Kids & DHA: The Complete Guide for Parents

by Maryann Tomovich Jacobsen, MS, RD on December 13, 2009

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I’m excited to have Evelyn Tribole, MS, RD as our expert this month. She is an award-winning registered dietitian, with a nutrition counseling practice in Newport Beach, California. She has written several books including The Ultimate Omega-3 Diet and Intuitive Eating. She is a highly respected dietitian.

“Children require omega-3 fatty acids the same way they require vitamins,” Tribole says when asked the one thing she wants parents to know about omega-3 fatty acids. “But parents need to understand that it’s not just DHA (docosahexaenoic acid) their children need, it’s also EPA (eicosapentaenoic acid).”

The problem with fortified products on the market, she explains, is they contain only DHA. And children need both. Even though DHA is the star player, DHA and EPA work together in a complex process.

In her book, The Ultimate Omega-3 Diet, Tribole argues that DHA is needed for brain development the same way calcium is required for bone growth. She says that each brain cell requires DHA for proper development. When DHA isn’t present in adequate quantities during rapid brain growth (early childhood), emotional and intellectual development can be affected.

“Kids need to eat fish at least twice a week to get the recommended amount of DHA.” Tribole says. “Parents can try fish tacos, tuna fish sandwiches or salmon patties with their kids.”

While her son was growing up, Tribole took him out for “Fishy Thursdays” and he’d try all kinds of different fish at restaurants. Now he loves fish.

“Every time the FDA comes out with a warning about fish, consumption goes down, which is too bad,” she adds. “If parents stick to low-mercury sources of seafood like salmon, trout, halibut, light canned tuna and cod, they will be fine.”

Should children who don’t eat fish regularly supplement with DHA/EPA? Tribole says yes and based on international guidelines she recommends children 2-3 years old get 433mg of DHA/EPA with a minimum of 145mg of DHA, 4-6 years old get 600mg of DHA/EPA with a minimum of 200mg of DHA and 7 years and older including adults get 650 combined with a minimum of 220 DHA. For pregnant women the DHA minimum is 300mg. Check the supplement facts label to see how much DHA/EPA is in each serving.

As for recommended supplements, Tribole put together this chart on her website listing quality products categorized by cost. Supplements especially for kids include Coromega and Nordic Naturals. For another kids’ supplement, check out my review of Carlsons for Kids fish oil.

What about vegetarian children? Tribole explains that plant sources of omega-3 fatty acids such as flaxseed and walnuts do not contain DHA/EPA and convert very small amounts of DHA in the body. Most lacto-ovo vegetarians (consumes milk and eggs) don’t have problems taking fish oil supplements but vegans may be against it. There are algae-based DHA supplements but they don’t contain EPA.

Tribole emphasizes the importance of lowering omega-6 fatty acids in the diet. “I like to compare omega-6 fatty acids to sodium in the diet,” she says. “Both are essential nutrients but too much can take a toll on health.”

Because omega-6 (see sources below) and omega-3 fatty acids compete for the same limited enzymes, too much omega-6 can crowd out omega-3s. And too much omega-6 fatty acids in the body can increase one’s risk of inflammation, increasing the risk of developing chronic diseases.

Due to changes in the food supply, she explains in her book, we eat 10-20 times the omega-6 fatty acids our ancestors ate.

“To cut back I tell families to start with three items – margarine, salad dressing and spreads like mayonnaise.” she says. “These products are made with omega-6 vegetable oils such as soybean, cottonseed and corn oil.”

Vegetable oils low in omega-6 fats include canola and olive oil. She advises families to choose canola-based margarines like Canoleo or Canola Harvest, make their own salad dressing with canola or olive oil and buy a canola-based mayonnaise.

When asked other ways families can increase their intake of omega-3 fatty acids she says they can buy dairy products that come from “pasture-fed” or “grass fed” animals – and being organic is no guarantee. When animals are fed their natural diet of grass instead of a corn-grain diet, she explains, they naturally have higher levels of omega-3s and lower levels of omega-6. One example Tribole provides is Straus Family Creamery which sells pasture-fed dairy products.

She says the Mediterranean diet is a good example of a diet balanced with the right kinds of fat. For more on this fascinating topic check out Tribole’s book, The Ultimate Omega-3 Diet.

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For more on what to feed your kids see our Nutrition for Children section.

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{ 52 comments… read them below or add one }

Estela @ Weekly Bite December 14, 2009 at 11:54 am

Maryann, thanks so much for posting this!

Great info!

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Stacy December 14, 2009 at 12:06 pm

great info…however, what are the requirements for kids under 2?

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Maryann Tomovich Jacobsen, MS, RD December 15, 2009 at 12:31 am

Stacy,

Good question. The first year of life babies will get DHA from either breastmilk or fortified-formula. Breastfeeding moms need to make sure they are getting enough omega-3s in their diet (Tribole recommends 300mg/day). At one year most children switch to whole milk and miss out on the DHA they were getting. Based on average calories for a 12-23 month year old, 325mg combined DHA/EPA and 110mg DHA would be a reasonable amount to aim for.

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Stacie.Make.Do. April 14, 2010 at 2:42 pm

One of my kids is allergic to both fish and tree nuts, so we tend to cut those out of our household diet. Is there any hope for us? What about peanuts?

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Maryann April 16, 2010 at 3:23 pm

Stacie, will send you an email.

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Thea April 17, 2011 at 11:22 pm

Great advice! I recently switched my 11 month old son from a DHA fortified formula to a toddler formula. We had also cut out fish. He started to have small temper tantrums which I think are because of Omega 3 deficit? We now give him salmon twice a week, about a palm-ful portion. How else should we supplement his diet? Thank you!

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J.C. July 1, 2011 at 2:47 pm

Could you please let me know what I should give my 4y/o, my 15m/o, & myself that is vegan (no fish or gelatin)? Thanks! I hate us missing out on EPA, but am at a loss as to what to do other than flax/chia.

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Maryann Tomovich Jacobsen, MS, RD July 3, 2011 at 8:27 am

As you know there are plenty of algae based sources of DHA but without the EPA. I found this online and it claims to be vegan with both DHA and EPA http://www.vegetarian-dha-epa.co.uk/

Let me know if you need more help!

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Charissa July 6, 2011 at 10:52 am
Roshi January 25, 2012 at 8:56 am

Could you please advice me If DHA 320mg and EPA 130 mg composition in a single softgel is suitable for 2 yrs boy and 6 yrs old girl in vegetarian source of Omega3 from algae?

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Munira July 3, 2012 at 10:03 pm

My 14 month daughter don’t get breast milk from beginning , i want to give her Omega-3 (gelatin free).which one is good for her now.pls….

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Maryann Tomovich Jacobsen, MS, RD July 5, 2012 at 4:11 pm

Munira — you just have to search around. I found this one but cannot vouch for the quality. http://www.devanutrition.com/vegan_dha_softgels.html

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Mani July 9, 2012 at 8:12 am

I would be very cautious on the dosage that is recommended. Many sources of EPA/DHA introduce risks of arsenic and mercury. No matter how good the processing is, there is still risk. It would be better to get your sources from walnuts and dairy.

All the studies done are in small scale that show the benefit of DHA/EPA. The brain development benefit is an exaggeration. We all want healthy, smart kids but giving them DHA/EPA in large dosages will not achieve it.

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Maryann Tomovich Jacobsen, MS, RD July 9, 2012 at 12:47 pm

Thanks for you comment Mani. Can you send me the data that shows there’s risk from fish oils or low mercury souces of fish? Walnuts do not contain DHA and only fortifed dairy will but there is no EPA in that. Can you also tell me what data you are using to say that the brain development benefits are an exaggeration? The first two years are most important and is why all formulas contain DHA now. Again, this is a research-based site so I like to see research to support people’s claims. Read more from the WHO recommendations for children http://www.who.int/nutrition/topics/FFA_summary_rec_conclusion.pdf. Accordign to them there is convincing evidence that
DHA plays a “critical role in retinal and brain development” from 0-24 months and that is likelly to plan an important role throughout childhood.

Thanks!

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Deepk Arora September 12, 2012 at 5:36 am

I would like to ask about the average dose for child and adult OF DHA
DHA isolated from which algae.
I shall thank

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Jay Stephens October 18, 2012 at 2:45 am

some of the new vegetarian algae supplements have both EPA and DHA -for example the product here has 400mg DHA and 100mg EPA: http://www.nuique.com/omega3/

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Christy October 18, 2012 at 8:52 pm

My daughter has severe allergies. We have recently been asked to place her on 5 grams of Omega 3 per day to help with inflammation in her body. I am wondering if this is a safe to do for a short period of time. Currently we are using Nordic Naturals Ultimate Omega, but I have only given her the normal adult dosage once per day which is 1280 mg.
Thanks.

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Maryann Tomovich Jacobsen, MS, RD October 19, 2012 at 6:37 am

I cannot say whether or not that is safe. I have never heard of giving high amounts omega 3s to treat food allergies. Who is recommending this? Check with your pediatrician or get second opinion.

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Lyndsey Huss, RD December 21, 2012 at 11:22 am

Would you happen to know the original reference for the “international guidelines” of children 2-6 years old being recommended the below amounts of DHA/EPA? I have been researching this for a few hours and can’t find the original reference…

“…based on international guidelines she recommends children 2-3 years old get 433mg of DHA/EPA with a minimum of 145mg of DHA, 4-6 years old get 600mg of DHA/EPA with a minimum of 200mg of DHA…”

Thanks!

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Lindsay33 December 30, 2012 at 8:07 pm

Hi,
I give my kids Horizon Organic milk with Omega 3s. I sometimes give them the chocolate too. They love it and don’t like to drink other milks now. Is this a good source of DHA? Is it worth the extra cost? I will do anything to help them develop healthy little brains! Thanks!

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Maryann Tomovich Jacobsen, MS, RD December 31, 2012 at 9:39 am

You’ll have to check the label but most milk with DHA has about 30mg per cup. So the key is to incorporate other sources such as fish and DHA-fortifed eggs. The milk alone without other sources isn’t enough to get them to recommended levels.

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TinaB January 8, 2013 at 3:32 pm

I have a 10 1/2 yr. old 74 pounds boy with attention and focus problems, it was suggested DHA fish oil 850 mg of total omega-3, is this too much? I usually do less than more.

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Syed Mashhood Hasan February 13, 2013 at 7:56 am

Dear Sir/Madam.
I have a daughter 27 years age with epilepsy uncontrolled ceisures/ short jerks. Can I give her DHA or DHA/EPA? and how much dosage per day. Her weight is bout 40 Kg.

thanks a lot.

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Maryann Tomovich Jacobsen, MS, RD February 14, 2013 at 4:11 pm

I would check with her doctor.

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Nick April 1, 2013 at 11:46 pm

Hi Maryann,

My wife had Omega 3 supplements throughout her pregnancy (325 mg DHA) and unfortunately could only Breastfeed for 2 months (still taking supplements) then our daughter had DHA fortified formula until she was 1 then she went off milk. From 1 year to 20 months she had an excellent diet (and still does) which included COD and Salmon once a week (sometimes twice) plus organic eggs & milk (not fortified) then at 20 months until now (she is 4 in July) she has had a daily dose of fish oil which we buy from our GP which contains about 225mg DHA as she went off fish. Does this all sound okay to you? my concern was always perhaps not enough DHA between 1year -20 months?

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Maryann Tomovich Jacobsen, MS, RD April 2, 2013 at 6:04 pm

Nick — sounds like she is doing great! Try not to worry about the past as there is nothing you can do but it sounds like she got enough DHA those first important two years.

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Julio April 8, 2013 at 11:25 am

It’s very effortless to find out any topic on net as compared to textbooks, as I found this paragraph at this site.

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Valerie April 11, 2013 at 10:18 am

CANOLA IS GMO!!! That is the worst recommendation one could make about Om 6 and 3…better choices are Olive oil, sesame oil, chia seeds, flax oil and flax seeds…such a great post but terrible judgment on the Canola.

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Maryann Tomovich Jacobsen, MS, RD April 11, 2013 at 12:32 pm

Valerie — this article was about fat type and not GMO. People can choose organic canola oil if they are worried about that. For more on canola benefits see this post http://blogs.webmd.com/food-and-nutrition/2012/07/the-skinny-on-canola-oil.html

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Denice April 12, 2013 at 7:27 pm

I like reading through an article that will make people think.
Also, thank you for allowing for me to comment!

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Andrea April 21, 2013 at 4:03 am

Hi,
I have recently started giving Nordic Naturals Children’s DHA to my 18 months old son containing 205mg of EHA and 300g of DHA in one dose (2.5ml of liquid) but I am confused about the age recommendations and wonder if this is too much. There is only one reccomended dose on the bottle 2.5ml and showing figures it provides for 4 year olds and other figures for under 4 year olds. It also says to ask doctor if giving to children under 8 months but I know he can take it now but I’m unsure if dosage is correct.

Also I was wondering if you recommend Nordic Naturals as the oil is derived from cod livers and I read that oil from livers can contain high level of vitamin A. Their website argues this and states that pure cod livers have healthy levels of vitamin A and the bottle of the oil I have says there is 213-750 I.U in one dose which is 9-30% of RDA. What is your opinion on this please? Would you say this is safe or would you recommend another brand?
My boy eats some fish but is a little picky at the moment. He is not the fastest developer so I am hoping this will help a bit with his progress.
Thank you very much!

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Maryann Tomovich Jacobsen, MS, RD April 27, 2013 at 7:32 am

Andrea,

I would contact the company. I’m sure they have a dietitian or some health professionals that can field these questions. I believe it is a reputable brand. I use Carlson’s fish oil for kids (lemon) and i like that I can spoon up as much as I like.

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Lashonda April 24, 2013 at 4:59 pm

Hi,
I thought DHA was in breastmilk, so I didn’t take a supplement for it after my daughter was born. She’s almost a year old. Did my not taking DHA or eating fish regularly harm her development? What should I do from this point on? Thank you.

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Maryann Tomovich Jacobsen, MS, RD April 27, 2013 at 7:22 am

Lashonda, I’m sure you didn’t harm your child’s development. DHA is naturally in breast milk. If you get more DHA in your diet it will increase. Do you eat fish?

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Michelle June 18, 2013 at 6:11 pm

My son has multiple food allergies. 2 of which are sources of DHA/omega-3 – Walnuts, Flaxseed and Eggs. He can eat fish and we try to give it to him, when he actually wants to eat. He’s 20 months so pretty picky. I’ve picked up a DHA supplement with EPA. Would that be ok? Are there other foods that he can eat with DHA/omega-3?

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Maryann Tomovich Jacobsen, MS, RD June 20, 2013 at 7:24 am

You can buy some fortified foods but those don’t have much. I would stick with the supplement as it likely will give him all that he needs. Keep offering fish ; )

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kartik July 22, 2013 at 10:47 am

Madam I have 1 year and 3 months old boy I want to give him nordic kids dha.so please tell me the ideal dosage of dha and epa.

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Tammie August 13, 2013 at 1:16 am

Hello,
I have been looking for Omega 3/DHA/EPA suppliments for my son who is 7yrs old. It has be for kids ones? Or I can buy adult bottle and both of us can share?

“Kirkland Signature Omega-3 Fish Oil Concentrate 1000 mg Fish Oil with 30% Omega-3s (300 mg)”

Is it too sromg for 7 yrs old or okay? I am so confused now. I don’t want him to give too much pills to take.

Sorry for such a silly questions.
Thank you.

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Pooja October 17, 2013 at 10:16 pm

Hi,

My OB did not prescribe me a prenatal with DHA :-( .

I have a 3.5 month old son, breastfeeding. I just started prenatal with DHA about 3 days ago.

Is there something I need to give to my baby as I did not take the DHA supplements during pregnancy?

Thanks,
Pooja

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Maryann Tomovich Jacobsen, MS, RD October 24, 2013 at 11:48 am

No,you are doing the right thing. Did you eat fish during pregnancy or other foods with DHA?

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Jayesh November 9, 2013 at 7:23 pm

Hello.
I have a daughter n she is 8 months old.
She is on breast feeding.
Plz guide me whether what to give n when to start n in what quantity shall we give her for best development for her brain.
Thanks.

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Bri B January 26, 2014 at 1:04 pm

I too have a question on safety of omegas derived from cod liver oil. I know it is relatively low in mercury, but if we give a daily dose, is it still considered a safe amount?

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shoba April 26, 2014 at 11:58 am

Hai madam, I used enfalac for my son since new born baby step by step. Nw his guin to b 18mnt .wat milk powder can I giv him.

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Raj June 18, 2014 at 2:10 pm

Hi,
I did not know about Fish oil and DHA and my Dr. did not tell about it, my girl is 3 years 9 months and is slow at learning. Just got the Carlson fish oil. It says 2.5 ml for kids of 4+, is it safe?
She seems to be slow in learning, should i be worried? or do something else?

Thanks

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Wendy July 4, 2014 at 8:31 pm

Hi,
I found this thread as I was searching for a non fish/non nut or seed source of DHA for myself as part of a nutritional program I want to try to improve my overall health.

I just wanted to reassure all the parents out there who seem anxious about their children who have allergies.

I am 47 and by the time I was 4 years old my parents were told I was allergic to everything apart from cereals and horses. Seriously. Back then, my emergency treatment for my asthma attacks was a small pink tablet that dissolved slowly in water, while one parent rubbed my back, talked me calm and helped me control my breathing.
I am anaphylactically allergic to nuts, fish, seeds (and fruit containing seeds) and highly allergic to multiple other substances. It is the proteins I am allergic to – so nowadays I can cope with traces of oils – apart from peanut or any kind of fish oils. Cows milk gives me eczema. I carry an epipen.

But growing up I couldn’t – so didn’t eat any dairy products, no fish, no nuts or seeds, no tomatoes, only fruits with stones like plums – and only peeled peaches as the skins made me itch.

I have an IQ of 138, and despite being off school due to ill health for 2-3 days out of every 5, I still have a university level education and received no additional tutoring at home. I have a good memory. Altho, less so as the years catch up on me :)

So, please……try not to stress out too much. The human body is an amazing thing. And modern science is so much more advanced than it was back when I was little. As long as you give your child as varied a diet as possible – keep away from processed, refined and GMO foods as much as you can, read to them, give them access to real play….not just structured play, but time to use their imagination and to just ‘be kids’ getting dirty and having fun, and quiet time to play – they will be fine.

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liyun qiu August 25, 2014 at 4:51 pm

My child was 13 months, the doctor diagnosed her eyes with high myopia, the doctor opened the nemans DHA al gal oil softgel this medicine, is to help her eyes and brain, do you have what good DHA al gal oil softgel, thank you

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Dana Orsman September 24, 2014 at 12:48 pm

Hi. Good info, but I have the same challenge as Stacie…I have one child with a severe fish allergy and one with a severe nut allergy, so we avoid those products. What can we substitute to get the necessary omega3 combo?

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Moongazer September 24, 2014 at 2:34 pm

Dana,

Hi, I replied on the thread. I’m not a dr, but I wanted to let the parents of children with severe allergies know that it is possible to have a severely restricted diet as a child and still turn out ok as an adult.

I am able to tolerate flax seed oil, despite being severely allergic to nuts and seeds because it’s the protein I react to, not the fats. Altho plain old fear stops me trying fish oils as fish = sudden death to me. But it might be worth having a word with your allergy dr about flax seed oil.

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Habiba October 22, 2014 at 12:18 pm

Hi Maryann. Great article! We are currently using a purified, super-concentrated omega 3 fish oil. It is certified free of PCBs, pesticides, mercury, heavy metal and dioxide. A 5ml serving – which is the daily recommended intake as per the instructions – has 1900 mg of omega 3 fatty acids in total; 900 mg EPA, 600 mg DHA, and 400 mg of ‘other’ omega 3 fatty acids. I used it while I was pregnant with our first and second child. Our first child just turned one. Is it ok if we give him the 5ml serving daily, or will that be too much for him? Can he overdose? We have not fully introduced fish into his diet and the oil is very convenient to give. However, we are a bit reluctant because of the high omega 3 content in this oil (1900 mg). We would really appreciate your advice and feedback! If you wish, you can check out the company’s website at http://www.therealthing.co.za.
I am also breastfeeding the second child, and I continue taking the oil, although not every day. Is that ok or is it too much for the newborn?
Thank you very much

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iris November 10, 2014 at 4:18 pm

hi, my niece is only 4 weeks:) and am not sure whether she chould take DHA mix up with milk or not?

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Maryann Tomovich Jacobsen, MS, RD November 11, 2014 at 4:17 pm

There should be enough DHA in her formula or breast milk. Breastfeeding moms should get at least 200mg DHA either from diet or supplements as mom’s intake is is related to how much is in breast milk.

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Pranab naskar December 7, 2014 at 4:05 pm

I Ve got 22 months old boy. Who was born in London . My main concern is during pregnancy baby mother ate wild salmon twice a week(130).after he brought up in london til 23 months. I tried to provide required quantity omega-3 source from fish and others. BUT NOW -he is been kept in India for 6 months. My concern is in india no such type of fish nor other source of omega-3. OR may be I don’t know much. Could u plz advice Wht shall I do to provide enough omega-3 or DHA to his diet.
Thank you
Pranab

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