However with the wide array of prenatal supplements on the market how do you know which one is right for you? I have provided a guide below on the key nutrients to consider when choosing a prenatal supplement/s.
Many of you have probably heard about the importance of folate during pregnancy. Folate is essential for healthy cell division, DNA synthesis and the formation of the neural tube in the foetus.
The recommended daily intake (RDI) of folate in pregnancy is 600mcg/day. The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) recommend taking a supplement containing at least 400mcg folic acid 1 month prior to conception and for the first 12 weeks of pregnancy (1). If you are at an increased risk of neural tube defects (e.g. taking anticonvulsant medication, pre-pregnancy diabetes mellitus, previous child or family history of NTD, BMI >30 or malabsorption condition such as Crohn’s disease or coeliac disease) a 5mg daily dose is recommended (1).
Iodine during pregnancy is vital for maintaining normal functioning of the thyroid gland, regulating the foetus metabolism and development of the foetus brain and nervous system. Iodine deficiency during pregnancy can result in stunted growth, reduced intelligence and retardation.
The RDI of iodine is 220mcg, however a large literature review have advised an intake of 250-300mcg (2). RANZCOG recommend taking a supplement with a minimum 150mcg iodine prior to conception, during pregnancy and whilst breastfeeding (1). If you have had a thyroid condition please check with your healthcare professional before taking an iodine containing supplement.
During pregnancy iron requirements increase significantly from 18mg per day to 27mg per day. This is due the large increase in red blood cell volume and demands from the developing foetus and placenta.
Iron levels should be tested at your first antenatal visit and again at approximately 28 weeks and supplementation provided if required (1). Iron supplementation is also recommended if you are at risk of deficiency including if you are vegetarian/vegan or are having multiple pregnancies (1).
As iron supplements can cause constipation and nausea a multi-vitamin with iron (especially high dose iron) may not be the best option if you have adequate iron stores and are consuming a diet rich in iron containing foods such as meat, poultry, fish, wholegrains, legumes, nuts and leafy greens.
Adequate vitamin D is essential for muscle and bone development in the foetus as it helps to maintain calcium and phosphorus levels. Low vitamin D levels have also been linked to an increased risk of preeclampsia, gestational diabetes and low birth weight (3). Whilst the RDI of vitamin D is 5mcg (200IU), the Institute of Medicine recommend a higher intake of 10-15mcg/day (400-600 IU). The vitamin D levels in prenatal vitamins usually vary between 5mcg-25mcg (200-1000IU).
If you have not had your vitamin D levels tested I would highly recommend discussing this with your healthcare professional to see if you are at risk. If you are deficient you will most likely need an additional vitamin D supplement.
Niacin is essential during pregnancy as it contributes to the foetus brain development. It can also improve digestion, reduce nausea and migraines in the mother.
During pregnancy the RDI is 18mg/day. Whilst you generally can meet this requirement through diet if consuming adequate meat, dairy and wholegrains I often still recommended choosing a supplement containing adequate niacin. There is however an upper limit in pregnancy of 35mg/day.
Vitamin B12 is important for neurological development in the foetus. If you are vegetarian or vegan it is recommended that you take a supplement containing vitamin B12 (1). The RDI during pregnancy is 2.6mcg per day. Most prenatal multivitamins contain the minimum RDI however if you are at risk of deficiency or have a known deficiency I would recommend choosing a multivitamin with additional vitamin B12.
Choline is only recently starting to gain attention for its important role in pregnancy. Choline is required for neural tube development, brain development and cognition, health of the placenta and nutrient transport of the foetus.
The RDI during pregnancy is 450mg/day. Unfortunately research has shown that less than 1% of women are meeting this requirement (4). Some prenatal multivitamins are starting to add choline, however the dose varies widely. If you are not on a supplement containing choline I would highly recommend regularly consumption of choline rich foods such as eggs, beef, soybeans, chicken breast, fish and dairy products.
Omega 3’s, in particular docosahexaenoic acid (DHA) is vital for foetal brain and eye development. The RDI during pregnancy is 115mg/day. If you do not each much seafood it is highly recommended to choose a supplement containing DHA (1).
Calcium is important to ensure your baby builds strong bones, teeth, healthy heart, nerves and muscles. If you avoid dairy and do not consume other high calcium alternatives it is recommended that you take a calcium supplement to meet the RDI of 1000mg (1). As prenatal vitamins contain minimal calcium most women requiring calcium will need to take a separate calcium supplement.
In summary there are many nutritional considerations when choosing the right prenatal multivitamin for you. Please also remember that more is not always better when it comes to supplementing.
If you would like to have a complete dietary assessment and supplement check to ensure your nutritional needs are being meet during pregnancy please give us a call on 9570 1277 to book an appointment.