The Fish Oil We Use
Someone asked us what brand of fish oil we use for J-Man. It’s Nordic Naturals Children’s DHA. This isn’t so much the result of extensive brand shopping, but rather it’s what Whole Foods had in stock that satisfied some basic requirements.
Upon the recommendation of one of his therapists, we decided to try fish oil based on research that it has helped some autistic and children with speech delays or apraxia. “Helped” was measured primarily by improved cognitive testing scores and speech usage over a 90-day period. Because of its widespread use (I take capsules myself) and researched benefits for a variety of things - not to mention there doesn’t seem to be any indication that it does any harm - we decided to give it a try.
There are a lot of questionable products and practices out there involving supplements and other related treatments for autism. Fish oil seems at worst benign. First do no harm should be the rule for everything we try for our kids.
I don’t recall exactly what we paid for it, but 4 fl oz bottle of this brand (it’s berry-flavored liquid) should run about $14-15; an 8 oz will run about $25 or so. By my rough figuring, this is about 50 and 100 doses respectively. A dose is 2.5ml or 1/2 tsp.
From their product page, one dose contains:
EPA: 205 mg
DHA: 313 mg
Other Omega-3s: 113 mg
500 ish milligrams for EPA + DHA appears to be a fairly accepted sweet spot for fish oil for autistic and speech delayed kids in the couple of studies I read. Keep up with the research as best you can to see how this evolves. Largely they are taking educated guesses at this point.
Here are the requirements we set when we looked for fish oil:
- It had to be as pure and free of toxins and crap that are in low-quality fish oil as much as humanly possible. (generally this is down to fractions of parts per zillion)
- It had to be in liquid form because of J-Man’s severe oral defensiveness and lack of interest in eating anything weird or having it mixed in his food.
- It had to hit that 500 mg ’sweet spot’ (see above).
- A dose had to involve 1 tsp or less of liquid (i.e. 5ml or less) because giving him much more liquid than that in an oral syringe is extremely difficult. Hell would freeze over before he took liquid medicine from a spoon.
- We had to be able to get it fairly easily and not order it from Outer Mongolia.
- It had to not taste or smell like fish ass.
The Nordic Naturals stuff succeeded on all but the last count, though I don’t readily know what a fish’s ass tastes or smells like. I imagine liquid fish oil is a close approximation if nothing else. We realized pretty much no product is going to taste that great. I put a little on my tongue and found it tolerable. Mary found it disgusting, but she has Super Sensitive Nose so there was no hope there to begin with.
An important thing to note about this and other fish oil products is that many of them also contain Vitamin A. If your child is getting a significant amount of Vitamin A from other sources and supplements, be aware of this. Vitamin A in higher than recommend doses can be toxic. If you decide you need to give your kid a double dose to get to that 500mg point, make sure you aren’t doubling the Vitamin A into an unsafe range.
Like I said, fish oil in any non-capsule form - which is the fate of most of us with younger kids - can easily taste and smell like Charlie the Tuna’s feet, or worse. Even in its other ‘child-friendly’ forms (flavored chews, mix in their food type stuff, etc.), it’s pretty unpleasant. The feedback I’ve read is that fruit-flavored versions are generally the most palatable. One brand I saw somewhere has chocolate-flavored chews. Just thinking about this sends me running for the mental floss.
Here’s a link to the Nordic Naturals product page, if you’re curious. I get nothing out of this if you buy some, in case you’re wondering.
Standard disclaimer: Talk with your doctor, therapists, and other qualified professionals before giving your kid anything. I am not qualified to tell you anything other than what we are doing with our son. I’m not endorsing this brand nor are we advising you to give your kid fish oil nor are we claiming it will help your kid at all nor am I claiming that superstring theory is correct. With autism, there’s so much we don’t know. Treat all advice you get from people with that principle in mind. A recording this is. Yoda, yoda, yoda.
8 comments
Thought you’d be interested in this short omega-3 video: http://www.youtube.com/watch?v=eIgNpsbvcVM
Hey, thanks Susan. I went to your site and read around a bit. Right now we have eggs from some of our neighbor’s chickens, so I wish I had some way to test for the omega-3 content in those! Maybe I’ll start indulging a little more in eggs - I wonder if upping my omega-3/DHA diet would help the J-man, since he’s still nursing?
Hi Tim,
My son Paul is 28 months old and has a PDD-NOS diagnosis. I’m ready to start the fish oil! We bought a brand called Coromega. I’ve tried it and it doesn’t taste like fish. I haven’t given it to my son yet. I’m not a pill person myself so giving Paul anything makes me nervous. Do you know how I would tell if he’s allergic to fish? I keep reading it’s fine if he’s not allergic to fish, but he’s never had fish! Your thoughts are appreciate
Liz
Liz, that’s a great question. My guess is that I doubt you could tell without an allergy test. From what I know about fish allergies (my uncle and nephew are allergic to shellfish and generally whatever comes out of an ocean), you can be allergic to one or more types of fish but not necessarily the others. That definitely complicates things.
If you have a history of fish allergies in your family, if it were me, I’d have that checked out by an allergist. There’s also a difference between being allergic and being intolerant. My uncle would go into anaphylaxis if he took a bite of shellfish, but I don’t think fish intolerant people would have anywhere near that kind of issue.
Supposedly, high-quality, highly-refined fish oil supplements have filtered out most of the types of proteins that people with fish allergies would be allergic to. Does this remove the problem? No, but at least for me I go straight for the good stuff and feel a lot more comfortable with giving it to J-Man. I ignore the fact that fish oil pills exist at places like Target. There’s enough crap in those pills that I wouldn’t give them to my kid, or myself for that matter.
J-Man had a little piece of catfish once and hated it, but that’s no test of anything. He loathes most all kinds of foods.
So, I’m not sure what to tell you. If you would feel more comfortable giving it to him knowing for sure, it may be worth having Paul tested just for your own peace of mind. You might find out a lot of other useful information, too.
Let me know what you discover. I’m like an information sponge and love to hear what everyone finds out. Thanks!
I just started my 3 1/2 year old on fish oil. We got the Nordic Naturals capsules…my main concern was getting my child to consume them. I first tried to hide it in some juice, which didn’t work, and finally I resorted to teaching him how to swallow the capsule (it is very small) and rewarding him with some normally off-limits treat. I was surprised it actually worked.
I took DHA Omega-3 supplements throughout my 2nd pregnancy, and my 2nd child is so much easier to deal with than my first. I’m starting to feel like I short changed my first by not giving him this head start. I didn’t know about the supplements back then.
Thanks for your fish-oiling tutorial.
Yeah, mixing things into his food was a non-starter. Even when we grind his multivitamin into its constituent molecules, he can still pick them out of his applesauce. We’ve progressed to grudging acceptance and that’s about it. The multis are berry flavored, so that helps.
I mixed about 10 parts iced tea to one part apple juice once and he spotted that in the first mouthful. We knew there was no way in the world we could mix something into his food or drink at this point.
If fish oil could come in a chewable pill, we might could get him to take it. It took the better part of a year to get him to take his Prevacid by himself (in the Solutab form), and that has about the crunchy chewability of a Sweettart. For J-Man, crunchy = good.
Capsules still aren’t happening around here. And as I wrote in another post, he doesn’t value anything enough as a treat (normally-off-limits or otherwise) so bribery isn’t something we’ve learned around here. We’re working on it.
I have no idea how to tell what affects one kid to the next. All of our friends’ kids have two completely mismatched pairs of children in their houses such that I’m beginning to think that phenomenon is part of the laws of physics now. If we have another, we try to imagine what he/she would be like based on the law of opposites. It’s a weird thing to ponder.
In any case, I’m not sure what Mary would or could do differently next time around. If there’s a more disciplined person in pregnancy and nursing as her, I’ve never met them.
Glad to know Nordic Naturals capsules are small. Will definitely have to keep that in mind when we upgrade to something more pill-like someday. Thanks!
Just discovered your site this weekend as we have come to suspect my 18 month old grandson, Connor, may have a speech delay. Spent the weekend surfing websites and reading The Late Talker - his mom already had a copy since she was an SLP before she had him. But I digress - my question is about your post on the fish oil. You mentioned being careful about any that had Vitamin A. When I looked up the products on the Nordic Naturals, the description of the one you use - Children’s DHA specifically says it contains “healthy levels of naturally occurring vitamins D and A”. So how do we know how much is too much? This is all very confusing and a bit overwhelming. I am however, hooked on your blog. You are straightforward with just enough humor to get me to laugh out loud at least once every other blog. LOVE your pop culture references! (Hee Haw, Princess Bride, etc.) Thanks for sharing your pain and progress.
Gigi,
The Late Talker is a great book in my opinion. The information gets pretty technical in places, but you need that kind of meat when you’re diving into these waters over the long haul. It also has some good guidance on IEPs for school in general, whether they’re speech-related or not. (We have IEPs on the brain lately…) One of these days I need to draft a reading list to share; that book would be on it.
Anyway, here’s what I read about Vitamin A, but as always, your pediatrician would know way more than me.
According to the two toddler-y vitamins in the house, they say the recommended daily allowance of Vitamin A for kids between ages 2-4 is 2,500 IU (international units - no idea what that translates into in actual weight). The Nordic Naturals fish oil we use has somewhere between 325-750 IU per dose, so roughly 15-30% based on those numbers if my figuring is correct. The problem is that I looked around some more and some places set that recommended number quite a bit lower (closer to 1000 IU), and then in some cases they use other units of measurement than IUs.
It gets more confusing in that not all Vitamin A is created equal. Kinds of Vitamin A like beta-carotene and most other vitaminy goodness from fruits and vegetables apparently has no bearing at all on Vitamin A toxicity. It looks like only stuff in supplements ‘counts’.
I couldn’t find a straight, specific answer on toxicity, because I think it varies from person to person. However, this straightens it out enough for me to feel comfortable with what we’re doing:
What I did read had it on the order of needing many, many times the recommended amount per day (like a factor of 10 or more) over a long period of time (like months). Apparently, it’s nearly impossible to achieve this without supplements, and even then, it looks like it would take a combination of many different daily supplements to do any harm.
From the research the therapist and I looked at, here’s where a problem theoretically might occur.
Example: (I’m pulling these numbers out of my ear, but hopefully it’s a decent illustration.)
Some fish oil supplement contains 100mg of EPA/DHA and 1000 IU of Vitamin A per dose.
Let’s assume the ’sweet spot’ for EPA/DHA for toddlers in this situation is 500mg per day. You’d then have to give the toddler the equivalent of five doses to get to 500mg EPA/DHA. This isn’t in itself any issue. All fish oils vary a lot in what they consider a ‘dose’, which is why you need to read the label. If you have to give your kid a cupful to get enough in him, it defeats the point, and a company’s idea of a dose and the reality of the dose you have to give aren’t necessarily the same.
Where things go potentially into a problem area is that this means you’re also giving the toddler five times as much Vitamin A as is on the label, which would be 5000 IU - a fairly significant amount. If you’re already giving him a multivitamin, that may add another 2500 IU of Vitamin A. And if for some reason you’re giving him another supplement as part of some other treatment, he could be getting more still. Since supplements are usually given over a long period of time, getting significant doses of Vitamin A from multiple sources - every day for months - could cause some issues.
I think the moral of the story is, it doesn’t seem like any one supplement would cause a problem, but if a parent is for whatever reason giving their child multiple supplements, the accumulation of Vitamin A could possibly cause a problem if it adds up to a big number. A very high excess of it from supplements (again many times whatever the RDA is) per day over a long period of time can accumulate in the liver. Again, whatever comes out of fruits, veggies, etc. appears to be exempt from this issue.
I don’t know if this helps. I’m not remotely an expert on this stuff. Smarter people than me have told me that fish oil with a little Vitamin A and a regular toddler multivitamin is fine. So I’m going with that. As always, peds are the people to ask first if you have any concerns. This is about the sum total of what I know, and I feel perfectly comfortable with this routine for our son, if that’s reassuring to people.
Thanks for reading our blog! Glad you’re hooked.
We appreciate your kind words. We aim to bring laughter and honesty to the world as best we can. And hopefully we have more progress than pain, but both are just part of what life is sometimes.
Also - we’ve been through gobs of speech therapy already, so if you have questions, just let us know. Though with his mom being an SLP, we can’t hold a candle to that smartness-wise.
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