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1. Omega-3s support brain growth and brain function
The brain grows at its greatest rate from birth up until about 2 years old, though development continues throughout childhood and adolescence. Over 60% of the brain is made up of fat and the Omega-3 fatty acid DHA (docosahexaenoic acid) makes up around 10-15% of this. DHA is necessary for the development of the sensory, perceptual, cognitive, and motor neural (nerve) systems during the brain growth spurt. The DHA-rich parts of the brain are thought to be responsible for activities such as planning, problem solving, and focused attention.12

DHA in particular is recognized as essential for normal brain function. It helps to improve membrane fluidity, which means that nerve impulses, or messages, are transmitted more effectively.   In animals, low brain DHA results in changes in behaviour and is associated with learning problems and memory deficits. In humans, studies indicate that DHA supports normal IQ and preserves learning and memory.

A review of 7 different studies which reported on the results of DHA supplementation on school performance, found that 5 of the studies showed DHA improved school performance, including learning ability, reading and spelling.3

2. Omega-3s may improve reading and maths skills
Researchers at Oxford University studied children given 600mg omega-3 daily for 4 months. The results of this study, called the DOLAB study, showed that children in the bottom 20% for literacy boosted their reading age by 3 weeks more than the placebo group and those in the bottom 10%, by 1.9 months. Though more research is necessary to confirm or rule out these findings, the results indicate that omega-3 may be particularly helpful for those children with the poorest reading skills who are underperforming.4

In another study in Bradford, where pupils were given omega-3 fish oil on a daily basis, this resulted in 81% of pupils showing an improvement in reading, 67% in writing and 74% in Maths.

3. Omega-3s may improve children's sleep
Most parents are on a quest for a good night’s sleep for their children! The DOLAB study also investigated whether omega-3 supplementation could have a beneficial effect on sleep. The results showed that poor sleep is significantly associated with lower blood levels of DHA, and that DHA supplementation led to a reduction in the number of night-time disturbances, as well as 58 minutes more sleep per night on average!5

4. Omega-3s for depression in children
There are several studies demonstrating the effectiveness of omega-3s for depression in adults, but depression in children is actually becoming more common too. A controlled, double-blind pilot study in Israel looked at the effects of an over-the-counter omega-3 supplement in children aged 6-12 with major depression. The results were fantastic, with the majority of the children taking the omega-3 supplement having 50% fewer symptoms at the end of the trial and several children going into complete remission. The results showed that the majority of the children taking the omega-3 supplement had 50% fewer symptoms at the end of the trial and several children went into complete remission.6

A further study specified that supplementation of at least 60mg per day of EPA and 1560mg of DHA for 6 weeks significantly improved global functioning and reduced symptoms of mania & depression in patients with juvenile bipolar disorder.19

5. Omega-3s for ADHD
Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder. Standard treatment with stimulants can have severe side effects and intolerance and so the demand for alternative treatments is high. Research has shown that lower levels of omega-3 are found in ADHD patients’ blood when compared to those without ADHD.

There have been numerous studies on fatty acid status in children with ADHD7,8, with historically some inconsistent findings over their effectiveness in the management of the condition. However, an article published in 2019 concluded, after looking at the available data & research, that combined doses of EPA & DHA equal to or above 750mg per day over 12 weeks have shown significant improvements of symptoms of ADHD.20

Furthermore, it is important here to consider maternal fatty acid status prenatally, as this also has been shown to affect the outcome of ADHD & other neurological disorders in offspring.21

There have been lots of studies on the effects of omega-3 on ADHD but the results have been inconsistent. An article just last year reviewed a range of studies carried out between 2000 and 2015 and found that whilst the results were sometimes inconsistent, overall, showed that there is evidence that omega-3 intake can benefit those with ADHD.7,8

6. Omega-3s improve learning and behaviour in developmental coordination disorder
The Oxford-Durham study was an exciting study which looked at the effects of omega-3 supplementation on children with developmental coordination disorder (DCD). At the end of the trial, the results showed that there was a significant improvement in reading, spelling and behaviour in those who had taken omega-3 supplements, and the authors concluded that omega-3 is a safe and efficacious treatment option for children with developmental coordination disorder.9

7. Early omega-3 exposure may reduce incidence of children’s allergies
A recent 2017 article reported that eating oily fish or fish oil supplementation in pregnancy may be a strategy to prevent infant and childhood allergic disease, whilst a study in infants from birth to 6 months found that omega-3s were able to modify markers of immunity and potentially be protective against allergies.10, 11

In addition, Bisgaard et al. reported a significantly reduced incidence of persistent wheeze or asthma at ages 3 to 5 years in children whose mothers took fish oil during pregnancy.12

This indicates that consumption of omega-3 during pregnancy by the mothers or intake of omega-3 in infancy may be able to help reduce the incidence of allergic diseases, including asthma.

8. Omega-3s may reduce incidence of respiratory illness and diarrhoea in infants
Omega-3 fatty acids may have a beneficial effect on the immune system, as discussed above, and this may help to reduce the frequency of common infant illnesses. One study looked at the incidence of respiratory illnesses (such as bronchitis, bronchiolitis, cough, croup) and diarrhoea in infants fed with formula supplemented with omega-3 fatty acid DHA, versus infants fed on formula with no added DHA. The results found that the number of episodes of respiratory illness and diarrhoea in the first 12 months of life was significantly reduced in the infants fed the DHA-enriched formula.13

9. Omega-3s may reduce insulin resistance in obese children
In a study on obese children and adolescents, it was found that omega-3 fatty acid supplementation was able to significantly reduce glucose (blood sugar) and insulin (the hormone that is secreted when blood sugar levels increase) concentrations, as well as decrease triglyceride concentrations - triglycerides being the main components of body fat. These results suggest that omega-3s may be very useful as a supportive therapy for obese children and adolescents with insulin resistance.14

10. Omega-3s may help to support healthy bones
And finally, you may want to consider the impact of omega-3s on bone health in growing children. The link between omega-3s and bone health is less well known but research in this area has accelerated in recent years. Research has mainly focused on the value of dietary omega-3s to protect against bone loss in older adults, yet is likely relevant at any age, and certainly worth considering as children move through different stages of accelerated bone growth during childhood and adolescence. Research has shown that omega-3s may help to support osteoblasts – highly relevant for growing children since these are the cells that build healthy bone. Omega-3s also help to keep inflammation in check, which is also great news for building healthy bones since excessive inflammation activates osteoclasts – the cells that break bone down.15-17 Another possible mechanism by which omega-3s may help to support healthy bones is via supporting calcium absorption – an essential mineral needed for healthy bone structure.18

References:
1. Kuratko CN. Et al. The relationship of docosahexaenoic acid (DHA) with learning and behaviour in healthy children: a review. Nutrients. 2013; 5: 2777-2810.
2. Kidd, PM. Omega-3 DHA and EPA for cognition, behaviour, and mood: clinical findings and structural-functional synergies with cell membrane phospholipids. Alternative Medicine Review. 2007; 12(3): 207-227.
3. Kuratko et al. The Relationship of Docosahexaenoic Acid (DHA) with Learning and Behavior in Healthy Children: A Review. Nutrients. 2013 Jul; 5(7): 2777–2810.
4. Richardson et al. Docosahexaenoic acid for reading, cognition and behavior in children aged 7-9 years: a randomized, controlled trial (the DOLAB Study). PLoS One. 2012;7(9)
5. Montgomery et al. Fatty acids and sleep in UK children: subjective and pilot objective sleep results from the DOLABstudy--a randomized controlled trial. J Sleep Res. 2014 Aug;23(4):364-88. 
6. Nemets et al. Omega-3 treatment of childhood depression: a controlled, double-blind pilot study. Am J Psychiatry. 2006 Jun;163(6):1098-100.
7. Chang et al. Omega-3 Polyunsaturated Fatty Acids in Youths with Attention Deficit Hyperactivity Disorder(ADHD): A Systematic Review and Meta-Analysis of Clinical Trials and Biological Studies. Neuropsychopharmacology. 2017 Jul 25
8. Konigs and Killiaan. Critical appraisal of omega-3 fatty acids in attention-deficit/hyperactivity disorder treatment. Neuropsychiatr Dis Treat. 2016; 12: 1869–1882.
9. Richardson and Montgomery. The Oxford-Durham study: a randomized, controlled trial of dietary supplementation with fatty acids in children with developmental coordination disorder. Pediatrics. 2005 May;115(5):1360-6.
10. Miles and Calder. Can Early Omega-3 Fatty Acid Exposure Reduce Risk of Childhood Allergic Disease? Nutrients. 2017 Jul; 9(7): 784.
11. D’Vaz et al. Fish oil supplementation in early infancy modulates developing infant immune responses. Clin Exp Allergy. 2012 Aug;42(8):1206-16.
12. Bisgaard H., Stokholm J., Chawes B.L., Vissing N.H., Bjarnadóttir E., Schoos A.M., Wolsk H.M., Pedersen T.M., Vinding R.K., Thorsteinsdóttir S., et al. Fish oil-derived fatty acids in pregnancy and wheeze and asthma in offspring. N. Engl. J. Med. 2016;375:2530–2539.
13. Lapillonne et al. Infants fed formula with added long chain polyunsaturated fatty acids have reduced incidence of respiratory illnesses and diarrhea during the first year of life. BMC Pediatr. 2014 Jul 2;14:168.
14. Juarez-Lopez et al. Omega-3 polyunsaturated fatty acids reduce insulin resistance and triglycerides in obese children and adolescents. Pediatr Diabetes. 2013 Aug;14(5):377-83. 
15. Griel AE, Kris-Etherton PM, et al. An increase in dietary omega 3 fatty acids decreases a marker of bone resorption in humans. Nutr J 2007; 6: 2
16. Lavado-Garcia J, Roncero-Martin R, et al. Long-chain omega-3 polyunsaturated fatty acid dietary intake is positively associated with bone mineral density in normal and osteopenic Spanish women. PLOS One. 2018 Jan 5; 13(1): e0190539
17. Weiss LA, Barrett-Connor E, et al. Ratio of n-6 to n-3 fatty acids and bone mineral density in older adults: The Rancho Bernardo Study. Am J Clin Nutr. 2005 Apr; 81(4): 934-8.
18. Hay AW, Hassam AG, Crawford MA, et al. Essential fatty acid restriction inhibits vitamin D-dependent calcium absorption. Lipids. 1980;15(4):251–254.
19. Clayton et al. Reduced mania and depression in juvenile bipolar disorder associated with long-chain omega-3 polyunsaturated fatty acid supplementation. Eur J Clin Nutr. 2009 Aug;63(8):1037-40.
20. Chang, J.PC., Su, KP., Mondelli, V. et al. High-dose eicosapentaenoic acid (EPA) improves attention and vigilance in children and adolescents with attention deficit hyperactivity disorder (ADHD) and low endogenous EPA levels. Transl Psychiatry 9, 303 (2019).
21. López-Vicente M et al. Prenatal Omega-6:Omega-3 Ratio and Attention Deficit and Hyperactivity Disorder Symptoms. J Pediatr. 2019 Jun;209:204-211.e4. doi: 10.1016/j.jpeds. 2019.02.022. Epub 2019 Mar 28.

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