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Is it safe? · Pregnancy Smart

Is cod liver oil safe during pregnancy?

Assigned clinical reviewerMatt Stahl· PharmDDraft · pending clinical reviewUpdated

What does the evidence say about cod liver oil during pregnancy?

  1. Taking too much preformed vitamin A while pregnant can cause birth defects, including abnormal eyes, skull, lungs, and heart, and the upper limit for adults is 3,000 mcg a day against a recommended 770 mcg. 1
  2. Doses above 20,000 IU of vitamin A per day, especially the preformed retinol type, have been linked in some studies to an increased chance of birth defects, and staying under 10,000 IU daily is advised unless a provider directs otherwise. 2
  3. Cod liver oil is one of the standard omega-3 supplement forms alongside fish oil, krill oil, and algal oil, and eating 8 to 12 ounces of fish and seafood a week during pregnancy may improve your baby's health. 3
  4. Fish liver oils are among the best natural sources of vitamin D, which is why cod liver oil delivers two fat-soluble vitamins at once and why the daily 4,000 IU vitamin D ceiling is part of the same calculation. 4
  5. Supplements do not need FDA approval before they are sold, and the standing advice is to be cautious about taking anything beyond a standard prenatal during pregnancy. 5

Is cod liver oil safe in each trimester?

  • First trimester. This is the window where preformed vitamin A matters most for how organs form, so it is the worst time to stack cod liver oil on top of a prenatal that already contains vitamin A. If you have been taking it, bring the bottle to your next appointment rather than guessing at the label.
  • Second trimester. Vitamin A and vitamin D content vary a lot between brands and even between a liquid and a capsule of the same brand. If you want the omega-3s, this is a good time to switch to a product that states its DHA per serving and contains no added retinol.
  • Third trimester. DHA demand is highest in the third trimester as your baby's brain and eyes develop quickly. Eating fish or taking a DHA-specific supplement covers that without the vitamin A load. Very high omega-3 doses can also affect bleeding, which is worth raising before delivery.

Frequently asked questions

Can you take cod liver oil while pregnant?

It is not automatically off-limits, but it is the one fish oil that needs a label check. The concern is preformed vitamin A, which accumulates in the body and has a real ceiling in pregnancy. Your provider can look at your prenatal and the cod liver oil label together and total the vitamin A.

Why is cod liver oil different from regular fish oil?

Cod liver oil is pressed from the liver, and liver is one of the richest sources of preformed vitamin A there is. Standard fish oil comes from the flesh of the fish, so it carries the omega-3s without that vitamin A concentration.

Is cod liver oil good for the baby's brain?

The DHA in it does support fetal brain and eye development, and DHA levels are especially high in brain and retinal cells. You can get the same DHA from eating fish, from an algae-derived oil, or from a prenatal that includes DHA, none of which carry the vitamin A issue.

What can I take instead of cod liver oil during pregnancy?

Algae oil is the usual swap, since it delivers DHA with no vitamin A and no fish taste. Two to three servings a week of lower-mercury fish like salmon or sardines is the food route. Ask your provider which fits what your prenatal already covers.

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References

  1. Vitamin A and Carotenoids: Consumer Fact Sheet, NIH ODS

    ODS · https://ods.od.nih.gov/factsheets/VitaminA-Consumer/

  2. Vitamin A: MotherToBaby Fact Sheet

    MotherToBaby · https://mothertobaby.org/fact-sheets/vitamin-a/

  3. Omega-3 Fatty Acids: Consumer Fact Sheet, NIH ODS

    ODS · https://ods.od.nih.gov/factsheets/Omega3FattyAcids-Consumer/

  4. Vitamin D: Consumer Fact Sheet, NIH ODS

    ODS · https://ods.od.nih.gov/factsheets/VitaminD-Consumer/

  5. Dietary Supplements: What You Need to Know, NIH ODS

    ODS · https://ods.od.nih.gov/factsheets/WYNTK-Consumer/

These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.