How To Choose A Prenatal Supplement

Most Bioavailable Form of Important Nutrients During Pregnancy

Folic acid: 5-Methyltetrahydrofolate or folinic acid or folate (from real food)

Vitamin B₆: Pyridoxal 5’-Phosphate

Vitamin B₁₂: Methylcobalamin

Iron: Ferrous fumarate, iron citrate, iron picolinate

Calcium: the form of calcium matters since the amount of calcium your intestines absorb during pregnancy doubles! Read more about pregnancy, calcium, and bone health. 

Folate Is The Natural Form: Take It Early

Perhaps the most important reason to take a prenatal is folate (the natural form); folic acid is the synthetic form, which you want to avoid. All women of child-bearing age, even if not planning or trying to conceive, are strongly encouraged to take 400 mcg of a bioavailable form of folic acid every day. Bioavailable forms of folic acid include: folate (from real food), 5-Methyltetrahydrofolate and folinic acid form. 

Studies show getting enough folate and B₁₂ before sperm meets egg, and in the early stages of pregnancy, can dramatically reduce the risk of neural tube defects (like spina bifida). Once pregnant, folic acid needs increase to 800 mcg per day. There's also a link between taking folic acid in the first month of pregnancy and a decrease in infant's autism risk.

Iron Tidbits

Iron needs jump to 30 mg per day when pregnant. This mineral is the building block for baby's cells.

There are so many different forms of iron—it can be quite confusing. Ferrous iron is much better absorbed than Ferric iron, and there are different forms of ferrous iron…some are better than others.

Ferrous fumarate is a good form, and ferrous sulfate is the cheapest and constipates most people. 

Iron citrate and iron picolinate are a bit more expensive but more easily absorbed and typically not constipating. 

Calcium binds with iron to prevent it from being absorbed, so avoid eating calcium-containing products at the same time as iron supplements — wait at least two hours after eating calcium-containing products before taking your iron supplement. On the other hand, to increase and improve iron absorption, take it with vitamin C. Also, the amount of iron absorbed decreases with increasing doses. For this reason, ideally take your iron supplement in two or three equally spaced doses, if possible.   

Choline for Brain Development 

An “extra” to consider in a prenatal supplement is choline, which plays an important role in reducing neural tube defects (1, 2) and is important in later stages of pregnancy when the memory center of baby’s brain is developing (3). The adequate intake level established for pregnant women is 450 mg choline/day. Choline is found in foods such as egg yolks, beef, broccoli, cauliflower, spinach, wheat bran, wheat germ, nuts and beans.

Iodine for Thyroid Health

Iodine aids your baby-to-be's thyroid and brain development, and studies show many American women aren't getting enough. The recommendation is 150 mcg per day. Not all prenatals contain iodine, or this quantity of it, so examine the prenatal supplement label for iodine before purchasing. You can also use iodized salt as a source of iodine.

Examine The "Other Ingredients" Section

Examine the “other ingredients” list on the prenatal vitamin. Find one manufactured without any additives, binders, fillers, artificial colors, or artificial sweeteners commonly found in mainstream prenatal supplements. Avoid magnesium stearate, and if you're sensitive to allergens, examine whether the product contains milk, soy, eggs, fish, nuts or wheat. 

Definitely avoid artificial colors because they contain aluminum!! An artificial color will say something like this: Blue 2 Lake, and "Lake" indicates Aluminum! You definitely don't want to succumb your baby to that neurotoxin! Look for a supplement form in either a liquid or vegetarian capsule. Avoid tablets because they do not dissolve well in your stomach.

Timing Tips When Taking A Prenatal Vitamin

Trust me on this one because it happened to me…take your prenatal 6+ hours before going to sleep or it may keep you awake due to the powerful B-vitamins. Also, if one serving of your prenatal vitamin requires you to take more than one capsule, take them at different times throughout the day to achieve the maximum absorption. For example, one serving of my prenatal supplement is 6 capsules, so I may take 3 capsules at breakfast and 3 at lunch or 2 at breakfast, 2 at my mid-morning snack, and 2 at lunch. 

Take your prenatal vitamin throughout your pregnancy, and even during breastfeeding. Take your prenatal vitamin with food (avoid dairy to ensure the iron is absorbed), and include some fat in that food so the fat-soluble vitamins (A, D, E, K) can be absorbed and transported throughout the body. 

Other Crucial Nutrients In A Prenatal Vitamin

Vitamin D, DHA, probiotics and decreasing exposure to toxins are so important during pregnancy that I wrote about them in separate blogs. Here's more information: vitamin D during pregnancy, probiotics during pregnancy, healthy fats during pregnancy, and 10 ways to decrease toxic exposure during pregnancy. 

Don't Overload On Supplements 

A nutrient-rich diet combined with a high quality prenatal supplement ensures the best start for your little one, but more isn't better when it comes to taking vitamins. If you’re interested in taking additional supplements or herbs, check with your doctor first, especially since some vitamin megadoses and herbs can be harmful when you're pregnant.

In Health and Happiness,

Kelly Harrington, MS, RDN

Registered Dietitian Nutritionist for Healthy Goods

 

References:

1.  Shaw GM, Carmichael SL, Laurent C, Rasmussen SA.  Maternal nutrient intakes and risk of orofacial clefts. Epidemiology. 2006;17:285–91.

2.  Shaw GM, Carmichael SL, Yang W, Selvin S, Schaffer DM.  Periconceptional dietary intake of choline and betaine and neural tube defects in offspring. Am J Epidemiol. 2004;160:102–9.

3.  Wu BT, Dyer RA, King DJ, Richardson KJ, Innis SM.  Early second trimester maternal plasma choline and betaine are related to measures of early cognitive development in term infants.  PLoS One. 2012;7(8):e43448. doi: 10.1371/journal.pone.0043448.