Is Fish Oil Supplementation Right for Kids?

Kids and adults alike need vitamins, minerals, and other nutrients to maintain a healthy, functioning body. For kids, these nutrients are also used for vital growth and development.

Just like other important nutrients for growth and development (such as vitamin D, iron, and calcium) kids need omega-3 fatty acids.

ALA is found in plant oils. Foods like walnuts, soybeans, flaxseeds, hemp seeds, and chia seeds are good sources of ALA. EPA and DHA are primarily found in fatty fish, but you can also get them from eating other seafood and even some algae.

ALA is called an "essential fatty acid." Our bodies cannot make ALA on its own, which means we have to get it from food sources. EPA and DHA can be made in our bodies from ALA, but the process is inefficient.

These are some reasons why USDA MyPlate recommends that kids eat fish that is rich in omega-3 fatty acids, such as salmon, trout, and herring. If your kids don't regularly eat these fish, you might want to look for another source of omega-3 fatty acids to include in their diets, such as:

• Algal DHA supplements
• Fish oil supplements
• Foods and beverages that are supplemented with DHA or EPA
• Multivitamins that contain DHA/EPA

Fish Oil Benefits

Omega-3s are important to many aspects of health, growth, and development. For example, they make up the membranes that surround our cells. Levels of DHA are especially high in the retina, brain, and sperm cells. 

The important role omega-3s found in fish have in our health is well-known. What is unknown is whether fish oil supplements provide health benefits.

When it comes to infants and children, studies on cognition and behavior are usually the focus. While lower mercury fatty fish intake during pregnancy and breastfeeding might be beneficial to a baby's health, the same benefits cannot be implied via fish oil supplements. The same goes for studies on the benefits for kids.

Sources of Fish Oil

You can get DHA and EPA from several food sources, including:

• Cod liver oil
• Fatty fish. Herring, rainbow trout, mackerel, salmon, tuna, and sardines have the highest levels of DHA and EPA.
• Other fish. Pollock, flounder, scallops, clams, shrimp, catfish, canned albacore tuna, canned light tuna, and fish sticks have less DHA and EPA than fatty fish, but they do contain some.
• DHA-fortified foods and drinks. These products may use fish-derived DHA or algae-derived DHA.

If you plan to supplement using DHA-fortified foods, keep in mind that the amounts found in fortified foods are likely less than would be found in a serving of fatty fish. If food is something that your child eats regularly, the amount can add up. However, this amount should be added to the daily intake total if you are considering offering an additional fish oil supplement.

Fish Oil Dosage

The American Heart Association (AHA) recommends that adults eat a variety of fish (preferably those high in omega-3 fatty acids ) at least twice a week. Adults should also eat plenty of foods that are rich in ALA, such as flaxseeds, walnuts, soybeans and soybean oil, tofu, flaxseed, and canola oil.

While it might not be a hearty endorsement, the AHA does state that there is "some limited evidence that suggests eating fish rich in EPA and DHA may reduce the risk of mortality from cardiovascular disease."

There is not yet a more specific milligram per day recommendation for DHA and ARA for kids. If they are getting the fish oil from eating fish, the National Institutes of Health (NIH) recommendation for kids is two servings of fatty fish in a week.

A serving for a one-year-old is 2 ounces and increases to 4 ounces by age 11. In 2008, the World Health Organization (WHO) released recommendations for DHA intake for kids—two servings of fatty fish would cover those needs.

Young kids can eat two servings a week of other fish that are lower in mercury, such as canned light tuna, salmon, sardines, pollock, and catfish.

Women who might become pregnant, pregnant women, nursing mothers, and young children should not eat any fish that has high mercury levels, such as swordfish, bigeye tuna, shark, orange roughy, king mackerel, and tilefish.

Fish Oil Supplements

There are many ways to introduce fatty fish to your children—even starting when they are still babies. The sooner you begin to incorporate fish into a child's food choices, the more likely they are to enjoy it.

You can get creative with your offerings, which will help your child develop a healthy relationship with a variety of foods, including fish. For example, salmon and tuna can be made into tasty burgers or fish cakes, and you purée canned fish to easily add to a marinara sauce. If your child does not eat fish regularly, your pediatrician might recommend that you give them a supplement.

There are a variety of fish oil supplements for kids. You can even find gummy vitamins with fish oils included. If you choose to supplement, keep in mind that amount of omega-3 fatty acids supplements contain will vary greatly.

Multivitamins that are advertised as including DHA might actually contain very little DHA. Be sure to check the label to ensure you are getting the amount of DHA that has been recommended by your pediatrician. You might want to ask them which brands they trust.

What You Need to Know

There is a lot for parents to consider when thinking about fish oil in fish and fish oil supplements. DHA, ALA, foods fortified with DHA derived from algae, and the risks of mercury in fish are just some of the facts you will want to understand.

Here are some other things to keep in mind about fish oil.

Choose Supplements Carefully

If you opt to include a supplement in your child's routine, look for a fish oil supplement or omega-3 supplement that contains both DHA and EPA if you want the possible benefits of fish oil. Include a variety of sources. Fish, algae, and fish oil are all sources of omega-3 fatty acids.

The fishy taste of some fish oil supplements is often masked by other flavoring ingredients. Read the ingredients list and labels carefully.

Be Aware of Allergies

Do not give your kids fish oil supplements if they are allergic to fish or shellfish.

Learn About PCBs and Mercury

There are concerns that some fish oil supplements can be contaminated with polychlorinated biphenyls (PCBs) or mercury. This is because the FDA does not have to approve supplements or ensure that they are safe or effective.There are things you can look for to help ensure a pure product:

• Buy supplements that state they are USP (United States Pharmacopeia) certified can help to make sure they meet quality, purity, and potency.
• Choose brands that use a third-party certification.
• Molecular distillation also removes mercury and PCB.

Understand the Ingredients

Omega-3 fatty acids are essential fatty acids. This means that our bodies can not produce them on their own and need to get them from our diet, either from the foods we eat and drink or from a supplement.

There are no % daily values for DHA, EPA, or ALA. This is true even if you see them listed on some food labels or supplements. There are, however, adequate intakes set for omega-3 fatty acids for kids. These numbers include ALA, DHA, and EPA all in a single recommendation.

Consider the Environmental Impact

Researchers have started to study the environmental impact of overfishing smaller fish to produce fish oil supplements. You can often find this addressed on individual brand websites. Do a quick search before making a purchase, as data changes as fishing changes.