FDA Revision: Fish Consumption Advice for Pregnant and Breastfeeding Mothers and Young Children
Learning Objectives and CME/Disclosure Information
This activity is intended for healthcare providers delivering care to women and their families.
After completing this activity, the participant should be better able to:
1. Counsel a patient regarding fish consumption during pregnancy 2. Restate the foods to avoid as they pertain to Listeria
Estimated time to complete activity: 0.25 hours
Susan J. Gross, MD, FRCSC, FACOG, FACMG
President and CEO, The ObG Project
Disclosure of Conflicts of Interest
Postgraduate Institute for Medicine (PIM) requires faculty, planners, and others in control of educational content to disclose all their financial relationships with ineligible companies. All identified conflicts of interest (COI) are thoroughly vetted and mitigated according to PIM policy. PIM is committed to providing its learners with high quality accredited continuing education activities and related materials that promote improvements or quality in healthcare and not a specific proprietary business interest of an ineligible company.
The PIM planners and others have nothing to disclose. The OBG Project planners and others have nothing to disclose.
Faculty: Susan J. Gross, MD, receives consulting fees from Cradle Genomics, and has financial interest in The ObG Project, Inc.
Planners and Managers: The PIM planners and managers, Trace Hutchison, PharmD, Samantha Mattiucci, PharmD, CHCP, Judi Smelker-Mitchek, MBA, MSN, RN, and Jan Schultz, MSN, RN, CHCP have nothing to disclose.
Method of Participation and Request for Credit
Fees for participating and receiving CME credit for this activity are as posted on The ObG Project website. During the period from Dec 31 2017 through Dec 31 2021, participants must read the learning objectives and faculty disclosures and study the educational activity.
If you wish to receive acknowledgment for completing this activity, please complete the post-test and evaluation. Upon registering and successfully completing the post-test with a score of 100% and the activity evaluation, your certificate will be made available immediately.
For Pharmacists: Upon successfully completing the post-test with a score of 100% and the activity evaluation form, transcript information will be sent to the NABP CPE Monitor Service within 4 weeks.
Joint Accreditation Statement
In support of improving patient care, this activity has been planned and implemented by the Postgraduate Institute for Medicine and The ObG Project. Postgraduate Institute for Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
Physician Continuing Medical Education
Postgraduate Institute for Medicine designates this enduring material for a maximum of 0.25 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Continuing Nursing Education
The maximum number of hours awarded for this Continuing Nursing Education activity is 0.2 contact hours.
In July 2019, the FDA revised its advice on fish consumption for women who are pregnant, considering pregnancy, breastfeeding or have young children. The FDA continues to encourage women to eat fish, 2-3 servings of lower-mercury fish per week (or 8 to 12 ounces). In addition, the fish chart remains unchanged. However, there is concern that women may be limiting their diets due to mercury concerns. The purpose of this revision is to highlight benefits of fish consumption. The FDA states that
The FDA’s revised advice highlights the many nutrients found in fish, several of which have important roles in growth and development during pregnancy and early childhood. It also highlights the potential health benefits of eating fish as part of a healthy eating pattern, particularly for improving heart health and lowering the risk of obesity.
Note: ACOG has also released a practice advisory in support of the FDA and EPA guidance with an important addition
Providers should counsel women that pregnant women avoid all raw and undercooked seafood, eggs, and meat due to concerns regarding Listeria
Nutritional Value of Fish Consumption
Healthy omega-3 fats (DHA and EPA)
More vitamin B12 and vitamin D than any other type of food
Iron which is important for infants, young children, and women who are pregnant or who could become pregnant
Other minerals like selenium, zinc, and iodine
FDA & EPA Fish Chart
“Recommendations for women of childbearing age (about 16-49 years old), especially pregnant and breastfeeding women, and for parents and caregivers of young children”
The FDA and EPA fish chart covers 62 types of fish and recommendations for consumption are based on the following categories
Best Choices List: Eat two to three servings a week (accounts for 90% of fish choices in the US) or
Good Choices List: Eat at one serving a week
Note: The chart also includes a category titled “Choices to Avoid” due to highest mercury levels
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Disclosure of Unlabeled Use
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.
The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information
presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.
Jointly provided by
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