Pregnancy is an exciting time filled with happiness, anticipation, some nausea, and a lot of decisions. One of the first decisions you will need to make—ideally even before conception—is choosing a prenatal vitamin.
What Is a Prenatal Supplement?
A prenatal supplement, also known as a prenatal vitamin, provides women who are currently trying to conceive or are currently pregnant or breastfeeding with the additional nutrients they need to support their child’s growth and development and their own health. Unlike general multivitamins, prenatal vitamins are specifically formulated to meet the increased nutrient needs of women during this time. Prenatal supplements have been found to promote fertility, prevent birth defects, decrease the risk of miscarriages and preterm births, and minimize the symptoms of morning sickness.
A prenatal supplement, also known as a prenatal vitamin, provides women who are currently trying to conceive or are currently pregnant or breastfeeding with the additional nutrients they need.
Prenatal vitamins should be used as a supplement to, not a replacement for, a healthy diet. They do not contain all of the nutrients that you and your baby need, so it is essential that you still do your best to eat a balanced diet.
Why Should I Take a Prenatal Supplement?
As a registered dietitian, there are very few times when I recommend taking a supplement, because, in general, it is best to get your nutrients from food. However, I do recommend a supplement for all women trying to conceive and those who are currently pregnant or breastfeeding. This is because nutrient needs increase during pregnancy and lactation, and even women who eat nutrient-dense diets may fall short of some of their nutrient recommendations at some point.
First and foremost, you should know there is no perfect one-size-fits-all supplement.
Overall, it’s better to take a prenatal vitamin as an insurance policy to ensure that you are getting the nutrients you need for you and your baby in order to decrease unwanted pregnancy complications or birth defects. This is one of those times when it’s better safe than sorry!
What Should I Look for in a Prenatal Supplement?
First and foremost, you should know there is no perfect one-size-fits-all supplement. All women have different diets and needs, so what your friend or sister needs in a prenatal vitamin is likely different than what you need. The best way to determine what you need in a prenatal supplement is to analyze your diet, lifestyle, skin tone, health concerns, and lab values to figure out which nutrients you may be getting lower amounts of. Registered dietitians are the perfect resource to help you analyze all of these factors and choose the right supplement for you. However, there are basic things that everyone should look for in a prenatal vitamin:
1. Choose a supplement that has been third-party tested.
Since there is currently no governing organization that oversees the safety, content, purity, dosage, and effectiveness of nutritional supplements, there are often differences between what supplements claim and what they are actually composed of. Supplement manufacturers may voluntarily submit some or all of their products to third-party organizations to test their products. Choosing a third-party-tested or certified product helps you know that the supplement is free of harmful substances and someone other than the supplement company is vouching for its quality. Typically, supplements that are third-party tested will have this noted on the label in writing or with an independent seal of approval from certifiers such as NSF (National Science Foundation), USP (United States Pharmacopeia), or Consumer Lab.
2. Look for the active forms of vitamins.
Vitamins have many different chemical forms and some are better absorbed by the body than others. Therefore, it is important to make sure that the vitamins, especially B vitamins, in your supplement are presented in the form that is most readily absorbed by the body. Here are some of the active forms to look for in your supplement:
· Folate: L-methylfolate, 5-methyltetrahydrofolate, and/or 5-MTHF
· Vitamin B6: pyridoxal-5-phosphate
· Vitamin B12: Methylcobalamin and/or adenosylcobalamin
· Vitamin A: Retinyl palmitate
· Vitamin D: vitamin D3 and/or cholecalciferol
3. Make sure the prenatal vitamin is comprehensive.
Many prenatal vitamins, especially the multivitamins that only require one pill daily, leave out a lot of vitamins and minerals, including iodine, vitamin B12, choline, magnesium, vitamin D, and vitamin K2. In general, you want your vitamin to include all of these in addition to iron, DHA, and at least 600 mcg of folate.
4. Avoid a supplement with both iron and calcium.
While it may seem great that your supplement has both of these minerals together, iron and calcium actually compete for absorption in our bodies. Therefore, when you take them at the same time, your body is unable to absorb all of the iron from the supplement. Since calcium needs do not increase during pregnancy, I recommend choosing a prenatal vitamin that contains iron and not calcium. However, if you do need to supplement with calcium as well, make sure that your calcium supplement is taken separately and at least two hours apart from your iron-containing prenatal supplement.
5. Look at the omega-3 fatty acid source.
Omega-3 fats, specifically DHA, are essential to obtain during pregnancy either through your diet alone or in conjunction with a supplement. DHA is important for your baby’s developing brain, eyes, and nervous system. If you are choosing a supplement that contains DHA, make sure the source of DHA is from small-fish oil or is algae based. It is important to avoid DHA supplements from fish liver oil or cod liver oil, since these can contain toxic vitamin A levels. Additionally, a lot of supplements contain flaxseed oil. While flaxseed oil does contain another omega-3 fatty acid called ALA, it is not converted to DHA in a sufficient amount, so it should not be your only source of omega-3s.
When Should I Take My Prenatal Vitamin?
I recommend that you take your prenatal vitamin with meals. This will help increase the absorption of the vitamins and minerals within your supplement and prevent nausea. However, you should avoid taking your prenatal vitamin with eggs, tea, milk, and cheese, since these foods and drinks will limit your body’s ability to absorb the iron from the supplement.
If you are trying to conceive or are thinking about having a baby soon, it is important to take your prenatal vitamin at least one month before trying to get pregnant.
Most prenatal vitamins that require multiple doses daily will likely recommend that you split the doses throughout the day. This is because your body can only absorb so much at once. However, if you are having trouble sleeping after starting your prenatal vitamin, try to take your prenatal supplements earlier in the day. For example, if your prenatal dose is three pills daily, then I would recommend taking two pills in the morning and one pill in the afternoon to improve your ability to sleep.
If you are trying to conceive or are thinking about having a baby soon, it is important to take your prenatal vitamin at least one month before trying to get pregnant. This is because the neural tube closes just six weeks after conception, which is before most women realize they are pregnant. Therefore, in order to prevent neural tube defects, it is crucial to start your prenatal supplement early.
Overall, remember that just like all other supplements, your prenatal vitamin is not meant to be a replacement for a nutrient-dense diet. Therefore, it is important that you continue to eat a healthy, balanced diet that is appropriate for pregnancy. It is additionally important to make sure that you talk to your OB-GYN or primary care provider before starting any medications or supplements.
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