The 7 Best Fish Oil for Kids of 2023

Are Fish Oil Supplements Beneficial for Kids?

Fatty fish like salmon, tuna, mackerel, herring, and sardines are rich in the EPA and DHA omega 3 fats that research has shown to be beneficial for health. However, if your kids don't eat fish, you may be wondering if they can get enough omega 3s from plant foods. Indeed, foods like walnuts, flax, canola oil, soy, and chia seeds, also contain omega 3 fats. However, the form of omega 3s these plant foods have, known as ALA, is not as easily converted into the EPA and DHA forms.

Therefore, it may be beneficial to ensure your child is regularly eating fatty fish or to consider supplementing with DHA and EPA. Those who may benefit from a fish oil supplement include:

Children who rarely eat fish: Manaker suggests that “children may need to be exposed to fish a few times before they accept the unique taste. Adding fish to familiar foods like mac and cheese may help children eat this source of omegas a little easier.” If they still aren't eating fish regularly, talk to a healthcare provider about adding a fish oil supplement.

Children with ADHD: Fish oil is not a treatment for ADHD, however, there is some research showing that omega-3 fatty acids from either fish or plant sources may benefit children with the disorder when it comes to symptom improvement. If your child has this diagnosis, it may be worth a discussion with your healthcare provider.

Children with asthma or family history of asthma: Research has shown positive evidence with early introduction of fish (between 6-9 months of age) in addition to regular fish consumption (at least 1 time per week), as the child grows in the reduction of asthma symptoms. While these studies looked at fish consumption, it may be worth asking a pediatric healthcare provider about a fish oil supplement for children with asthma who do not regularly consume fish.

Children with behavior or mood disorders: A growing body of scientific evidence suggests that supplementation with omega-3 fatty acids may improve the quality of life and mental health status in children with emotional and behavioral issues. However, while there is research in this area, the studies are small. Dosing also varied from study to study. More research needs to be done, specifically in children. Most importantly, if your child struggles with behavior or a mood disorder, it is a good idea to discuss the pros and cons of omega-3 supplementation with a healthcare provider.

Children Who May Not Benefit from Fish Oil Supplements

Those who eat seafood 1-2 times per week: As stated previously, the AAP states that children eating fatty fish one to two times per week are likely meeting their omega-3 needs for growth and development. “Fish, especially oily coldwater fish like salmon, is one of the richest sources of DHA and EPA omega-3 fatty acids and supports brain, eye, and heart health,” says Manaker. 

Those with a fish or shellfish allergy: Allergic reactions can be serious. If your child is allergic to fish or shellfish, talk to a healthcare provider about the best supplementation option.

Those following a vegetarian/vegan lifestyle: If you and your family follow a vegetarian lifestyle, consuming a fish-based supplement may be something you are uncomfortable with. If that is the case, consuming omega-3 rich foods is important for your little one. You may also want to consider speaking to a healthcare provider about a vegan, algae-based supplement to help meet your child’s needs.

Those taking anticoagulant medications: Omega-3 supplements may interact with anticoagulant medications such as warfarin, heparin or other direct thrombin inhibitors. If your child is on such medications, speak with your child’s healthcare provider about possible interactions and increased bleeding risk.

How We Select Supplements

Our team works hard to be transparent about why we recommend certain supplements; you can read more about our dietary supplement methodology here. 

We support supplements that are evidence-based and rooted in science. We value certain product attributes that we find to be associated with the highest quality products. We prioritize products that are third-party tested and certified by one of three independent, third party certifiers: USP, NSF, or ConsumerLab. We also prioritize non-GMO, Organic, and products that are free of unnecessary and potentially harmful additives. We also consulted registered dietitian Lauren Manaker, MS, RDN, LD, CLEC, CPT, who specializes in pediatric and women’s health to discover what to look for in fish oil supplements.

It's important to note that the FDA does not review dietary supplements for safety and effectiveness before they go to market. Our team of experts has created a detailed, science-backed methodology to choose the supplements we recommend.

What to Look for in a Fish Oil Supplement for Kids

Third-Party Testing

Supplements that are third-party tested are sent to a lab where they are tested to ensure they contain what they say they contain and are not contaminated with specific high-risk, common contaminants. However, it’s important to note:

1. Third party testing does not test to see if a product is effective or safe for everyone, and it does not ensure the supplement will not interact with other supplements or medications.
2. Not all third-party testing is created equal. It is not uncommon for supplement companies to pay labs for certificates after conducting minimal to no testing. 
3. The third party certifications we can trust are: ConsumerLab, NSF, and USP. However, these certifications are difficult to obtain and/or expensive, so many companies choose not to get their products tested by one of these three organizations. 
4. Sometimes products tested by these three companies are more expensive to try to offset the cost they pay for certification.
5. Just because a supplement is not tested by one of these three companies, it does not mean it’s a bad product. We recommend doing some research on the reputability of the manufacturer, and calling up the manufacturer and their testing lab to determine their protocols and decide if you feel comfortable consuming the supplement.

Unfortunately, fish and fish oil may contain contaminants referred to as persistent organic pollutants (POPS). These are toxic chemicals that can negatively affect human health. They are transported by wind and water, therefore very difficult to control in our environment.

The consumption of fatty fish and fish oil supplements has become a point of entry for POPs to enter the human body, which in turn exposes our bodies to toxic compounds such as polychlorinated biphenyls (PCBs) and organochlorine pesticides (OCs). PCBs specifically have been shown to disrupt endocrine and cognitive development in children.

All fish contain trace amounts of mercury. Some fish, however, contain a much higher amount than others. Mercury can be toxic to the human nervous system and potentially cause irreversible damage. Because of this, the U.S. Food and Drug Administration (FDA) warns to limit consumption of fish to no more than two times a week for pregnant women, nursing mothers, and children.

To mitigate health risks associated with fish and fish oil supplements, there are various techniques manufacturers can implement to ensure quality and safety standards are met. Third party testing for heavy metals and contaminants is critical when choosing a supplement for your child. You also want to ensure the manufacturer you choose uses sustainable sourcing methods to ensure their fish come from healthy fisheries.

Form

Omega-3 fatty acids come in three different forms:

• EPA (eicosapentaenoic acid)
• DHA (docosahexaenoic acid)
• ALA (alpha-linolenic acid)

EPA and DHA (sometimes referred to as marine omega-3s) are found in fatty fish such as salmon, tuna, mackerel, herring, sardines, and some algae. ALA is found in plants like walnuts, flax, canola oil, soy and chia seeds.

When reading the label on omega-3 supplements, look for DHA and EPA on the ingredient list. Fish oil comes in a number of forms including ethyl esters (EE), triglycerides (TG), reformed triglycerides (rTG), free fatty acids (FFA) and phospholipids (PL). It has been found that the ethyl ester form is not as well absorbed as other forms, so choosing other forms is recommended.

Ingredients & Potential Interactions

It is essential to carefully read the ingredient list and nutrition facts panel of a supplement to know which ingredients and how much of each ingredient is included, relative to the recommended daily value of that ingredient. Please bring the supplement label to your healthcare provider to review the different ingredients contained in the supplement and any potential interactions between these ingredients and other supplements and medications your child is taking.

Fish oil supplements are generally considered to be safe. Side effects of taking fish oil can include a fishy aftertaste, bad breath, indigestion, nausea, loose stools and a rash. As mentioned earlier, if your child is allergic to fish or shellfish, talk to a healthcare provider before starting a fish-based supplement.  

Some companies choose to sweeten their supplements with sugar alcohols. While these may make the fish oil supplement more palatable, they can may cause digestive discomfort.

Omega-3 supplements may interact with anticoagulant medications. If your child is on such medication, be sure to speak with a healthcare provider about possible interactions before starting.

Fish Oil Dosage for Kids

“The guidelines state that children should be eating 4-6 ounces of fish every week. However, most children are not coming close to that suggested quantity,” says Manaker. Because of this challenge in having your children meet the guidelines, you may be interested in having them start taking a fish oil supplement.

Always speak with a healthcare professional before adding a supplement to your child’s routine to ensure that the supplement is appropriate for your child’s needs and to understand which dosage to take.

Unfortunately, experts have not established recommended amounts for omega-3 fatty acids, except for ALA. In the United States, the National Institutes of Health (NIH) has outlined average daily recommendations for ALA for all ages and genders.

• Birth to 12 months* - 0.5 g (total omega-3s instead of ALA alone)
• Children 1-3 years - 0.7 g ALA
• Children 4-8 years - 0.9 g ALA
• Boys 9-13 years - 1.2 g ALA
• Girls 9-13 years - 1.0 g ALA
• Teen boys 14-18 years - 1.6 g ALA
• Teen girls 14-18 years - 1.1 g ALA

How Much is Too Much?

The FDA recommends consuming no more than 5 g/day of EPA and DHA combined from dietary supplements for adults. Unfortunately, there is not an established upper limit of fish oil supplementation set for children.

Side effects can be very unpleasant consisting of bad breath, nausea, stomach upset, diarrhea, fishy smell and headaches. Only provide your child with what they need for their age, according to the package directions, when dosing. It can also be helpful to speak with a pediatric healthcare provider to figure out if your child needs a supplement and how much.

Omega-3s can increase the risk of bleeding. Anyone with a family history of a bleeding disorder or on anticoagulant medications, should speak with a healthcare provider before starting supplementation.

Why Trust Verywell Family

Brittany Scanniello, RD, is a registered dietitian-nutritionist and founder of Eat Simply Nutrition, a Colorado-based integrative nutrition company and private practice. She was previously a clinical pediatric dietitian, and one of her specialties in her current private practice is pediatric dietetics.