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Take Fish Oils for a Brighter Baby

Posted on: Tuesday, 13 March 2007, 21:00 CDT

By DR MARK PORTER

OMEGA-3-rich fish oil supplements have become increasingly popular with parents following research showing that they can have a significant impact on a child's development and behaviour.

And you don't have to wait for your baby to be born, according to new research in The Lancet showing that children whose mothers ate a lot of seafood during pregnancy are more likely to have higher IQs, be more coordinated and have better communication skills than those whose mothers didn't.

Yet, at the same time, the Food Standards Agency (FSA) is advising pregnant women to avoid some types of oily fish completely, because of fears that pollutants concentrated in the flesh could harm a developing baby. So what is a mum to do?

The FSA advice - to avoid shark, swordfish and marlin completely and to limit tuna consumption to two fresh tuna steaks or four medium-sized cans a week - is based on concerns that mercury in the fish could interfere with fetal brain development. But so could a lack of omega-3.

Many experts, including the team behind the Lancet study, now believe the benefits of a diet rich in oily fish exceed the risk from mercury contamination - particularly during the last three months of pregnancy when brain development is at its most rapid.

There is, however, another option that could give the same benefits without any risk - adding purified pollutant-free omega-3 fatty acids to your diet in the form of fish-oil supplements.

But which supplement should you go for?

Ask two experts and you are likely to get two different opinions. Most nutritionists I speak to suggest supplements containing a mix of the two main types of fatty acid (EPA and DHA) in a ratio of around 2:1. So if your chosen supplement contains 200 mg of EPA, then it should contain around 100 mg of DHA. But other experts believe that EPA is more effective on its own.

There is as much disagreement about dose, but 500-1,000 mg three times a week is probably a sensible minimum.

Avoid cod liver oil or any other type of supplement that contains vitamin A.

The vitamin has been linked to congenital abnormalities. If in doubt ask your pharmacist.

Be careful if you are prone to indigestion or heartburn (as many pregnant women are). Fish oils may be natural and safe, but they are not side-effect-free and some women who take them can experience quite severe indigestion and nausea.

Cutting back on the dose, or taking the capsules every other day, may help, but some women have to stop them altogether.

Will cash make us better?

THE NHS spends around Pounds 10 billion on medicines, most of which are used to treat or prevent long-term problems such as diabetes, high blood pressure and heart disease. But medicines only work if they are taken properly, and four out of 10 people on long- term medication don't take theirs regularly enough to derive any benefit.

Could paying people to take their pills properly help solve the problem?

There are lots of reasons why patients don't take their medication, ranging from forgetfulness to concern over side effects, and it doesn't seem to make any difference how ill the person is. Poor compliance is the main cause of organ failure in people who have had heart transplants.

So if the threat of ill health (the stick) isn't incentive enough, might the carrot approach be the answer? A recent experiment in east London where patients with mental health problems were offered up to Pounds 15 when they received their monthly injections, improved attendance significantly.

I am not sure I am comfortable with the concept of paying people to take their medicines.

It may work well in psychiatry, where patients often question the need for their treatment, but I'd rather see the money spent on campaigns to encourage more candour.

If you are not taking your pills, for whatever reason, please come clean with your doctor. We would rather know, because at best poor compliance is a waste of valuable resources, and at worst it could mean that your condition isn't being properly managed.

How to beat the heat

THIS week's edition of General Practitioner contains a useful review of the latest thinking on how to manage a high temperature in babies and young children.

The rationale for lowering fever is based on two main benefits. It should reduce the risk of febrile convulsions (as many as one in 30 children under five will have at least one epileptic-type seizure caused by a high temperature), and often makes the child feel more comfortable. But what is the best way of going about it?

Step one is to avoid the temptation to over-wrap your child. He or she may be shivering, but it's because they are too hot, so take clothes off, rather than put them on.

Step two is to give them a dose of paracetamol or ibuprofen (following the instructions on the label). There isn't much to choose between the two, but there is some evidence that ibuprofen works better and lasts slightly longer.

Step three used to involve tepid sponging - popping the child into a shallow tepid bath and gently sponging them - but the latest advice is that you shouldn't do this.

Paradoxically, by encouraging the circulation in the arms and legs to constrict, it may actually temporarily push a child's temperature up.

If, despite the above, their temperature remains high (above 38.5), consider adding a one-off dose of whichever drug you didn't use the first time. So, if they are having regular paracetamol, add in a one-off dose of ibuprofen, or vice versa.

THERE has been a lot in the media over the past week about natural family planning, in light of a study that found it was nearly as good as the Pill at preventing pregnancy. The women involved used changes in their body temperature and their discharge to work out their fertile period, and then used a condom or abstained from sex until it was over.

The signs signalling ovulation and the start of the fertile window are complex but the basic principle is that a woman's body temperature dips, and her secretions become clearer and more stretchy (like raw egg white), just before the egg is released.

Natural methods make a lot of sense in theory, but in my experience they simply don't work in practice. The real world is very different from the regimented protocols of a clinical trial, which is why the failure rate for the Pill in young women is as high as one in 25, rather than the one in 1,000 seen in trials.

And for natural family planning that real world rate could be as high as one in six. It may work brilliantly for some couples, but unless you have been properly instructed in what to look for, and have the willpower to stick to the rules (and most couples do not) then please don't depend on it. To do so is akin to playing Russian roulette.

Source: Evening Standard; London (UK)

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