Ask Dr. Harvey - OB

Eating more fish while pregnant increases baby’s IQ


Recent reports show many pregnant women in the United States are not consuming fish in amounts recommended by the Dietary Guidelines for Americans. In June of 2014, the FDA and the EPA revised their joint Fish Consumption Advice, Questions & Answers to encourage pregnant women, those who may become pregnant, breastfeeding mothers, and young children to eat more fish and to eat a variety of fish from choices that are lower in mercury.

Most of the studies that the FDA and EPA reviewed as part of a developing draft updated guidelines compared levels of fish consumption with the IQ of offspring.

These findings consistently demonstrate that among the women who consumed more fish during pregnancy there were improvements in the child’s IQ – noting that the positive effect extended to verbal as well as overall IQ.

General Guidelines

Pregnant women should consume 8 to 12 ounces of a variety of different types of fish per week.

Fish with a higher concentration of omega fatty acids and lower concentrations of mercury are preferred. The most favorable balance of fatty acids is found in salmon, anchovies, herring, shad, Atlantic and Pacific mackerel, pollock, and freshwater trout.

Oysters also have a good ratio of omega fatty acids, but women should only consume cooked seafood during pregnancy.

Albacore and bluefin tuna contain higher levels of mercury, but light canned tuna, although lower in omega fatty acids, also has substantially lower levels of mercury. Therefore, light canned tuna is reasonable for consumption during pregnancy.

Other commonly consumed seafood, such as cod, catfish, tilapia, and shrimp, may not possess the high concentrations of omega fatty acids of fish such as salmon, but they also feature lower mercury levels and may be recommended during pregnancy.

However, pregnant women should not consume shark, swordfish, king mackerel, or tilefish from the Gulf of Mexico because of unacceptably high concentrations of mercury.

The recommendations suggest that omega fatty acid supplements, including DHA in your prenatal vitamin, are a weak alternative to the consumption of dietary seafood, as supplements do not contain all of the other healthy nutrients that seafood does.

Pregnant women are reminded that consuming seafood should not result in excessive caloric intake. Healthy means of preparing seafood (eg, broiled vs fried) are stressed.

Pregnant women should pay attention to the source of seafood caught in freshwater bodies. Fish from water bodies with an advisory are to be avoided. If no advisory system is in place for a particular water source, adults should limit their consumption of seafood from that source to 6 ounces per week, and children should only consume 1 to 3 ounces per week.

The recommendations for seafood consumption among children mirror those for pregnant women. Children younger than 6 months should not be given seafood, and children younger than 6 years should consume 3 to 5 ounces of fish per week. This total can be increased to 4 to 6 ounces per week among children between ages 6 and 8 years, and older children can eat 8 to 12 ounces of seafood per week.

The same recommendations stressing low-mercury fish and avoiding fish known to have high levels of mercury apply to children.

The key take away:

Eat 8 to 12 ounces of a variety of fish each week from choices that are lower in mercury. The nutritional value of fish is important during growth and development before birth, in early infancy for breastfed infants, and in childhood.

If you have any questions about your pregnancy, call our office and set up an appointment with your doctor. We’ll be happy to talk through any concerns or questions you may have regarding your diet and your baby’s health.

Breastfeeding Tips


Relax: Breastfeeding is not going to be the easiest thing you have ever done in life.  It takes time, patience and persistence.  In the first few days of life, you and your baby are spending time getting to know each other.  Both of you are learning how to do something new.  I find that a lot of moms are very stressed about making breastfeeding work and this hinders success.  There are many people who can help you while at the hospital and even after discharge.  

Water, Water, Water:  I cannot stress this fact enough.  If you are not hydrated enough, your body is not going to have the fluid necessary to produce breast milk.  A good rule of thumb is that you will need six 8 ounce glasses of water a day for you and and additional 2 ounces of water for every 1 ounce of breastmilk you produce.

Nurse frequently:  I recommend nursing at least every 3 hours in the first few days of life.  This will help to stimulate production of breastmilk.  The amount of milk you produce is directly related to the amount of time the baby spends at the breast.  There are a few medications that can help if you are worried that you are not producing enough, but nursing frequently is the best way to increase production.  Conversely, some patients have trouble with too much supply, which can be addressed with various techniques and a few medications. 

Get a good latch:  The pigmented area of the breast (the areola) should be completely in the baby’s mouth.  A common mistake is that  only the very small portion of the nipple is in the baby’s mouth and this can cause a great deal of discomfort for the nipples.

Pump:  For those of you who need to go back to work after your maternity leave and even those who don’t, breast pumping is an option.  If you choose to pump, your baby can still get all the benefits of breastmilk and someone else can help with the feeding.  Pumped breastmilk can also be frozen and then thawed for use later.  You can even donate your breastmilk to the WakeMed milk bank if you have more than your baby needs.  This donated milk is then used for our smallest babies fighting to gain weight in the Neonatal ICU.


Summertime fun….But I’m pregnant!

It’s that time of year.  The sun is out, the temperature is off of the charts, and for many women, summertime is synonymous with beach or lake vacations. Let’s address the following hot topics: 

  • Hair removal
  • Tanning
  • Hot tubs
  • Booze

Do you want to get rid of unsightly hair growth during pregnancy?

Fortunately, mechanical hair removal with shaving, waxing, tweezing, or threading is considered safe.  In fact, laser and electrolysis are also considered safe, but some hyperpigmentation (darkening of the skin) may result.  

Chemical removal, with products such as Nair, is overall safe.  The chemicals are not absorbed.  However, many women, pregnant or not, have an irritating reaction to these products.  I would recommend testing a “not so sensitive” area of your body first.  Use caution in your “private” areas, especially if you are far enough along to not be able to see your bottom.  You do not want to leave the chemical in place too long as it can lead to serious burning.  

Can I get golden bronzed the easy way with self-tanning?

Most self tanners (ie Mystic Tan) use dihydroxyacetone (DHA).  This chemical, when sprayed onto the skin, give the appearance of a tan.  It has been used for over 50 years and is considered safe, as it does not penetrate the skin.  Make sure you do this in a well ventilated area. 

How about sun exposure? 

For those of you who like to tan the traditional way, take extra precaution with sun exposure.  Pregnant women are at higher risk of hyperpigmentation (darkening of the skin), leading to sun spots. 

When in the sun, make sure to stay well hydrated and get out of the sun if you become uncomfortable.  

Can I get in the hot tub?

This topic is not as clear.  Some studies show a potential increase risk of neural tube defects in women who had prolonged hot tub exposure.  That being said, the neural tube is formed by 6 weeks gestational age and many women are not even aware they are pregnant at that time.  Once out of this time frame, limit hot tube use to 10-15 minutes to be on the safe side.  Again, stay well hydrated.

How about alcoholic beverages?

The short answer is NO.  The US Surgeon General recommends abstinence in pregnancy.  There is no dose response known between amount of alcohol consumption and development of fetal alcohol syndrome or alcohol-related birth defects.  In addition, negative effects can be seen with alcohol consumption in all trimesters, not just the first.