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Eat Fish. It's Good For You

Particularly during pregnancy No. 2, I wasn't the type of mom to count the ounces of fish I ate. If I craved tuna at lunch, I ate a tuna sandwich. If I wanted fish for dinner, I made it. And I've never been one to turn down shellfish, baby or no baby. Now, that lack of worry isn't looking so bad.

The National Healthy Mothers, Healthy Babies Coalition -- a nonprofit group with nearly 150 members, including the American Academy of Pediatrics, the March of Dimes, the National Institute on Child Health and Human Development and the Centers for Disease Control and Prevention -- is recommending that pregnant and breast-feeding women eat at least 12 ounces of fish or seafood per week for optimal baby brain development.

That flies in the face of previous recommendations that pregnant and breast-feeding women eat no more than 12 ounces of fish because of the risks of mercury contamination.

Fish, it's good to have you back. You've had a bum rap for way too long.

Now, if we could just ditch those other "recommendations" like not gaining more than 35 pounds during pregnancy ... Oh, wait. Apparently, according to the latest study that's sure to fuel talk of changing pregnancy weight-gain recommendations, obese women who gained little or no weight during pregnancy reduced their risk of hypertensive disorder, had fewer C-sections and had normal birthweight babies, according to Dr. Raul Artal, study author and chairman of the department of obstetrics, gynecology and women's health at Saint Louis University School of Medicine.

Well, you win some, you lose some.

How did you approach pregnancy and nursing mom food guidelines? Will this change your eating habits?

By Stacey Garfinkle |  October 4, 2007; 8:50 AM ET  | Category:  Babies
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Comments


Do you realize that mercury is the second most toxic poison? Exactly how much do you think is too much for your child? I think I would hold off on the fish known to contain even small mercury levels. Maybe then you won't be giving your child a medication to pull mercury out of your child's system as we are. I'm not saying that eating fish is what caused my child's problem with mercury, I AM saying that even tiny bits of mercury can cause problems in a baby. I have also seen enough problems in many other children to know it's not always good to listen to what the "experts" say.

Posted by: texasmom | October 4, 2007 9:29 AM | Report abuse

There are some fish that are lowerer in mercury, so you could primarily eat those fish and reduce the risk of mercury. Particularly if your are pregnant, nursing, or a child. But overall, the National Healthy Mothers, Healthy Babies Coalition is saying the benefits outweigh the risks. Even for Tuna. For a more detailed discussion, here is a link to their web site:

http://www.brainybabieshealthykids.org/seafood-recommendations-for-pregnancy/

Posted by: Cliff | October 4, 2007 9:51 AM | Report abuse

If one needs to pay attention to such studies, and follow the guidelines. The thing to do is consume approximately 2 servings (12 oz) of seafood from the low mercury list. This presents, essentially, the closest you can get to splitting hairs.

You can also get suppliments of the important Omega-3 fatty acids, though I have no idea if these contain mercury as well. They do, however, taste terrible if you have to chew them (but really, what suppliments don't?).


Posted by: David S | October 4, 2007 9:58 AM | Report abuse

"You can also get suppliments of the important Omega-3 fatty acids, though I have no idea if these contain mercury as well. "

I look for bottles that say something like "mercury free." Are they? I have no way of knowing--but I've done what I can, and therefore I choose not to spend much time worrying about it. Also, the supplements I've had are gelcaps, not chewables, so the taste isn't an issue.

Posted by: Kate | October 4, 2007 11:03 AM | Report abuse

"you win some, you lose some"

What? So you're actually calling a study that shows advantages to obese women gaining little or no weight during pregnancy a LOSS? Huh?

I say YAY for some sort of proof that excessive weight gain during pregnancy is dangerous, and that obese women eating a healthy diet during pregnancy is a GOOD thing.

But apparently you just want to eat like a cow during your pregnancy and have people tell you that's OK.

Posted by: Anonymous | October 4, 2007 11:35 AM | Report abuse

texasmom - do you have any comments on this story - http://seattletimes.nwsource.com/html/health/2003906437_mercury27.html

Just propeganda?

Posted by: Anonymous | October 4, 2007 11:42 AM | Report abuse

Please consider the health data from EPA/FDA which form the basis for the 2004 advisory. It found women that consumed fish within the past 30 days were most likely to have unsafe levels of methyl mercury in their blood. If you are pregnant, be aware that methyl mercury is a potent nerve toxin. If you do eat fish, please consider shrimp or salmon, which had some of the lowest levels of mercury found in the EPA/FDA study. Perhaps I've lived in DC too long, but I would be very interested in finding out the sources of funding for this new recommendation targeted at a population of women that are often identified as the primary food shoppers in their household.

Posted by: mom of three | October 4, 2007 11:48 AM | Report abuse

My chicken-nugget-loving son (6 yrs) now enjoys salmon. Maybe it's true what they say about patience.

Posted by: Arlington Dad | October 4, 2007 12:31 PM | Report abuse

Posted by Anonymous @ October 4, 2007 11:42 AM:

"texasmom - do you have any comments on this story - http://seattletimes.nwsource.com/html/health/2003906437_mercury27.html"

I cannot comment for texasmom, but the study in question deals with mercury present in thermasol, an antibacterial compound found in vaccines more commonly earlier than 2001, but still found in some. The amount of mercury found in these vaccines is minute.

In the spirit of Mythbusters, I will warn concerning "incomming science content:"

The mercury found in most fish is a compound sometimes refered to as "methylmercury." Both this compound, and ethylmercury (found in thermasol) belong to a group of compounds that are called organomercury or organic mercury.

Organic Mercury compounds are more toxic than other mercury compounds or elemental mercury itself. We know that methylmercury is very toxic. Ethylmercury is caught up in the controversy regarding whether thermasol causes autism, and the science is inconclusive. The chances are that methylmercury is more toxic.

There is also the addition of the limited applications of a vaccine versus the regular intake of fish. Like most heavy metal poisoning, mercury poisoning has to do with the tendency of heavy metals to build up in the body because we have limited mechanisms to purge the body of them. Thus, you can understand why fish, consumed regularly, can be more dangerous than vaccines due to the greater likelyhood that mercury will build up in the body.

Posted by: David S | October 4, 2007 12:42 PM | Report abuse

Secret that the fishing industry does not want you to know about (as well as the grocery industry).

How about a plant-based way to obtain Omega-3?

Try flax seed (check your local farmer's markets or GNC, although it is more expensive at GNC).

Flax seed doesn't make anyone a lot of money, which is why I think it is not really promoted. I took two tablespoons a day in my morning oatmeal (nutty flavor, very mild). It also helps your digestive system (my husband first started using it for excessive stomach acid issues).

It should be ground and kept in the freezer (oils are delicate).

I love fish but don't like the thought of overfishing (going on like crazy) and mercury.

Viva flax seeds! A great healthy choice with no worries attached.

Posted by: Rebecca | October 4, 2007 1:11 PM | Report abuse

Thank you David S for your enligntening message. I believe that mercury containing fish and the use of mercury compounds in vaccines in the 90's through the early 00's are responsible for the marked increase in Autism. I never knew of the disease till recently.

Also in the 90's doctors encouraged all parents to own mercury containing thermometers instead of relying on the age old method of "hand feeling your child for a fever". Improper disposal of these thermometers have contributed to the increase in mercury in the habitats fish live in the US.

I stayed away from fish as much as possible when I was pregnant in 2006. Now I try to eat only fish not raised in US waters although I will occasionally eat any kind of fish.

As parents, lets help elliminate Autism by using only digital thermometers and continuing to advocate for the removal of mercury in anything injested by infants and pregnant women.

Posted by: Concerned | October 4, 2007 1:15 PM | Report abuse

Posted by Concerned @ October 4, 2007 01:15 PM:

"Thank you David S for your enligntening message. I believe that mercury containing fish and the use of mercury compounds in vaccines in the 90's through the early 00's are responsible for the marked increase in Autism. I never knew of the disease till recently."

"As parents, lets help elliminate Autism by using only digital thermometers and continuing to advocate for the removal of mercury in anything injested by infants and pregnant women."

I had not intended to insert the Thermisol/Autism debate into this thread, I think they are two different debates. I, myself, cannot say conclusively whether an Autism spectrum disorder is triggered by the ethylmercury found in Thermasol. Ethylmercury has not been thoroughly examined by the scientific community.

As for the presence of mercury compounds and elemental mercury found in other areas, I had not heard of mercury from thermometers is being an issue. Because thermometers contain elemental mercury, the toxicity is comparatively low. You can touch, or even eat small amounts of elemental mercury, it is the organomercury compounds you have to worry about.

I say this because these organomercury compunds are mostly manmade, and certainly the ones you have to worry about most in fish are the result of manmade organomercury compounds. The toxicity of the substances make them very good antibacterial and antifungal agents, and they have been used as such all over the place, not just in vaccines. The risk from thermometers is very small compared to bioaccumulation from the use of these chemeicals in agriculture and industry.

Posted by: David S | October 4, 2007 1:40 PM | Report abuse

I thought I should add something as well. The term "toxicity" may be misleading in that it represents the amount of a substance you can be exposed to before it can be harmful. Technically speaking, there is kind of toxicity threshold for even very common substances like water, at which it can be damaging to you.

Posted by: David S | October 4, 2007 1:51 PM | Report abuse

Thankfully, I'm past childbearing.

But I'm convinced that paying attention to the latest diet and food research during my second pregnancy (10 years ago) prevented a repeat of the nearly disastrous pre-eclampsia/toxemia/placental abruption/crash c-section of the first birth.

Adequate lean protein, and keeping salt in my diet were the latest-and-greatest recommendations for women at risk of pregnancy-induced hypertension. My blood pressure stayed normal and I had a successful VBAC. And younger son weighed a pound and a quarter more than older son at birth.

Seems to me that the newest recommendations can be followed by most women, but those who have risks that might be affected by mercury can use their best judgement about balancing the risks and benefits of seafood. Or weight-gain.

Posted by: sue | October 4, 2007 2:01 PM | Report abuse

I'm allergic to fish AND shellfish. They're both very high on the allergen count, and for some reason people constantly discount the fish allergy as a myth or try to correct me ("No, you're allergic to SHELLfish!"). My mom is allergic to fish too, but not shellfish.

I came out OK (and a genius). My mom came out of the pregnancy OK too, so...how closely do some of these guidelines need to be followed, and why do they always make it sound like YOU PERSONALLY ARE KILLING YOUR CHILD if you cannot accommodate some of these guidelines?

Posted by: Kat | October 4, 2007 2:02 PM | Report abuse

Posted by Kat @ October 4, 2007 02:02 PM:

"I came out OK (and a genius). My mom came out of the pregnancy OK too, so...how closely do some of these guidelines need to be followed, and why do they always make it sound like YOU PERSONALLY ARE KILLING YOUR CHILD if you cannot accommodate some of these guidelines?"

The best answer I can have is that it is the presentation adopted by the media is one designed to increase sales. Science is a pretty stoic discipline, particularly when it deals with the interpretation of statistics, and thus it needs to have some excitement added, even if that excitement is fear.

I will add that your allergy to fish and shellfish is not surprising to me. There are numerous things in both that you could be allergic to. Shellfish is a more common allergy (because of iodine), which would be where people are being led astray. However, it is not that fish are the only source of Omega-3 Fatty Acids; as Rebecca pointed out, there are many vegitable based sources as well. Fish are just a good source, not a necessary staple.

Posted by: David S | October 4, 2007 2:38 PM | Report abuse

Just posted to the NRDC blog @ http://switchboard.nrdc.org/blogs/htaylor/mercury_in_fish_is_still_bad_f.html:

If the government or some prestigious health organization tells me that I need to avoid something in order to protect my child, there is no question that I will follow that instruction. I am a first-born with first-born tendencies. Besides being too bossy and obsessively on time, one of my most annoying first-born compulsions is that when someone in authority tells me to do something, 99.5% of the time, I do it.

So, in my 4 ½ years as a pregnant and nursing mom, I have avoided certain fish because of their mercury content. Why? Because the government and health organizations told me to avoid certain fish in order to protect my children from mercury exposure. Easy, right? Well, following the rules is always easy until folks start to muddy the waters. Today, I opened the Washington Post to find the headline, "Mothers Again Urged to Eat Fish: Advisory at Odds With FDA Stance." Ugh! My internal conversation went between being bitter about having boycotted tuna-melt sandwiches all of these years and being seriously irritated that people are putting out information in a manner that is confusing.

It isn't confusing if you know the facts. Here is the deal: it isn't even a real, true change from what everyone has been saying for years. Here is what you need to know:

FISH IS GOOD, MERCURY IS BAD. IF YOU ARE A PREGNANT OR NURSING WOMAN, AVOID FISH THAT HAS A HIGH CONTENT OF MERCURY IN IT. Pardon the caps but I wanted to make sure that all of you moms who have no time to read this entire blog can at least get the bottom line before you have to rush off to tend to boo-boos or, like me, need to take a conference call so you can leave work in time to make dinner.

There are still some people who want more science about how much fetuses and babies are exposed to mercury by their moms but until that science is done, stick to the current American Academy of Pediatrics policy and FDA and EPA recommendations. Avoid eating shark, tilefish, king mackerel and swordfish because of high mercury content, and eat no more than six ounces per week of albacore tuna. If you want more information, not only can you go and visit their websites, but you can also visit NRDC's site at www.nrdc.org/mercury.

In the meantime, allow me to take a moment to talk directly to those much appreciated, prestigious health organizations and government officials who urge moms to eat fish: Dear smart folks, I am a working mom. I barely have time to take a shower much less keep up the pros and cons of each of your recommendations. I understand that science changes, evolves and gets better but can you do me a favor and just be clear of what I need to do to protect my children? If the mixed signals are confusing me - a person who actually works in the environmental world - than how are the other moms feeling? Thanks.

Posted by: Heather Taylor | October 4, 2007 2:48 PM | Report abuse

The Omega 3s from flaxseed oils (ALA) have not been proven to provide the same benefits as those from fish (DHA and EPA).

Posted by: Jim | October 4, 2007 3:13 PM | Report abuse

You know, it's strange. The Post's writers on the issue of mercury and pregnancy are just idiots. I've pointed this out before on here. They paint things as a false dilemma: Eat fish and poison your child with mercury or avoid fish and deprive your child of omega-3s.

As any currently or recently pregnant woman with a decent OB will tell you, pregnant women are strongly encouraged to take omega-3 supplements. Specifically, Expect provides omega-3 (yes, DHA) that does not originate in fish.

So, yes, you can have the best of both worlds: Avoid mercury and STILL get your omega-3s. Of course, why point this out when you can stir up controversy? Isn't it much more fun to have a completely stupid argument about, what turns out to be, a false choice?

Posted by: Ryan | October 4, 2007 3:19 PM | Report abuse

When I was pregnant with my daughter, I avoided tuna fish, which effectively meant I wasn't eating fish at all (DH doesn't eat cooked fish, so my fish consumption pre-pregnancy was generally limited to eating a tuna sandwich for lunch on occasion). I was given a list of high/moderate/low mercury fish, but never had any desire to memorize it. Avoiding fish entirely was simpler. I can't say that I'd do differently if I ever manage to get and stay pregnant again.

As far as the weight issue goes, I will admit to being obese. I gained 18 pounds when I was pregnant with my daughter, which was right in the range of what I was supposed to (15-20 pounds). It was kind of a kick going to the doctor and getting praised for my weight, for once.

Posted by: NewSAHM | October 4, 2007 3:22 PM | Report abuse

Ever wonder what women in other fish eating countries do? Countries like Iceland and Norway and Japan where women consume huge quantities of fish? They eat lots of fish and they seem to be okay. Is it possible we're a little too worried sometimes about these things? I have two kids, and I was careful in following my OB's recommendations. But what's recommended this decade may not be what they recommend in another 10 years. A little moderation might go a long way.

Posted by: Overseas | October 4, 2007 3:55 PM | Report abuse

Dear Jim,

I had no idea -- is it that the flaxseed ALA oils were not proven to be as beneficial in these studies or was it that they were not studied at all?

Thanks!

Posted by: Rebecca | October 4, 2007 4:08 PM | Report abuse

Ryan: Regarding this statement: "As any currently or recently pregnant woman with a decent OB will tell you, pregnant women are strongly encouraged to take omega-3 supplements."

I know my last pregnancy was now 3 1/2 years ago, but I never heard this. My OB practice is a fairly large, well-respected practice.

The American Heart Association says this about Omega 3 supplements: "Patients taking more than 3 grams of omega-3 fatty acids from supplements should do so only under a physician's care. The FDA has noted that high intakes could cause excessive bleeding in some people."

Posted by: Stacey Garfinkle | October 4, 2007 4:22 PM | Report abuse

My prenatal vitamins have a second pill that is a DHA supplement (300 mg). I picked them randomly from one of the many, many samples my doctor gave me, but many of the choices seemed to offer DHA supplements. 300 mg is nowhere close to 3 grams, though.

The recommendations say that you can eat DHA fortified eggs in addition to ocean fish in order to get the necessary Omega-3s. I don't think I've heard anyone say anything about mercury in eggs, so that seems like a safe route to take if you are concerned.

I will say that I think it all gets very confusing with what you should/shouldn't do/eat, etc. during pregnancy, not just with the fish. Doctors seem to recommend different things and it is hard to know what is or isn't okay. I've still got 6 months to go, hopefully I'll be able to find some sort of middle ground. I'm generally just trying to do what seems right and not worry too much.

Posted by: Carifly | October 4, 2007 4:56 PM | Report abuse

Regarding the linked article, it is my personal opinion that the CDC is issuing their statements about thimerosal as a "red herring" if you will. The overload of vaccines itself is a problem for children with weakened immune systems (ear infections/gastro issues) and seems to allow for problems with the MMR and DPaT vaccines especially. These problems seem to lead to an incapacity to get rid of the metals, among other things. BTW, did you know that Norway has a high rate of people who are allergic to fish? Also, my son does take EPA/DHA as one of his supplements, but it comes from Norway and doesn't contain certain contaminants.

Posted by: texasmom | October 4, 2007 9:39 PM | Report abuse

Well, Stacey, hopefully, carifly's comments help you to believe what I'm saying. Not to be too difficult, but three and a half years is a long time ago in terms of the fish, mercury, and DHA debate. Also, the supplements are 300 mg of DHA.

I mean, really, it hasn't been that long since scientists began figuring out how critical DHA was to brain development. Anyway, hopefully, your OB now knows about this. If he/she doesn't, I would strongly recommend getting a new OB, no matter how much you like him/her. One of the funny things about finding good doctors is that older, more "experienced" doctors are often out of date with the latest findings, despite CMEs.

Posted by: Ryan | October 4, 2007 10:00 PM | Report abuse

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