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Pregnancy /
Choosing a prenatal vitamin
Getting your nutrition essentials in pregnancy
By Tamera Young, RN, MSN
During pregnancy, your body needs additional vitamins and minerals to support itself and your growing baby. The best way to make sure you have the nutrition you need is to take a prenatal vitamin each day. Even if you regularly eat a varied, healthy diet, think of your prenatal vitamin as an insurance policy against any deficiencies each day from conception, through pregnancy and until you’ve finished breastfeeding your baby.

Prevent birth defects
Even if you’re just trying to conceive it’s best to start your prenatal vitamins before you get pregnant to support your baby during those earliest developmental days. Your prenatal vitamin should contain at least 400 micrograms of folic acid to prevent neural tube defects, such as Spina Bifida, which occur in the first 28 days of pregnancy, and often before you even miss a period and learn you’re pregnant.

Folic acid is the synthetic form of the B vitamin folate, which is found in leafy greens and other foods. Many prenatals have as much as 800 micrograms of folic acid, which is safe and helps prevent birth defects. Talk to your healthcare provider if you’ve had a pregnancy affected by a neural tube defect as you may need more folic acid than found in most prenatal vitamins.

Customize your vitamin
Does your throat close at the thought of swallowing a capsule? Look for a chewable, liquid or even gummy prenatal vitamin. Many pregnant women take the vitamin B6, particularly during the first trimester, to help with nausea and morning sickness. Most experts advise 50 milligrams of B6 daily if you’re dealing with morning sickness. You may find a prenatal vitamin that includes this in your daily dose and then you can skip the extra supplements.

If you’re prone to iron deficiencies, look for a higher level of iron in the prenatal vitamin you choose, but be aware that iron supplements can cause stomach upset and constipation. If you’re not anemic, you can pick a prenatal vitamin without iron.

Want to nourish a smarter baby? Many makers of prenatal vitamins are now including omega-3 fatty acids in the form of DHA (docosahexaenoic acid). This healthy fat has been shown to promote brain and eye development in the fetus and experts are currently exploring other ways that essential fatty acids benefit both you and your baby during pregnancy. You may also be asked to continue your DHA-supplemented prenatal vitamins postpartum if you are breastfeeding.

Read the labels
Not all prenatal vitamins are created equal and because not all supplements have been tested for safety in pregnant women, so it’s best to stick with boosting your basic needs during this time. For example, too much vitamin A can be harmful to your baby so this vitamin is often reduced in prenatals, which is one reason why a regular multivitamin just won’t work during and after pregnancy.

Ask your health care provider if you should boost your vitamin D intake during this time. Emerging research is showing that as much as 4,000 IU of vitamin D can reduce preterm labor and premature birth, but since this is new, it’s not part of the prevailing recommendation of 400 IUs of vitamin D each day.

And skip herbal supplements altogether – many are thought to be risky for your baby; discuss any herbs or other supplements with your health care provider before you take them.

Lastly, your prenatal vitamin isn’t an excuse for poor eating – strive to get the nutrition you and your baby need each day through your food.
Choose a prenatal vitamin with at least the following:

• 400 mcg of folic acid
• 400 IU of vitamin D
• 70 mg of vitamin C
• 6 mcg of vitamin B12
• 10 mg of vitamin E
• 3 mg of thiamine
• 2 mg of riboflavin
• 20 mg of niacine
• 15 mg of zinc
• 200 to 300 mg of calcium

Tamera L. Young, RN, MS, is an obstetric clinical instructor at Central Ohio Technical College in Newark, OH.

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