Relevant published information was not found as of the revision date.
Possible alternatives to Marine Oils
None listed
List of References
Lactation sources: Drugs and Lactation Database (LactMed) [Internet]. Bethesda (MD): National Library of Medicine (US); 2006-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK501922/1. Jackson KH, Harris WS. Should there be a target level of docosahexaenoic acid in breast milk? Curr Opin Clin Nutr Metab Care. 2016;19:92-6. PMID: 26751734
2. Koletzko B. Should women providing milk to their preterm infants take docosahexaenoic acid supplements? Clin Perinatol. 2017;44:85-93. PMID: 28159211
3. Amaral YN, Marano D, Silva LM et al. Are there changes in the fatty acid profile of breast milk with supplementation of omega-3 sources? A systematic review. Rev Bras Ginecol Obstet. 2017;39:128-41. PMID: 28315281
4. Meldrum SJ, D’Vaz N, Casadio Y et al. Determinants of DHA levels in early infancy: Differential effects of breast milk and direct fish oil supplementation. Prostaglandins Leukot Essent Fatty Acids. 2012;86:233-9. PMID: 22572105
5. U.S. Department of Health and Human Services and U.S. Department of Agriculture. Dietary Guidelines for Americans 2015-2020. Eighth Edition. 2015. https://health.gov/dietaryguidelines/2015/guidelines/
6. Stoutjesdijk E, Schaafsma A, Dijck-Brouwer DAJ et al. Fish oil supplemental dose needed to reach 1 g% DHA+EPA in mature milk. Prostaglandins Leukot Essent Fatty Acids. 2018;128:53-61. PMID: 29413361
7. Appleton KM, Rogers PJ, Ness AR. Updated systematic review and meta-analysis of the effects of n-3 long-chain polyunsaturated fatty acids on depressed mood. Am J Clin Nutr. 2010;91:757-70. PMID: 20130098
8. Delgado-Noguera MF, Calvache JA, Bonfill Cosp X et al. Supplementation with long chain polyunsaturated fatty acids (LCPUFA) to breastfeeding mothers for improving child growth and development. Cochrane Database Syst Rev. 2015;7:CD007901. PMID: 26171898
9. Klemens C, Berman D, Mozurkewich E. The effect of perinatal omega-3 fatty acid supplementation on inflammatory markers and allergic diseases: A systematic review. BJOG. 2011;118:916-25. PMID: 21658192
10. Gunaratne AW, Makrides M, Collins CT. Maternal prenatal and/or postnatal n-3 long chain polyunsaturated fatty acids (LCPUFA) supplementation for preventing allergies in early childhood. Cochrane Database Syst Rev. 2015;7:CD010085. PMID: 26197477
11. Quin C, Erland BM, Loeppky JL et al. Omega-3 polyunsaturated fatty acid supplementation during the pre and post-natal period: A meta-analysis and systematic review of randomized and semi-randomized controlled trials. J Nutr Intermediary Metab. 2016;5:34-54. DOI: doi:10.1016/j.jnim.2016.04.005
12. Warstedt K, Furuhjelm C, Falth-Magnusson K et al. High levels of omega-3 fatty acids in milk from omega-3 fatty acid supplemented mothers are related to less immunoglobulin E-associated disease in infancy. Acta Paediatr. 2016;105:1337-47. PMID: 26970335
13. Brei C, Stecher L, Brunner S et al. Impact of the n-6:n-3 long-chain PUFA ratio during pregnancy and lactation on offspring neurodevelopment: 5-year follow-up of a randomized controlled trial. Eur J Clin Nutr. 2017;71:1114-20. PMID: 28537583
14. Lauritzen L, Eriksen SE, Hjorth MF et al. Maternal fish oil supplementation during lactation is associated with reduced height at 13 years of age and higher blood pressure in boys only. Br J Nutr. 2016;116:2082-90. PMID: 28065179
15. Kajarabille N, Hurtado JA, Pena-Quintana L et al. Omega-3 LCPUFA supplement: A nutritional strategy to prevent maternal and neonatal oxidative stress. Matern Child Nutr. 2017;13:e12300. PMID: 27072591
16. Sandgruber S, Much D, Amann-Gassner U et al. Sensory and molecular characterisation of human milk odour profiles after maternal fish oil supplementation during pregnancy and breastfeeding. Food Chem. 2011;128:485-94. PMID: 25212160
17. Henderson RA, Jensen RG, Lammi-Keefe CJ et al. Effect of fish oil on the fatty acid composition of human milk and maternal and infant erythrocytes. Lipids. 1992;27:863-9. PMID: 1491604
18. Makrides M, Neumann MA, Gibson RA. Effect of maternal docosahexaenoic acid (DHA) supplementation on breast milk composition. Eur J Clin Nutr. 1996;50:352-7. PMID: 8793415
19. Jensen CL, Maude M, Anderson RE, Heird WC. Effect of docosahexaenoic acid supplementation of lactating women on the fatty acid composition of breast milk lipids and maternal and infant plasma phospholipids. Am J Clin Nutr. 2000;71 (1 Suppl):292S-9S. PMID: 10617985
20. Marc I, Plourde M, Lucas M et al. Early docosahexaenoic acid supplementation of mothers during lactation leads to high plasma concentrations in very preterm infants. J Nutr. 2011;141:231-6. PMID: 21169226
21. Scopesi F, Calevo MG, Risso FM et al. The impact of a DHA enriched diet on breast milk composition. Early Hum. Dev. 2011;87 (Suppl):S96. Abstract. DOI: doi:10.1016/j.earlhumdev.2010.12.038
22. Valentine CJ, Morrow G, Pennell M et al. Randomized controlled trial of docosahexaenoic acid supplementation in midwestern U.S. human milk donors. Breastfeed Med. 2013;8:86-91. PMID: 22568471
23. Sherry CL, Oliver JS, Marriage BJ. Docosahexaenoic acid supplementation in lactating women increases breast milk and plasma docosahexaenoic acid concentrations and alters infant omega 6:3 fatty acid ratio. Prostaglandins Leukot Essent Fatty Acids. 2015;95:63-9. PMID: 25701002
24. Hurtado JA, Iznaola C, Pena M et al. Effects of maternal omega-3 supplementation on fatty acids and on visual and cognitive development: A randomized trial. J Pediatr Gastroenterol Nutr. 2015;61:472-80. PMID: 25988553
25. Cimatti AG, Martini S, Munarini A et al. Maternal supplementation with krill oil during breastfeeding and long-chain polyunsaturated fatty acids (LCPUFAs) composition of human milk: A feasibility study. Front Pediatr. 2018;6:407. DOI: doi:10.3389/fped.2018.00407
26. Gibson RA, Neumann MA, Makrides M. Effect of increasing breast milk docosahexaenoic acid on plasma and erythrocyte phospholipid fatty acids and neural indices of exclusively breast fed infants. Eur J Clin Nutr. 1997;51:578-84. PMID: 9306083
27. Barman M . Effect of maternal supplementation with fish oil during pregnancy and lactation on allergy development in childhood. Acta Paediatr. 2016;105:1348. PMID: 27381168
Disclaimer: This material is provided for educational purposes only and is not intended for medical advice, diagnosis, or treatment. Consult your healthcare provider with any questions.
