05 Apr Supplements for Pregnancy
Paige Mandel, MS RD CDN
If you are pregnant or trying to conceive (TTC), one of the first (of many) questions you may ask your doctor and/or dietitian is “what supplements should I take?”. Meeting nutritional requirements is at the utmost importance during this time, as deficiencies can affect both maternal and fetal health. At Laura Cipullo Whole Nutrition, our dietitians are here to help you learn, understand and meet your perinatal nutritional needs through food, as well as recommend supplements when and where necessary to fill any nutritional gaps that food alone won’t fulfill.
While we will always recommend to consult with your medical doctor first, our most standard supplementation recommendation is a prenatal vitamin and DHA. Some prenatal vitamins will contain DHA, if not, additional supplementation is most recommended. It is important to review your bloodwork with your medical team and discuss any dietary restrictions you adhere to, in order to screen for additional specific nutritional deficiencies that may require further supplementation.
What should I look for in a prenatal vitamin?
The American College of Obstetricians and Gynecologists outlines the key nutrients of focus for pregnancy to be “folic acid, iron, calcium, vitamin D, choline, omega-3 fatty acids, B vitamins, and vitamin C”.1
*These values are general recommendations, it is most important to consult your OBGYN and medical team to review your blood work to assess your individual needs. Higher or lower doses of certain nutrients might be suggested by your health care provider for supplementation depending on circumstances and medical history*
Folic acid: at least 400 micrograms (pregnant mamas actually need 600 micrograms each day- you will get some but not enough from diet, so your prenatal vitamin should have at least 400 mcg and up to 800)
Folic acid is B vitamin that has been studied to help prevent birth defects of the fetus’s brain and spine called neural tube defects (NTDs), and supports the general growth and development of the fetus and placenta. “When you are pregnant you need 600 micrograms of folic acid each day. Because it’s hard to get this much folic acid from food alone, you should take a daily prenatal vitamin with at least 400 micrograms starting at least 1 month before pregnancy and during the first 12 weeks of pregnancy”.1
Iron: 27 milligrams1
Iron helps red blood cells deliver oxygen to the fetus. This is the general recommendation for iron needs, consult with your OBGYN to review your labs, as needs may be higher in individuals with iron deficiency anemia, suggesting further supplementation. If you are experiencing any symptoms of vertigo, this could be indicative of your iron levels being too low, have your doctor check your levels.2
Calcium: 1,300 milligrams for ages 14 to 18; 1,000 milligrams for ages 19 to 501
Calcium is helps support the growth of your fetus’s bones and teeth. It is not essential for your prenatal to contain 100% of your calcium needs, as it is one of the easier minerals to meet needs through the diet. Milk and dairy products such as cheese and yogurt at optimal sources. If you have intolerance to dairy or adhere to a dairy-free diet, consult with your dietitian to discuss other sources of calcium to determine need for supplementation.
Vitamin D: 600 IU
Vitamin D helps promote healthy eyesight and skin as well as supports (with the help of calcium) the building of your fetus’s bones and teeth. Generally, all women require at least 600 IU/day of vitamin D. Vitamin D levels are often low in many individuals, therefore further supplementation may be indicated above this value.
Choline: 450 milligrams
Choline contributes to your fetus’s brain development, yet is not often found in many prenatal vitamin brands. Brands that do contain choline: Honest, Ritual. Choline needs are more easily met through the diet (chicken, beef, eggs, milk, soy products, and peanuts)1.
What about DHA?
Docosahexaenoic acid (DHA), is an omega-3 fatty acid essential for the growth and functional development of the brain in infants3. “Several studies confirmed the benefit of omega-3 supplementation during pregnancy in terms of proper development of the brain and retina”4, as DHA is a “major structural fat in the human brain and eyes, representing about 97% of all omega-3 fats in the brain and 93% of all omega-3 fats in the retina”5.
To optimize pregnancy outcomes and fetal health, consensus guidelines have recommended that pregnant women consume at least 200 mg of DHA per day6.
If your prenatal vitamin does not contain DHA, it is recommended to additionally incorporate a prenatal DHA supplement, also referred to as fish oil, with a dosage of at least 200 mg.
LCWNS clients have successfully used and reviewed Honest Prenatal DHA and Nordic Naturals Prenatal DHA as brands they continue to use and tolerate in their pregnancies. Note, this is not sponsored, and we always recommend consulting with your medical doctor and team before beginning any supplementation to ensure it is best for your individual needs.
When should I start taking them?
Ideally, you begin taking a prenatal vitamin at least one month before conception. If you are a woman of reproductive age, it is generally safe to begin finding a prenatal vitamin long before trying to conceive to find one you best tolerate and adjust to taking a vitamin consistently, daily. Due to the fact that the baby’s neural tube, which becomes the brain and spinal cord, develops during the first month of pregnancy, it is essential to begin any necessary supplementation with folic acid and the other key nutrients discussed if not before, as soon as you are aware you are pregnant7. It is important to take only the recommended dose of a prenatal vitamin and avoid taking excess of your daily needs. Higher doses not medically indicated could be harmful to your baby.
- Nutrition During Pregnancy. Accessed April 1, 2022. https://www.acog.org/en/womens-health/faqs/nutrition-during-pregnancy
- Articles. Cedars-Sinai. Accessed April 8, 2022. https://www.cedars-sinai.org/health-library/articles.html
- Horrocks LA, Yeo YK. Health benefits of docosahexaenoic acid (DHA). Pharmacol Res. 1999;40(3):211-225. doi:10.1006/phrs.1999.0495
- Swanson D, Block R, Mousa SA. Omega-3 Fatty Acids EPA and DHA: Health Benefits Throughout Life1. Adv Nutr. 2012;3(1):1-7. doi:10.3945/an.111.000893
- Greenberg JA, Bell SJ, Ausdal WV. Omega-3 Fatty Acid Supplementation During Pregnancy. Rev Obstet Gynecol. 2008;1(4):162-169.
- Coletta JM, Bell SJ, Roman AS. Omega-3 Fatty Acids and Pregnancy. Rev Obstet Gynecol. 2010;3(4):163-171.
- Prenatal vitamins: Why they matter, how to choose. Mayo Clinic. Accessed April 1, 2022. https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/prenatal-vitamins/art-20046945