Pregnancy increases the body’s requirements for energy (overall calories, protein, and carbohydrate) and vitamins and minerals. You can think of vitamins and minerals as nutrients needed in teeny amounts that make all the systems in your body work properly. Although in most cases healthy adults are able to meet all of their vitamin and mineral needs by eating a diet plentiful in a variety of fruits, vegetables, whole grains, lean protein, and non-fat or low-fat dairy (or fortified soymilk), in the case of pregnancy – yes you really need to take a supplement!
- How early before trying to become pregnant should you start on a prenatal supplement? You need to start on at least a folic acid supplement containing 400 μg (or the option to take a full prenatal supplement; note folic acid needs increase during pregnancy to 600 μg) at least one month prior to trying to become pregnant (1). Take a full prenatal supplement during pregnancy, and remain on this until the baby is born.
- What should you be looking for in a prenatal supplement? Look for one that definitely meets the folic acid requirements (400 μg if taking 1 month prior and 600 μg if pregnant) and iodine (at least 150 μg), as these are particularly important for proper brain and nervous system development (1,2). Some prenatal supplements on the market are missing iodine completely. Aside from this it’s basically an enhanced multivitamin with minerals. Bear in mind your supplement might not meet 100% of each micronutrient, because the expectation is you will meet the remainder of your needs through foods you eat.
- Is there one that’s recommended? Personally, I recommend choosing a prenatal supplement that’s been approved via third-party testing because the Food and Drug Administration (FDA) does not require supplements to be tested prior to going to market. Two ways to check for testing are by viewing ConsumerLab.com, or choosing a supplement with the USP-verified label. A few supplements which have been third-party tested and meet most pregnancy needs are: Enfamil Expecta Prenatal* (you can choose to take or not take the DHA capsule, see below – this is the prenatal I take), NOW Prenatal Gels, or NatureMade Prenatal Multi. Some physicians may instruct you to take any supplement you can tolerate, however bear in mind that without proper testing there is no guarantee what’s in the capsule matches what the bottle says or that the supplement does not exceed contamination limits.
- What about DHA in prenatals? There are no set guidelines for recommended amounts of EPA or DHA needed for normal healthy adults or during pregnancy. DHA may be particularly important during pregnancy for brain and visual development of the baby. It’s recommended you include fish twice weekly in the diet. Benefits of DHA supplementation in pregnancy have been inconsistent. If you choose to take a supplement, consider the research in pregnant women has utilized varying amounts between 200 and 800 mg of DHA daily.
Nutrition and Neural Development
What’s the deal with folic acid?
Folate (vitamin B9) is a water-soluble vitamin, which means it’s not stored in the body and must be replenished frequently. Folic acid is the synthetic form of folate found in supplements. Folic acid (or folate) plays an important role in neural tube development of the baby which occurs in the first few weeks of pregnancy, often before a woman might know she’s pregnant. Failure to have adequate folic acid intake could result in serious neural tube defects for your baby, namely anencephaly (missing part of the skull or brain) and spina bifida (lack of neural tube closure). If a supplement contains more than 600 micrograms, it’s not necessarily concerning as excess folic acid will be excreted in the urine.
And what about iodine?
Iodine is a mineral. It is a component of the thyroid hormones thyroxine (T4) and triiodothyronine (T3). During pregnancy iodine plays an important role in development of the central nervous system and skeletal system. Iodine deficiency is the leading cause of preventable mental retardation worldwide. Some prenatal supplements do not contain the recommended amount of iodine, so be sure to check your labels.
Set yourself up for health by eating a variety of nutrient-dense foods prior to becoming pregnant. Proper pre-pregnancy nutrition ensures adequate nutrient stores for proper growth for the baby. Eating a variety of nutrient-dense foods prior to and throughout pregnancy, in addition to taking a prenatal supplement while pregnant, and maintaining an active lifestyle is important for the health of both you and your baby!
- Centers for Disease Control and Prevention. Facts about folic acid. Accessed October 6, 2016. Available at https://www.cdc.gov/ncbddd/folicacid/about.html.
- American Academy of Pediatrics. Iodine deficiency, pollutant chemicals, and the thyroid: New information on an old problem. Pediatrics. 2014;133(6):1163-1166. Available here.
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