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! That could have been a big problem since there are some crucial nutrients needed for a baby's development in the first weeks of pregnancy. Also, taking a QUALITY prenatal vitamin is critical if you want a healthy pregnancy. You already know that. It is choosing the correct prenatal that people often want guidance on.
Most Bioavailable Form of Important Nutrients During Pregnancy
Folic acid: 5-Methyltetrahydrofolate, L-5-methylfolate, folinic acid, folate (from real food)
L-5-methylfolate (L-5-MTHF) requires no additional metabolic steps to be used by the body, thus it is often the preferred choice for those with absorption or metabolic defects (ie: people with the MTHFR gene mutation)
Folinic acid quickly converts to L-methylfolate as needed in the body, but is not “pre-methylated.” Folinic acid may be easier for individuals who are sensitive to methylated nutrients to tolerate than supplemental L-methylfolate.
Vitamin B6: Pyridoxal 5’-Phosphate
Vitamin B12: Methylcobalamin
Iron: Ferrous fumarate, iron citrate, iron picolinate
Calcium: the form of calcium matters since the amount of calcium your intestines absorb during pregnancy doubles! Read more about pregnancy, calcium, and bone health.
Folate Is The Natural Form: Take It Early
One of the most important reasons to take a prenatal supplement is to ensure you and your baby get enough folate (the natural form). The amount increases from 400 mcg/day to 800 mcg/day once pregnant. There's also a link between taking folic acid in the first month of pregnancy and an infant's autism risk.
Folic acid is the synthetic form, which you want to avoid. All women of child-bearing age, even if not planning or trying to conceive, are strongly encouraged to take 400 mcg of a bioavailable form of folic acid every day. Bioavailable forms of folic acid include: folate (from real food), 5-Methyltetrahydrofolate, L-5-methylfolate, and folinic acid form.
Studies show getting enough folate and B12 before sperm meets egg, and in the early stages of pregnancy, can dramatically reduce the risk of neural tube defects (like spina bifida).
Iron Tidbits
Iron needs jump to 30 mg per day when pregnant. This mineral is the building block for baby's cells.
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.
Calcium binds with iron to prevent it from being absorbed, so avoid eating calcium-containing products at the same time as iron supplements — wait at least two hours after eating calcium-containing products before taking your iron supplement. On the other hand, to increase and improve iron absorption, take it with vitamin C. 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.
Iodine for Thyroid Health
Iodine aids your baby-to-be's thyroid and brain development, and studies show many American women aren't getting enough. The recommendation is 150 mcg per day. Not all prenatals contain iodine, or this quantity of it, so examine the prenatal supplement label for iodine before purchasing. You can also use iodized salt as a source of iodine.
Examine the "Other Ingredients" Section of the Supplement
Examine the “other ingredients” list on the prenatal vitamin. You're looking for a prenatal that does not contain any additives, binders, fillers, artificial colors, or artificial sweeteners commonly found in mainstream prenatal supplements. Avoid magnesium stearate, and if you're sensitive to allergens, examine whether the product contains milk, soy, eggs, fish, nuts or wheat.
Definitely avoid artificial colors because they contain aluminum!! An artificial color will say something like this: Blue 2 Lake, and "Lake" indicates Aluminum! You definitely don't want to succumb your baby to that neurotoxin! Look for a supplement form in either a liquid or vegetarian capsule. Avoid tablets because they do not dissolve well in your stomach.
Timing Tips for When Taking A Prenatal Vitamin
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.
Take your prenatal vitamin throughout your pregnancy, and even during breastfeeding. Take your prenatal vitamin with food (avoid dairy to ensure the iron is absorbed), and include some fat in that food so the fat-soluble vitamins (A, D, E, K) can be absorbed and transported throughout the body.
Other Crucial Nutrients In A Prenatal Vitamin
Vitamin D3, DHA, probiotics, and decreasing exposure to toxins are all very important during pregnancy, so I wrote about them in separate blogs. Here's more information: vitamin D during pregnancy, probiotics during pregnancy, healthy fats during pregnancy, and 10 ways to decrease toxic exposure during pregnancy.
Don't Overload On Supplements
A nutrient-rich diet combined with a high quality prenatal supplement ensures the best start for your little one, but more isn't better when it comes to taking 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.
In Health and Happiness,
Kelly Harrington, MS, RDN
Registered Dietitian Nutritionist for Healthy Goods
References:
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.
