Supplements in Pregnancy and What to Look Out For

Health & Wellness on 05.17.11
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I am a big advocate for eating whole foods to get your daily vitamins, and I agree with Rachel that eating organic should be a priority when pregnant but, of course, there are times when supplementing is appropriate. Pregnancy is one of those times.

If you are like me, the first trimester and beyond is full of morning sickness including nausea and vomiting, pure exhaustion, general crankiness, and a lot of stress. This makes getting all the nutrients your pregnant body and growing baby needs very difficult. This is where a few good supplements make their appearance. Of course, if you are feeling sick, taking a handful of huge and smelly vitamins (aka horse pills) may seem next to impossible. But your baby will benefit from the much needed nutrients.

What Supplements to Take During Pregnancy


The first one to consider is a good prenatal. In general, I tend to be a fan of food-based vitamins. These are vitamins that are made from whole foods versus synthetic chemical isolates. They tend to be absorbed better and can be easier on the stomach.

There are so many prenatals available in stores today; it can be a challenge to find the right one. Some are even linked to a good cause like funding donations of vitamins to women in developing countries. Here are a few of my things to look out for:

Excessive Vitamin A: Make sure the prenatal does NOT contain too much Vitamin A. Too much can lead to birth defects or some cancers.  Pregnant women should not exceed 3,000mcg per day from food and vitamins combined.  Most of your Vitamin A can be consumed through your diet with animal products and dairy foods. Some prenatals can have up to 4,000mcg so do not double up on those.

Avoid Certain Herbs: Watch out for some herbs. Certain prenatals contain herbs that are not proven safe for pregnancy and cross the placenta. Here is a list of herbs to avoid during pregnancy.

Food Dyes and Parabens: Some prenatals contain food dyes or parabens. I would be wary of taking these unnatural food additives during pregnancy.

Sufficient Folic Acid: Pregnant or nursing moms need 600mcg of folic acid to help decrease risk of neural tube defects and cleft lip. It also decreases risk of anemia in mom, low birth weight, miscarriage, and preterm delivery. Most prenatals have the correct amounts, but it is definitely on the "must check" list. 

Vitamin D

Although I am an advocate for getting your nutrients from food, Vitamin D might be the one exception because food sources of D are sparse and absorption from sun exposure is limited in the winter.  In fact if you live north of Atlanta, GA you do not make Vitamin D from sun exposure for 6 months out of the year.  Food sources include fortified beverages like milk, soy milk, and orange juice, or fatty fish like salmon or sardines. Vitamin D deficiency can lead to preeclampsia or fetal bone abnormalities.  Currently the Institute of Medicine recommends pregnant women take 600 IU/day, however many experts feel this is not enough and recommend closer to 2000-4000 IU/day.

Fish Oil

Again, I recommend getting your fish oil from actually eating fish. While pregnant or breastfeeding, there are some fishy rules to follow. Some fish are not as safe to eat regularly due to large quantities of mercury-swordfish, king mackerel, tilefish, and shark.  High mercury levels can damage the fetal brain and nervous system.  Stick to consuming 12 ounces max of safe fish per week. (The Monterey Bay Aquarium's Super Green Seafood List includes recommendations for fish that are both environmentally sustainable and low in contaminants.)

If, for whatever reason, you are finding it difficult to eat safe fish on a regular basis, supplementing with fish oil is a must.  Fish oil is loaded with healthy Omega-3 fatty acids which can help develop baby's brain, retinas, and nervous system in the womb and can speed development, help eyesight, and lower risks of certain cancers after birth. Omegas can also help us mamas by reducing risks of preterm labor and helping ward off postpartum depression.

Look for fish oil with both DHA and EPA. Make sure the supplement is actually derived from fish, not algae.  I usually keep mine in the fridge to keep them fresh and this also limits their somewhat fishy smell.

Ultimately, supplements should not replace healthy foods during pregnancy, but they can be an aid to ensuring you are getting the right nutrients.

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