Prenatal Vitamins For Pregnancy: Which Supplements Do I Need to Take?
Some of the most common nutrition questions I hear are often in regard to supplements:
Should I be taking supplements?
What kind of vitamins are best for me?
What are the most important supplements to take?
With the overload of nutrition information available on the Internet and overwhelm of new “nutrition products” on a daily basis, it’s easy to see why there is so much confusion surrounding this topic.
Supplements Can Be Helpful
In general, I strongly believe that supplements cannot replace a nutrient-dense diet, and it is always helpful to re-evaluate potential nutrient gaps with food intake first before adding any supplements. However, I also feel that even the most well-intentioned diet may not be sufficient in providing all the vitamins and minerals that our bodies may need in the optimal quantities.
There are also specific times during a woman’s life where nutrient demands are increased, such as pregnancy and postpartum. Having adequate nutrient intake through diet and supplementation is important for both mother and baby through these crucial life phases.
This is where I think supplements can be helpful. Meeting increased nutrient requirements through food alone can be challenging, especially for a mama who may be juggling multiple things in life while caring for little ones, making self-care even more difficult to keep a priority.
Sitting down for a meal may be as rare as taking a long shower alone, and your food intake might be consistent of the leftovers on your kids’ plates. Even the most vigilant diet may have minor nutrient gaps, and supplements can ensure that nutrient needs are met on a daily basis.
Nutrients Needed During Pregnancy
For a mama who is growing a baby, there are many increased nutrient demands in order to support a healthy pregnancy. Optimal nutrition and supplementation during pregnancy is important for both mother and her developing baby.
Some of the vitamins, minerals, and nutrients that are important during pregnancy include but are not limited to folic acid, calcium, iron, omega-3 fatty acids, choline and probiotics.
Folic Acid
This B-vitamin is crucial in pregnancy to help prevent serious birth defects of the spinal cord. Neural tube defects can occur at the earliest stages of pregnancy, which is why it is important to supplement with folic acid before conception (when possible).
Supplementation with folic acid before pregnancy and through the first trimester can help decrease neural tube defects by up to 70 percent [1]. Folic acid can also help reduce risk of preeclampsia in pregnant women as well as other defects in baby, including heart defects, cleft lip and cleft palate.
It is recommended to get 400 micrograms (mcg) of folic acid daily before and during pregnancy.
Calcium
Women who are pregnant and breastfeeding need 1,200 - 1,400 milligrams of calcium per day, which is equivalent to about four 8-ounce glasses of milk. Calcium is crucial for maintaining and building bone health in a pregnant mama and supporting the skeletal growth of baby.
Research has found that women who received about 1,500 milligrams per day of calcium during pregnancy had a decreased risk of preeclampsia, which is a leading cause of premature birth [2].
Pregnant women who do not get adequate calcium are at increased risk of bone loss, as the growing baby will take what is needed directly from it’s mother’s bones. Crazy, right? If you’re not an regular dairy consumer, a calcium supplement may be especially important during pregnancy.
Iron
During pregnancy, a woman’s blood volume increases by 30-50% to support her growing baby, which can cause anemia for some pregnant mamas.
Women who may not be eating iron-rich foods, who are carrying multiples, or who have had two pregnancies close together may be at increased risk for developing anemia.
Anemia during pregnancy can lead to a host of complications during pregnancy, for both mother and baby, so it is crucial to support your body with this important nutrient. The daily requirement for iron during pregnancy is 27 milligrams.
Omega-3 Fatty Acids
These essential fats are critical for fetal neurodevelopment. Research has also found that omega-3 supplementation in high-risk pregnant women played an important role in reducing spontaneous premature births [3].
DHA, an omega-3 fatty acid, is particularly crucial for fetal development of the brain and retina during the third trimester. Seafood consumption is an excellent source of omega-3 fatty acids, but due to risk of mercury contamination, servings should be limited.
For these reasons, omega-3 supplements containing both EPA and DHA fatty acids should be considered during pregnancy.
Choline
This lesser known nutrient has proven crucial to both mother and developing baby during pregnancy. Commonly found in foods, such as egg yolks, poultry, lean red meat, fish, nuts, legumes, and cruciferous vegetables, this essential nutrient plays an important role in prenatal brain development.
Choline is a water-soluble nutrient with a similar profile to B vitamins. During pregnancy, women have an increased need for choline, yet the majority of women consume less that then recommended 450 milligrams per day.
A recent study discovered significant cognitive benefits in the offspring of women who daily consumed close to twice the currently recommended amount of choline during their last trimester [4]. The findings from this study suggest that even a moderate increase in maternal choline intake during pregnancy may produce cognitive benefits for offspring.
Adding a choline supplement during pregnancy can help ensure that you are receiving adequate amounts of this crucial nutrient to support prenatal brain development.
Probiotics
Probiotics are "good" bacteria, or live microorganisms, that can offer a host of health benefits when eaten and/or taken via supplements, including boosted immune function, improved digestion, anti-inflammatory properties, and a reduced risk of many diseases.
The health of our gut microbiome directly impacts multiple systems in our bodies, including our immune system, neurodevelopment and mental health. Prioritizing your gut health, particularly during pregnancy and postpartum, can be one of the most important steps for maintaining overall health and wellness.
Because this is a relatively new but expanding area of research, there has not yet been established guidelines for probiotic supplementation for women during pregnancy. However, including a variety of probiotic foods, including yogurt, kefir, kimchi, sauerkraut, and others, can help boost friendly bacteria in the gut.
Recent research has found that consuming probiotics during pregnancy may reduce the chances of premature birth and preeclampsia in late pregnancy, showing promising benefit.
Probiotic supplements often combine different species together and work for different health conditions. It is important to speak with your prenatal dietitian and/or health provider to determine the right type of probiotic for you during pregnancy.
Supplements During Pregnancy
Again, because a woman’s nutrient needs are unique and often increased during pregnancy, supplementing can support a healthy mother and baby by covering basic requirements, especially if there may be gaps in the daily diet.
It is important to reiterate that supplements cannot replace a balanced, varied diet; However, they can be helpful in complementing a nutrient-rich diet during pregnancy and postpartum.
Many women are able to obtain nutrients they need by eating a diet that includes a variety of foods from the major macronutrients, including proteins, carbohydrates and healthy fats.
Choosing a diet that includes a wide variety of foods can offer your body the optimal opportunity for getting needed nutrients, and supplements can help provide back up support.
This can be especially helpful when nutrient needs are higher during pregnancy. Nutrient deficiencies can be particularly harmful to a developing baby, so pregnancy is an important time to consider supplementation.
Consult Your Healthcare Provider
Lastly, it is absolutely important to remember that you should always check with healthcare provider before beginning any supplementation regimen.
The information in this article is strictly informational and should not be used as medical advice. Please consult with your healthcare provider to discuss an individualized approach for nutrient supplementation.
If you are an expecting mama needing extra support during your pregnancy, please visit my Service Page to learn more about how a prenatal dietitian nutritionist can help you have a healthy pregnancy, including customized supplement recommendations.
Are you an expecting mama? What supplements do you take to support a healthy pregnancy?
References:
[1]: Center for Disease Control, “Effectiveness in Disease and Injury Prevention Use of Folic Acid Prevention of Spina Bifida and Other Neural Tube Defects”, https://www.cdc.gov/mmwr/preview/mmwrhtml/00014915.htm Accessed 26 August 2017
[2]: World Health Organization, “Calcium supplementation during pregnancy to reduce the risk of pre-eclampsia”, http://www.who.int/elena/titles/calcium_pregnancy/en/ Accessed 26 August 2017
[3]: Greenberg, J. A., Bell, S. J., & Ausdal, W. V. (2008). Omega-3 Fatty Acid Supplementation During Pregnancy. Reviews in Obstetrics and Gynecology, 1(4), 162–169.
[4]: Marie A. Caudill, Barbara J. Strupp, Laura Muscalu, Julie E. H. Nevins, Richard L. Canfield. Maternal choline supplementation during the third trimester of pregnancy improves infant information processing speed: a randomized, double-blind, controlled feeding study. The FASEB Journal, 2017; fj.201700692RR