Do I Need a Prenatal Vitamin?
by Andrea Brookhart, PharmD, BCACP
From the day you find out you’re pregnant, you should begin taking a prenatal vitamin supplement daily and continue taking it throughout your pregnancy. In fact, if you are planning to become pregnant, it is appropriate to take a daily vitamin with 400-800 micrograms (mcg) of folic acid (a form of folate) before you find out you are pregnant.
I chose to begin a prenatal vitamin a few months before I planned to become pregnant, and I have continued to take my prenatal vitamin daily throughout my pregnancy. In fact, I plan to continue to take my prenatal vitamin daily for a short period of time after my twins arrive this summer, before switching back to a standard women’s daily vitamin.
What should I look for in a prenatal vitamin supplement?
Many prenatal vitamin supplements contain the basic nutritional requirements that may not be met by your daily diet. There are certain things to look for in a prenatal vitamin, including 600-800 mcg of folic acid and 27 milligrams (mg) of iron. Folic acid prevents neural tube defects in babies and anemia in mothers, among other complications, and can be difficult to obtain from your diet. Iron helps support your body’s production of blood cells, as your blood volume increases throughout pregnancy, and may help prevent pregnancy-related anemia. There has not been enough benefit shown to recommend iron supplementation outside the amount found in daily prenatal vitamins unless your obstetrician recommends otherwise.
In addition, quality prenatal vitamins will help you get the calcium and vitamin D your body needs to support a healthy pregnancy. Between your diet and a supplement, you should consume 1,000 mg of calcium per day, with the majority coming from your diet and up to 250 mg coming from your vitamin. Your diet and supplementation should also provide you a total of 600 international units (IU) of vitamin D3 per day. Consuming a healthy diet and a prenatal vitamin supplement with an additional 400 IU of vitamin D will provide what you need.
What are some prenatal vitamin supplements that meet these criteria?
What else might be good to look for in my prenatal vitamin supplement?
Vitamin B6 has been shown to reduce morning sickness, so having it in your prenatal vitamin may provide you with the bonus benefit of reduced nausea!
What should I do if my vitamin makes me nauseous?
First, try taking the vitamin at night before bed. This way, you will sleep through any discomfort. If you still have trouble tolerating your prenatal vitamin, speak with your obstetrician. She may recommend a prescription-only prenatal supplement that will be better tolerated.
When is my prenatal vitamin supplement not enough?
Many times, gummy prenatal vitamins are missing minerals recommended in prenatal vitamin supplements, like iron and calcium.
Your obstetrician will recommend any additional supplementation that you may need based on a range of factors including medications you take, health conditions and results from lab work. For example, some women are asked to take additional iron if they become anemic during pregnancy. Also, women pregnant with twins or triplets may be asked to take additional folic acid or iron supplements.
Up to 40-60% of the population has impairment in their ability to convert folic acid to its bioactive form, L-methylfolate. For a small subset of that group, the impairment is significant enough that taking a prenatal vitamin supplement with the bioactive form of folate, L-methylfolate, may be warranted. One small study has shown women randomized to receive a prenatal vitamin with the bioactive L-methylfolate had lower rates of anemia. Ask your obstetrician if he or she recommends that you take a prenatal with L-methylfolate if you are concerned.
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Disclaimer: This information is educational only and not providing healthcare recommendations. Please see a healthcare provider.