Is It Safe to Take Nature Made Fish Oil During Pregnancy?

Is there any concern about accidentally taking Lecithin fish oil?

Hello Doctor: I am a pregnant woman who is over 31 weeks along.
Recently, I went to Costco to purchase calcium and fish oil, and I consulted with the pharmacist present, so I have been taking the products with peace of mind.
However, today I unexpectedly came across a blog by another pregnant woman that mentioned fish oil should be discontinued after seven months of pregnancy.
Out of curiosity, I searched for information and found that my fish oil, Nature Made, contains 1932 mg of fish oil (including 600 mg of EPA and 400 mg of DHA), which may not be suitable for pregnant women.
Here is the ingredient webpage: http://sh2.obuy.tw/tw1111/item.asp?item_id=1515275.
I learned that pregnant women should avoid high levels of EPA, as it can inhibit platelet aggregation and potentially lead to excessive bleeding during delivery.
I was alarmed to see this information because I am still taking it.
I have consumed 84 capsules over a total of 42 days.
The only comfort is that I often forget to take them, so I have only taken 84 capsules from mid-pregnancy until now.
However, I have continued to take some after seven months, and I am very worried about the potential effects on myself or my baby.
I sincerely ask for your assistance in addressing this concern.
I am feeling quite anxious.
Thank you.

Miyagi, 20~29 year old female. Ask Date: 2011/10/30

Dr. Chen Changfu reply Obstetrics and Gynecology

During pregnancy, it is generally understood that any medication should be avoided unless it is necessary and effective, in order to prevent adverse effects on the fetus.
Pregnant women should not consume excessive amounts of fish oil, which is rich in fat-soluble vitamins.
After discontinuing its use, the body will gradually metabolize the excess fat-soluble vitamins.
Regular and timely prenatal check-ups should alleviate any concerns.
Best wishes to you!

Reply Date: 2011/10/30

More Info

Taking fish oil during pregnancy, particularly Nature Made fish oil, raises important considerations regarding safety and dosage. Fish oil is known for its omega-3 fatty acids, specifically EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid), which are beneficial for both maternal health and fetal development. However, the concerns you've raised about the EPA content and its potential effects on blood coagulation are valid and warrant a thorough discussion.

Firstly, it's essential to understand the role of omega-3 fatty acids during pregnancy. DHA is particularly important for fetal brain and eye development, and many healthcare providers recommend that pregnant women ensure adequate intake of DHA. The American Pregnancy Association suggests that pregnant women consume fish or fish oil supplements to meet their DHA needs, as it can support cognitive development in infants.

However, the concern regarding EPA is noteworthy. High levels of EPA can indeed have a blood-thinning effect, which may pose risks during labor and delivery due to the potential for increased bleeding. This is particularly relevant for women who may have other risk factors for bleeding or those who are scheduled for a cesarean section. The general recommendation is to limit EPA intake during the later stages of pregnancy, especially after the seventh month, to mitigate these risks.

Regarding the specific product you mentioned, Nature Made fish oil contains 600 mg of EPA and 400 mg of DHA per serving. While these amounts are within the range often found in fish oil supplements, the cumulative intake over time and individual health factors should be considered. Since you have already consumed 84 capsules over 42 days, it is advisable to evaluate your total EPA intake and discuss it with your healthcare provider.

If you are concerned about the safety of continuing this supplement, it would be prudent to consult with your obstetrician or a healthcare professional who specializes in maternal-fetal medicine. They can provide personalized advice based on your health history and the specifics of your pregnancy. They may recommend discontinuing the fish oil or switching to a product with a higher DHA to EPA ratio, which is generally considered safer during pregnancy.

In addition to fish oil, it's crucial to focus on obtaining omega-3 fatty acids from dietary sources. Fatty fish such as salmon, sardines, and mackerel are excellent sources of DHA and EPA and can be included in your diet, provided they are low in mercury. The FDA recommends that pregnant women consume 8 to 12 ounces of low-mercury fish per week.

Lastly, while supplements can be beneficial, they should not replace a balanced diet. Ensure that you are also getting adequate amounts of other essential nutrients, such as folic acid, iron, calcium, and vitamins, which are critical during pregnancy. If you are taking a prenatal vitamin, it may already contain some of these nutrients, but discussing your overall supplementation strategy with your healthcare provider is essential.

In summary, while fish oil can be beneficial during pregnancy, caution is warranted, particularly regarding EPA content. Consult with your healthcare provider to determine the best course of action for your specific situation, and consider dietary sources of omega-3 fatty acids as a safe alternative. Your health and the health of your baby are paramount, and professional guidance will help ensure both are well cared for during this critical time.

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