How much fish should I eat during pregnancy and conception?

I’m a pescatarian, which means I eat fish but no other kinds of meat, and I would hate to give up eating it. For a start, it’s delicious! But more importantly, it’s really, really good for me, especially as I don’t get protein from other kinds of meat.

Eating more fish is one of the NHS website’s top eight tips on on eating healthily – as well as lean protein, fish contains lots of vitamins and minerals, omega-3 fatty acids and fish oils which help brain and eye development, reduce inflammation and help prevent cardiovascular disease. It’s just a great source of so much good nutrition.

As is so often the case, however, we humans have managed to mess things up by polluting the world around us – in this case we’ve polluted the seas with mercury and other heavy metals, mainly (according to Wikipedia) from coal power stations and chlorine production plants. The Wikipedia page on Mercury in Fish has a comprehensive table on which fish absorb the most mercury – tilefish, swordfish and shark are the worst and luckily they’re not commonly eaten in England. In general oily fish are higher up the table, and white fish are lower (but that’s only a rough guide).

The human body is usually able to eliminate this mercury, but it can be toxic to foetuses, damaging their nervous systems. This is a deeply horrible thought, and when you consider that raw fish such as shellfish are also not recommended as they can cause food poisoning, I imagine most people’s first reaction (and mine too) is to steer miles clear of anything that’s been anywhere near the sea.

We need to be really careful about having that reaction, though, because when I read more about it, omega-3 is really important for a developing baby – according to a 2007 study (summarised in lots of news articles at the time including on the BBC and Guardian websites) it boosts intellect, improves social skills and even benefits eyesight, among lots of other things. Plus, there are all the vitamins, minerals and proteins to consider – all of these are good for nourishing a baby, and we all know that it’s much more effective to get them through diet rather than supplements.

All this conflicting information might seem very confusing, but actually it’s in line with what the usual sources of information on diet during pregnancy recommend – you should carry on eating fish, but in moderation. The brilliantly thorough NHS webpage on fish and shellfish sums this up, and I’m going to paste a big chunk of it here so you have it to hand:

“Eating fish is good for your health and the development of your baby. But pregnant women should avoid some types of fish and limit the amount they eat of some others.

When pregnant, you can reduce your risk of food poisoning by avoiding raw shellfish. Below is advice from the Scientific Advisory Committee on Nutrition and the Committee on Toxicity about eating fish when trying to get pregnant, or when pregnant or breastfeeding:

  • Shark, swordfish and marlin: do not eat these if you are pregnant or trying to get pregnant. All other adults, including breastfeeding women, should eat no more than one portion per week. This is because these fish can contain more mercury than other types of fish, and this can damage a developing baby’s nervous system.
  • Oily fish: if you are trying for a baby, pregnant or breastfeeding, you should have no more than two portions of oily fish a week. A portion is around 140 grams.
  • Canned tuna: if you are trying for a baby or are pregnant, you should have no more than four cans of tuna a week. This is because tuna contains higher levels of mercury than other fish. If you are breastfeeding, there is no limit on how much canned tuna you can eat.

Even though I’m still not pregnant yet (*sob*) I’m trying to get into these good habits now so I’m ready to enjoy a healthy and safe pregnancy diet.

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Conception support vitamin supplements: yes or no?

We all know that taking a folic acid suppliement is really important as lots of folic acid helps babies to develop healthy nervous systems. But what about other vitamins and minerals? Should I be taking a special conception support supplement?

I am a fish-eating vegetarian (my parents stopped eating meat when I was a child, so it’s mainly habit rather than ethics) and I’ve always taken a multivitamin just in case I’m missing anything important in my diet. But I had no idea that specific supplements existed for conception support – for men as well as women – until I stumbled upon them in Boots.

As part of our slightly paranoid desire to do everything possible to make a healthy baby, my husband and I thought we’d better get dosed up. He ordered some Conception for Men tablets from Healthspan – http://www.healthspan.co.uk/pregnancy/pregnapure-conception-for-men/productdetail-p3197037-c3167.aspx – and I bought some Conception Support tablets in Boots – http://www.boots.com/en/Boots-Pharmaceuticals-Conception-Support-30-Tablets-_1161201/. Today I had a good look at the ingredients on both packets.

The men’s supplement is full of crazy stuff that you’ve never heard of. What on earth are Maca and L-Arginine? (Answers: Maca is a South American plant that enhances ‘endurance’ and acts as an aphrodisiac (!) and L-Arginine is an amino acid that’s supposed to combat erectile dysfunction.) I’m not trying to boost my husband’s ego, but he’s a normal healthy 31 year old, and he just doesn’t need these things to fulfill his part of the baby-making process! The other ingredients are standard multivitamins and minerals, so he’s going to go back to his normal tablets when he finishes this box.

As for my Boots tablets for women, they look much more sensible – 200% RDA of folic acid, plus all the other standard vitamins and nothing I haven’t heard of! The great thing about them is that they don’t contain anything that would be bad if I did get pregnant, like Vitamin A. Pregnant women shouldn’t take Vitamin A supplements as too much can cause birth defects, and the damage is often done in the early weeks or months of pregnancy when you might not even realise that you’re pregnant. My conception support tablets don’t contain Vitamin A or retinol (another form of the vitamin) so this isn’t an issue. I think I’ll definitely carry on taking them.

What about the benefits of other vitamins and minerals in the conception supplements? A study in December 2011 suggested that conception multivitamins do boost fertility amongst women with fertility problems – http://www.telegraph.co.uk/health/healthnews/8928234/Women-trying-to-conceive-should-take-vitamins-researchers.html.- but there’s no evidence to say that they’re helpful for normal conception. I get the impression that the best conception support supplements are just normal multivitamins that we’re encouraged to take now because nutrition is particularly important when you want to conceive. Unless you’re a man with an actual sexual dysfunction – in which case I’d drop the Maca and L-Arginine and get to the doctor – you should probably just eat healthily, and take a folic acid supplement and a multivitamin without Vitamin A.

And when I’m actually pregnant, I’ll have to do all this research all over again for pregnancy vitamins! It’s a pretty busy and confusing market.