Should I be giving my kids DHA supplements?

I keep hearing about how important DHA is for kids’ health, and that the best sources come from fish. My kids don’t like fish. Should I be giving them DHA supplements?

Question:
Ellen Rome, M.D.
ABOUT THE EXPERT

Ellen Rome, M.D.

Dr. Ellen Rome is a board-certified pediatrician who was among the first in the U.S. to be board certified in adolescent medicine. She... Read more

DHA is an omega-3 that is essential for a child’s brain, eyes and heart health. My preference for children would be to look to food sources -- in your kids’ case, nonfish food sources -- to get their DHA and other omega-3s before giving them a supplement. (However, you should never underestimate the power of foods in disguise. Fish can taste a whole lot like chicken when it’s prepared in a kid-friendly nugget form, breaded and baked to a golden crispness!)

DHA is the main fatty acid in the brain and other organs and is critical for optimal function. The body’s DHA comes from the conversion of alpha-linolenic acid (ALA), which is an omega-3 found in many plants. This conversion is slow. To get more rapid boosts in DHA levels, you need to get DHA from sources such as coldwater fish, including salmon and tuna. High levels of ALA are found in flaxseeds, which can be ground up and added to salads, muffins and pesto or sprinkled over whole-wheat pasta.

Some newer studies are pinpointing a possible connection between protection against certain cancers and autoimmune diseases. Spinach, kale, salad greens, chia and canola oil all contain ALA. Walnuts are also a great source of ALA. They have six times the amount of omega-3 compared with other nuts. (Nuts in general, by the way, are packed full of antioxidants, fiber, minerals and amino acids. However, we recommend the 5-year-old and under crowd avoid all nuts due to the risk of aspiration, or having it go down their windpipes instead of into their stomachs.) For school-age children, you can do the same thing that I recommended with flaxseeds: Add walnuts to salads, muffins and whole-wheat-pasta, or grind them up in pesto. For adults, eating walnuts as well as other nuts several times a week was associated with a significant decreased risk of having a heart attack. Heart attack risk isn’t something we worry about in children, but the antecedents of heart disease begin by age 10, so getting your child used to nuts, fish and other food forms of omega-3’s is a good preventive strategy. Meanwhile, chia seeds and ground flaxseeds can be used in many recipes and provide an excellent source of ALA, as well as fiber. Cooking with canola oil also provides ALA, and some canola oils come supplemented with ALA.

If you have a child who won’t touch any of the above foods, supplements are worth considering, although the jury is still out with respect to evidence-based recommendations in children.

Answer: