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Release Date: 11/06/2014

There is no doubt that pregnant and breastfeeding women try to do everything they can to ensure a healthy outcome for their baby, including eating a healthy, well-balanced diet that provides the necessary nutrients for fetal growth and development. In recent years, there has been significant debate about the consumption of fish among pregnant and breastfeeding women.

In June, following a survey that found that the majority of pregnant women do not eat much fish and thus may have inadequate intake of certain omega 3 fatty acids, the Food and Drug Administration (FDA) and the Environmental Protection Agency (EPA) issued updated advice on fish consumption for pregnant and breastfeeding women.

Toward clarifying this complicated issue, Katharine D. Wenstrom, MD, director of the Division of Maternal-Fetal Medicine at Women & Infants Hospital of Rhode Island, co-director of the hospital’s Integrated Program for High-Risk Pregnancy, and a professor of obstetrics and gynecology at The Warren Alpert Medical School of Brown University, has published a Viewpoint in the November 2014 issue of American Journal of Obstetrics & Gynecology entitled, “The FDA’s new advice on fish: it’s complicated.”

“This is a complicated issue, as fish high in omega 3 acids have incredible health benefits for a developing fetus and a growing baby, but some fish also pose significant risk,” said Dr. Wenstrom. “My colleagues often tell me that their patients ask, ‘Do I eat fish, or not? And if so, which fish is safe to eat and which should I avoid?’. In balancing the risks and nutritional benefits of different types of fish, pregnant and breastfeeding women should eat at least eight ounces and up to 12 ounces of fish per week, including salmon, pollack, squid, sardines and oysters, which offer the highest levels of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), with the lowest levels of mercury.”

Omega 3 acids EPA and DHA, which are found in very high levels in some fish, are essential components of membranes in all cells of the body and are vital for normal development of the brain and retinal tissues and for maintenance of normal neurotransmission and connectivity. Maternal ingestion of adequate quantities of EPA and DHA has been associated with better childhood IQ scores, fine motor coordination, and communication and social skills, as well as other benefits. Unfortunately, taking omega 3 fatty acid or fish oil supplements does not seem to have the same beneficial effects of eating fish.

Some fish that offer high levels of omega 3 acids are also dangerously high in mercury and should be avoided or at least limited in consumption, especially during pregnancy and while breastfeeding. The FDA specifically advised against pregnant and breastfeeding women eating shark, tilefish, swordfish and king mackerel because they have the highest levels of mercury. They also recommended limiting consumption of albacore tuna to six ounces per week.

For information about the FDA’s draft guidelines, visit

About Women & Infants Hospital

Women & Infants Hospital of Rhode Island, a Care New England hospital, is one of the nation’s leading specialty hospitals for women and newborns. A major teaching affiliate of The Warren Alpert Medical School of Brown University for obstetrics, gynecology and newborn pediatrics, as well as a number of specialized programs in women’s medicine, Women & Infants is the 12th largest stand-alone obstetrical service in the country and the largest in New England with approximately 8,500 deliveries per year. A Designated Baby-Friendly® USA hospital, U.S.News & World Report 2014-15 Best Children’s Hospital in Neonatology and a 2014 Leapfrog Top Hospital, in 2009 Women & Infants opened what was at the time the country’s largest, single-family room neonatal intensive care unit.

Women & Infants and Brown offer fellowship programs in gynecologic oncology, maternal-fetal medicine, urogynecology and reconstructive pelvic surgery, neonatal-perinatal medicine, pediatric and perinatal pathology, gynecologic pathology and cytopathology, and reproductive endocrinology and infertility. It is home to the nation’s first mother-baby perinatal psychiatric partial hospital, as well as the nation’s only fellowship program in obstetric medicine.

Women & Infants has been designated as a Breast Imaging Center of Excellence by the American College of Radiography; a Center of Excellence in Minimally Invasive Gynecology; a Center of Biomedical Research Excellence by the National Institutes of Health (NIH); and a Neonatal Resource Services Center of Excellence. It is one of the largest and most prestigious research facilities in high risk and normal obstetrics, gynecology and newborn pediatrics in the nation, and is a member of the National Cancer Institute’s Gynecologic Oncology Group and the Pelvic Floor Disorders Network.
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