August 10, 2016
The British Medical Journal (BMJ) recently published an article summarizing current guidance on prenatal multivitamin supplementation, and reviewing the evidence behind it. We know your mind's in overdrive, asking: Should I be taking multivitamins? Which ones are most important? Which ones should I avoid? These are definitely questions you'll want to bring up at your next appointment with your GP or OBGYN, and discuss what is best for your unique needs based on health profile and family history. But to gain a better understanding of what's in (or what shouldn't be in) a prenatal multivitamin, the BMJ's recent article is a fantastic source of information. Since their investigation isn't accessible to everyone, we've provided you with a breakdown of everything you need to know.
If you are trying to conceive, are currently pregnant, or are a new mother, then there are two vitamins you absolutely need to know about: folate and Vitamin D. During this unique time in your life, these two vitamins are critically important for the health of you and your growing baby - and it's not always easy to get the recommended amount through your daily diet. That's why they're especially important when talking about your prenatal multivitamin. For all of our U.K. mums, it's important to know that you may be able to get these for free on the Healthy Start scheme! But of course - a healthy diet is all about variety, and the same goes for vitamins and minerals - it's all about making sure you get the right amount of all of your essential nutrients. So let's take a closer at what you need to know; we'll go over the basics of the two top nutrients you'll want in your prenatal vitamin, and then we'll give you some 'food fixes' so you'll know how to get them naturally in your diet as well.
What You Need to Know About Your Prenatal Multivitamin
Folate - Folate is the name for the natural form of this nutrient, but you'll see it listed as folic acid in any supplemental forms. The recommended daily amounts for prenatal folic acid is around 400 micrograms, and you're actually recommended to start getting this amount from the moment you start trying to conceive. If you weren't taking folic acid prior to your pregnancy - do not worry - just start getting it in your daily vitamin
intake as soon as you are pregnant. Now it's recommended to get 400-mcg per day up until you are 12 weeks in. Why? Folic acid is hugely important in promoting healthy neural development for your baby (and preventing spina bifida) - and since this stage of development occurs primarily in your first trimester, this is the time when you want to make sure you're getting enough of it.
- Food fixes: Peas, beans, orange juice, spinach, and wholegrain cereals and breads
Do note that higher risk populations for folate deficiency include those with a family history of neural tube defects (NTDs).
Vitamin D - Vitamin D is a bit tricky when it comes to understanding how much to get on a daily basis. It's often listed in IU's, which stand for international units, and to be honest it's an arbitrary number as it's based on the biological activity of each substance. During pregnancy and when breastfeeding, the recommended daily amount is 600 IU's to keep your (and your baby’s) bones healthy and strong. The RDA
is also listed by weight as 15-mcg per day, so you can check for either number on your prenatal multivitamin. Did you know that Vitamin D also promotes a healthy gut and immune system by boosting calcium absorption? For more fun facts and information about vitamin D and deficiency, check out our blog post: Vitamin D deficiency? Hello, sunshine.
- Food fixes: Salmon, tuna, fortified milk and cereals, whole eggs, and sunlight! (not a food fix but it's the best way to get Vitamin D naturally!)
Do note that pre-eclampsia is associated with low levels of Vitamin D, and if this is something you're managing your GP will likely recommend an increase in supplementation of this vitamin. High-risk populations for a Vitamin D deficiency also include those carrying multiples, and those with a history of high blood pressure or diabetes.
Many pregnant women and new moms worry that they aren’t taking enough supplemental vitamins, but as long as you have these two ticked off your list, in all likelihood, you’re doing just fine. In most cases, these are the only vitamins that need to be supplemented for during pregnancy - as the other essential nutrients can be obtained through a healthy, balanced diet. However - first and foremost - make sure to discuss your unique nutritional needs with your healthcare professional to be certain you're getting everything you and your baby need.
To ease your mind, we've got some extra information on some key nutrients for pregnancy and supplementing considerations, as outlined by the BMJ's most recent report.
Iron - You may have heard that iron deficiency, or anemia, in pregnancy can lead to complications for both the mother and the fetus, and it's definitely a condition that needs close monitoring. However, the effects of iron deficiency on other conditions such as premature birth remain unclear. It's best to avoid iron supplements unless you've been screened for anemia and prescribed them by your doctor, as they can lead to diarrhea,constipation, or gastric irritation - things you don't need more of in pregnancy! Additionally, getting too much of a single nutrient can inhibit absorption of other vitamins and minerals.
- Food fixes: Lean beef and poultry, fish, beans and lentils, and dark leafy greens
Vitamins C and E - Clinical trials have shown that taking these supplements doesn’t affect the risk of stillbirth, premature birth, pre-eclampsia, and other complications, making them generally safe in a multivitamin. However, in most cases there is no need to supplement either of these nutrients, as they are easily obtained in healthy amounts from a balanced diet.
- Food fixes for Vitamin C: Citrus fruits, strawberries,
bell peppers, broccoli, and tomatoes
- Food fixes for Vitamin E: Sunflower seeds, nuts, almonds, spinach, and healthy plant oils
Vitamin A - This nutrient tends to get a lot of bad attention as animal sources (retinols) have been shown to be teratogenic, meaning they can disrupt fetal development, leading to birth defects or even miscarriage. However, Vitamin A is incredibly important for healthy development of your baby's major organs as well as establishment of healthy vision. Plus, Vitamin A will be very important for you leading up to birth as it's crucial for postpartum tissue repair. So what's the solution? It's simple - look for plant sources of Vitamin A (carotenoids), which are easily obtained through your diet. Do make sure that any supplements or multivitamins that you take do not contain any retinol versions of Vitamin A.
- Food fixes: Sweet potatoes, carrots, spinach, kale and cantaloupe
If you’ve found results from clinical trials that prove other multivitamins to be beneficial, keep in mind that some of the results may not be applicable to you, as the trials could have been taken in foreign countries, under different circumstances and various environmental pressures. When it comes to multivitamins, make sure to read labels carefully, consult with your doctor, and be empowered by what you've learned to make informed decisions.