I’m pregnant with baby #2, due in March! For the past 8 months, I’ve been devoted to giving this baby the best start to life.
Let’s talk Prenatal Supplements:
It all starts with a quality prenatal supplement. Even with the most solid diet, there are a handful of nutrients especially important during pregnancy. All pregnant women need more iron and folic acid. There are so many prenatal vitamins on the market, how do you go about choosing a quality prenatal supplement? Choose a prenatal vitamin that includes only the most active or absorbable forms of nutrients. For example, folic acid as 5-Methyltetrahydrofolate or folinic acid, vitamin B6 as Pyridoxal 5’-Phosphate, and vitamin B12 as Methylcobalamin.
Folic Acid Side Note:
Did you know all women of child-bearing age are strongly encouraged to take 400 mcg of folic acid every day, even if not planning or trying to conceive? This is because folic acid is critical for preventing neural tube defects and folic acid works only if taken before getting pregnant and during the first month of pregnancy, often before a woman even knows she’s pregnant.
Once pregnant, folic acid needs increase to 800 mcg per day. Again, look for the 5-Methyltetrahydrofolate or folinic acid form of folic acid.
Iron needs jump to 30 mg per day when pregnant. There are so many different forms of iron—it can be quite confusing. Ferrous iron is much better absorbed than Ferric iron, and there are different forms of ferrous iron…some are better than others.
Ferrous fumarate is a good form, and ferrous sulfate is the cheapest and constipates most people.
Iron citrate and iron picolinate are a bit more expensive but more easily absorbed and typically not constipating.
Milk, calcium and antacids should NOT be taken at the same time as iron supplements because the calcium binds with iron to prevent it from being absorbed. Wait at least two hours after eating these before taking your iron supplement. On the other hand, vitamin C increases iron absorption. Also, the amount of iron absorbed decreases with increasing doses. For this reason, ideally take your iron supplement in two or three equally spaced doses, if possible.
Choline for brain development:
An “extra” to consider in a prenatal supplement is choline, which plays an important role in reducing neural tube defects (1, 2) and is important in later stages of pregnancy when the memory center of baby’s brain is developing (3). The adequate intake level established for pregnant women is 450 mg choline/day. Choline is found in foods such as egg yolks, beef, broccoli, cauliflower, spinach, wheat bran, wheat germ, nuts and beans.
Examine the “other ingredients” list on the prenatal to find one manufactured without any additives, fillers, artificial colors, or artificial sweeteners commonly found in mainstream prenatal supplements. Look for a supplement form in either liquid or vegetarian capsules. Avoid tablets because they do not dissolve well in your stomach.
Simple Timing Tips:
Trust me on this one because it happened to me…take your prenatal 6+ hours before going to sleep or it may keep you awake due to the powerful B-vitamins. Also, if one serving of your prenatal vitamin requires you to take more than one capsule, take them at different times throughout the day to achieve the maximum absorption. For example, one serving of my prenatal supplement is 6 capsules, so I may take 3 capsules at breakfast and 3 at lunch or 2 at breakfast, 2 at my mid-morning snack, and 2 at lunch.
Don't overload on supplements:
More isn't better when it comes to vitamins. If you’re interested in taking additional supplements or herbs, check with your doctor first, especially since some vitamin megadoses and herbs can be harmful when you're pregnant.
A nutrient-rich diet combined with a high quality prenatal supplement ensures the best start for your little one. Stay tuned for more information about other important nutrients during pregnancy.
In Health and Happiness,
Kelly Harrington, MS, RDN
Registered Dietitian Nutritionist for Healthy Goods
1. Shaw GM, Carmichael SL, Laurent C, Rasmussen SA. Maternal nutrient intakes and risk of orofacial clefts. Epidemiology. 2006;17:285–91.
2. Shaw GM, Carmichael SL, Yang W, Selvin S, Schaffer DM. Periconceptional dietary intake of choline and betaine and neural tube defects in offspring. Am J Epidemiol. 2004;160:102–9.
3. Wu BT, Dyer RA, King DJ, Richardson KJ, Innis SM. Early second trimester maternal plasma choline and betaine are related to measures of early cognitive development in term infants. PLoS One. 2012;7(8):e43448. doi: 10.1371/journal.pone.0043448.