If you have ever stood in the supplement aisle wondering whether omega-3 actually matters for your child, you are not alone. There is a lot of noise around this topic — from bold claims on packaging to conflicting advice online. So I want to share what the evidence actually tells us, drawing on a book chapter I wrote.
What are omega-3 fatty acids?
Omega-3s are a family of polyunsaturated fatty acids that the body cannot make on its own, which means they need to come from food (or supplements). The three main types are:
- ALA (alpha-linolenic acid) — found in plant foods like flaxseed, chia seeds, and walnuts
- EPA (eicosapentaenoic acid) — found mainly in oily fish
- DHA (docosahexaenoic acid) — also found mainly in oily fish, and present in high concentrations in the brain
ALA can be converted into EPA and DHA in the body, but the conversion rate is very low — typically less than 10 per cent. This is why direct sources of EPA and DHA tend to be emphasised in the evidence.
Why they matter for the developing brain
DHA is a major structural component of the brain. It makes up a significant proportion of the fatty acids in the cerebral cortex and is concentrated in areas involved in memory, attention, and learning. It accumulates rapidly during foetal development and early childhood, which is one of the reasons why it is considered especially important during these periods.
EPA plays a different but complementary role. It is more closely linked to anti-inflammatory processes and appears to influence how the brain manages stress and mood regulation. Both are needed, and they work in different ways.
In a book chapter I wrote, published by Elsevier, I reviewed the evidence on how omega-3 polyunsaturated fatty acids support neuroprotection — the brain’s ability to defend itself against damage and dysfunction (Bujtor, Su & Borsini, 2022).
The evidence is not based on a single type of study, but a convergence of findings across human clinical trials, animal research, and cellular models. Taken together, these show that omega-3s — particularly EPA and DHA — act on some of the core biological systems that underpin brain health. These include reducing inflammation in the brain, supporting the structure and flexibility of brain cells, and influencing how the brain manages attention, mood, and stress. DHA plays a key structural role within brain cells, while EPA appears to be more involved in regulating inflammation and the body’s stress response.
There is also consistent evidence that omega-3s influence processes such as the growth of new brain cells, how well brain cells communicate with each other, and how the brain protects itself over time. In practical terms, this means they are involved not just in building the brain, but in maintaining and supporting how it functions day to day.
Alongside this, research has found that omega-3 levels can vary between individuals and across different groups of children. For example, some studies have found that children with ADHD tend to have lower levels of omega-3 fatty acids compared to their peers. This has led to growing interest in whether omega-3 status may influence areas such as attention and behavioural regulation. In some studies, increasing omega-3 intake has been associated with small improvements in attention and certain behavioural symptoms, particularly in children who start with lower baseline levels.
What is particularly interesting is that omega-3s appear to support some of the same underlying systems involved in attention, mood, and stress regulation — the same areas that medications are often designed to influence — but in a gentler, nutrition-based way. That does not mean they replace medical treatment, but it does help explain why they are increasingly being explored as part of a broader, supportive approach to brain health.
That said, the evidence is not uniform. Effects vary depending on the individual, the dose, and the type of omega-3 (for example, EPA-dominant vs DHA-dominant formulations). We are still building a clearer picture of who benefits most and under what conditions. What we can say with confidence is that omega-3s play a meaningful role in supporting brain function, particularly during periods of rapid development such as childhood.
What does this mean for children?
For children, the practical implication is relatively straightforward. The brain is developing rapidly throughout childhood and adolescence, and it requires the right building blocks to support that process. DHA is one of those key building blocks, and where possible, the aim is to provide this through food as part of a varied and balanced diet.
Low omega-3 status has been associated in a number of studies with differences in attention, mood regulation, and aspects of cognitive performance. However, it is important to be clear that omega-3 status is rarely the sole driver of these outcomes. Brain development and behaviour are complex and influenced by many interacting factors.
What the evidence does suggest is that ensuring adequate omega-3 intake is one meaningful way to support a child’s brain development. Not as a quick fix or a standalone solution, but as one part of a broader dietary pattern that supports overall health.
Where to find omega-3 in food
The richest dietary sources of EPA and DHA are oily fish. You might consider including some of the following in your family’s meals:
- Salmon — one of the richest sources of both EPA and DHA
- Mackerel — affordable and widely available
- Sardines — high in omega-3 and easy to add to pasta or toast
- Trout — a milder-flavoured option that some children prefer
- Anchovies — often more acceptable when incorporated into sauces or on pizza
For some families, including oily fish regularly can feel straightforward. For others, it is much more challenging — whether due to taste preferences, sensory sensitivities, feeding difficulties, or allergies. It is important to recognise that not all children will accept fish, and for some, it is not a safe or appropriate option. In these cases, the focus shifts to what is possible, rather than trying to force a specific food.
For families where oily fish is not regularly eaten, there are plant-based sources of ALA that contribute to overall omega-3 intake. However, as noted earlier, the conversion to EPA and DHA is limited:
- Flaxseeds and flaxseed oil
- Chia seeds
- Walnuts
- Hemp seeds
Fortified foods — such as certain eggs, milks, and yoghurts — may also contain added DHA and can be a useful option for children who do not eat fish.
In practice, many families use a combination of these approaches. Some children may accept small amounts of fish in specific forms, while others rely more on fortified foods or plant-based sources. The aim is not perfection, but to build a pattern of intake that supports the child’s needs in a way that is realistic and sustainable.
What about supplements?
This is a question that comes up frequently in clinic. Where dietary intake of omega-3 is consistently low — for example, in children who eat very little or no fish — a supplement may be worth considering.
For children, research typically focuses on combined EPA and DHA supplements, most commonly derived from fish oil, although algae-based supplements provide a plant-based source of DHA. One of the challenges in this area is that there is no single universally agreed dose for children. Studies vary widely in both the amount and ratio of EPA and DHA used, and responses can differ between individuals.
Looking at the research as a whole, omega-3 supplementation has been associated with small improvements in attention and some behavioural outcomes in children, particularly in those with lower baseline omega-3 levels. However, findings are not consistent across all studies, and the overall effect is modest. A recent Cochrane Review on polyunsaturated fatty acids for ADHD concluded that omega-3 supplementation may have a small benefit for ADHD symptoms, but the certainty of the evidence is low and results vary between studies.
From a dietary perspective, UK guidance recommends including fish in the diet twice per week, with one portion being oily fish. Where this is not achievable — for example, in children who do not eat fish — a supplement may be considered, ideally with guidance from a registered nutrition professional.
It is also worth noting that not all supplements are equivalent. The quality, dose, and ratio of EPA to DHA can vary considerably between products. If you are considering a supplement for your child, it can be helpful to discuss this with a registered nutritionist or dietitian who can assess your child’s overall diet and make a recommendation tailored to their needs.
For children with restricted diets
For children with restricted diets — whether due to sensory preferences, feeding difficulties, food-related anxiety, or allergies — omega-3 intake can sometimes be lower than ideal. Oily fish is not a food that many of these children will readily accept, and for some, it is not a safe or appropriate option.
In practice, children with restricted diets often rely on a small number of familiar foods, which can make it more challenging to meet certain nutrient needs consistently — including omega-3. This is not about a single food group, but about the overall pattern and variety within the diet.
In terms of support, there are a few different ways this can be approached. For some children, it may be possible to gradually build familiarity with new foods over time, including different forms of fish, but this is not always realistic or appropriate in the short term. For others, fortified foods that contain added DHA can provide a useful contribution. In some cases — particularly where intake is very limited or restricted — a supplement may be the most practical and achievable way to support omega-3 intake.
This is one of the reasons I pay close attention to omega-3 intake when working with children with feeding difficulties. The aim is not to add pressure around specific foods or to push dietary change before a child is ready, but to understand the nutritional picture and find ways to support it that are achievable and sustainable over time.
If you are concerned about your child’s diet or nutritional intake, it is always worth discussing this with a registered nutritionist or dietitian. They can help assess your child’s overall intake and work with you to find a way forward that is safe, appropriate, and realistic for your child and your family.
The bigger picture
Omega-3 is one part of a much larger nutritional story. In my research on diet and inflammation, the evidence consistently points to the importance of overall dietary patterns rather than single nutrients. Omega-3 sits within that context — it matters, but it matters most as part of a varied, whole-food-based diet that includes a range of nutrients working together.
The developing brain needs adequate nutrition across the board. Omega-3s are one piece of that puzzle, and one that the evidence suggests is well worth paying attention to.
Reference: Bujtor M, Su KP, Borsini A. (2022). Neuroprotection induced by omega-3 polyunsaturated fatty acids: focus on neuropsychiatric disorders. Elsevier book chapter. https://doi.org/10.1016/B978-0-443-23763-8.00048-8
Email: enquiries@lifespan-nutrition.co.uk
Clinic: Springbank Clinic, Sevenoaks, Kent
