I’m pregnant with baby #2! Luckily, I was already taking a prenatal supplement because I didn't know I was pregnant for a good six weeks. Oops! Since nutrition is obviously a top priority, choosing a prenatal supplement took some time. The requirements for calcium, iron, iodine, vitamin B6 and folic acid increase when pregnant.
There are so many prenatals on the market, how do you go about choosing a quality one with everything you need? One huge criteria for me was finding a prenatal with only the most active or absorbable form of the nutrients. For example, look for folic acid as 5-Methyltetrahydrofolate or folinic acid, vitamin B6 as Pyridoxal 5’-Phosphate, and vitamin B12 as Methylcobalamin. The form of calcium matters too since the amount of calcium your intestines absorb during pregnancy doubles! Read more about pregnancy, calcium, and bone health.
Folic Acid Side Note
Perhaps the most important reason to take a prenatal is folic acid. In fact, all women of child-bearing age, even if not planning or trying to conceive, are strongly encouraged to take 400 mcg of folic acid every day. 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. There's also a link between taking folic acid in the first month of pregnancy and a decrease in infant's autism risk.
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. Most artificial colors say something like this: Blue 2 Lake. "Lake" indicates Aluminum! Definitely don't succumb your baby to that! 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, such as vitamin D during pregnancy, probiotics during pregnancy, and healthy fats 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.