17 July 2017
Whether you are of childbearing age, you are trying to conceive, or just found out that you are pregnant, prenatal dietary supplements – alongside a healthy diet – can help provide the crucial nutrition that you and your baby need. But not all prenatal vitamins are the same.
So as a Registered Dietitian Nutritionist, when it comes to selecting prenatal dietary supplements for my patients here is what I look for and recommend.
Pregnancy or not, I encourage my patients to choose vitamins and minerals that are easy for the body to digest and absorb. But with the hormone changes that happen during pregnancy, nausea and vomiting can become an even bigger concern, further emphasizing the need for a supplement that is well tolerated. That is why for women of childbearing age, I typically recommend a multivitamin sourced from quality ingredients that is easy and gentle on the stomach.
I will also check to see how much and what type of iron is offered in the prenatal vitamin, since too much or some forms of iron can lead to gastrointestinal (GI) disturbances.1 And, if my patient is still having trouble with tolerance, I may recommend that she split her doses in half (some in the morning, some at night), or try a chewable or liquid vitamin instead of a capsule or tablet.2
Certain vitamins, like vitamins A, D, E and K, require the presence of certain nutrients to be absorbed, so taking a prenatal supplement at meal time may help boost absorption.
Also, because folate and folic acid are recommended to help prevent neural tube defects, I am sure to look for ample folate in prenatal dietary supplements. When considering folate status, I will also consider that up to 25 percent of the population may have a genetic variant limiting their conversion of folic acid to its active form, methylfolate.3 For those reasons, I’ll also look for methylated B-vitamins, specifically methylfolate, in prenatal dietary supplements.
Not only does pregnancy increase a woman’s need for folate, but pregnancy also increases a woman’s needs for special nutrients including vitamin D, choline and iodine.4-5 I always check to make sure that a prenatal offers enough of those special nutrients to help supplement a pregnant woman’s healthy diet.
And, because long-chain omega-3 fatty acids are crucial for the developing baby’s nervous system, experts recommended that women of reproductive age consume at least 200 mg per day of the important omega-3 fatty acid DHA.6 I recommend that a pregnant woman gets her DHA through fatty fish like salmon or sardines, or through a quality supplement – look for ones with life’sDHA®, a vegetarian DHA sourced from algae.
Ingredients like artificial colors, flavors, sweeteners or other fillers are likely not needed to deliver nutrition to the body for both mom and baby, so I’ll look to a product that avoids these ingredients.
Also, whether it is to decrease morning sickness, avoid swelling or boost sleep, sometimes during pregnancy, a woman will turn to herbal supplements. And sometimes that’s okay. But other times, an herbal supplement might actually be harmful for the developing baby. Since there are a wide variety of herbal supplements (and their dosage varies as well), check with a well-trained doctor or Registered Dietitian to determine what is appropriate for you.
Also, keep in mind that while vitamins and minerals are good, too much of a good thing may not be. Consider that you may be getting vitamins and minerals if you are consuming a healthy diet or a large amount of fortified foods and adjust as necessary.
As with all recommendations regarding your health, it is best to check with a well-trained physician and a registered dietitian to determine what supplements are best for you to help maintain your health and support that of your baby’s from before conception until after delivery. Do you have more questions about prenatal nutrition? Connect with me here www.YESNutritionLLC.com
1. Melamed, N., Ben-Haroush A., Kaplan, B. et al. Iron supplementation in pregnancy--does the preparation matter? Arch Gynecol Obstet. 2007;276(6):601-604.
2. Ahn E, Pairaudeau N, Pairaudeau N, et al. A randomized cross over trial of tolerability and compliance of a micronutrient supplement with low iron separated from calcium vs high iron combined with calcium in pregnant women [ISRCTN56071145]. BMC Pregnancy and Childbirth. 2006;6:10. doi:10.1186/1471-2393-6-10.
3. Greenberg JA, Bell SJ, Guan Y, Yu Y. Folic Acid Supplementation and Pregnancy: More Than Just Neural Tube Defect Prevention. Reviews in Obstetrics and Gynecology. 2011;4(2):52-59.
4. Dietary Reference Intakes (DRIs): Recommended Dietary Allowances and Adequate Intakes. Food and Nutrition Board, Institute of Medicine, National Academies. 2011.
5. Hollis BW, Johnson D, Hulsey TC, Ebeling M, Wagner CL. Vitamin D Supplementation during Pregnancy: Double Blind, Randomized Clinical Trial of Safety and Effectiveness. Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research. 2011;26(10):2341-2357.
6. Cetin, I., Koletzko, B. Long-chain omega-3 fatty acid supply in pregnancy and lactation. Curr Opin Clin Nutr Metab Care. 2008 May;11(3):297-302.
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