Gaby Vaca-Flores, RDN, CLE, shares recommended vitamins to take while pregnant. Plus: additional supplements for a healthy pregnancy, other prenatal nutritional needs, and vitamins to avoid during pregnancy.
Is it safe to take vitamins during pregnancy? How about while breastfeeding?
These are two of the most common questions that dietitians get from expectant and new mothers. It’s no secret that proper nourishment can better optimize your pre and postnatal care. But exactly which vitamins and supplements should you take during pregnancy?
In this article, we’re bringing things back to science-backed basics. When it comes to supplements and pregnancy, here’s the information you need to have a safe and healthy term.*
*This information should not be used in lieu of professional medical advice. Always follow guidance from your OB-GYN and/or primary care physician.
The Importance of Prenatal Nutrition
Meeting your daily nutrient needs during pregnancy is necessary to keep up with your rapidly changing maternal metabolism.
Of course, maternal nutrition is essential for healthy fetal growth and development. In fact, there’s growing research that suggests the effects of prenatal nutrition can trickle into adulthood.
For that reason, it’s important to learn about necessary vitamins for pregnant women, as well as additional supplement and macronutrient needs.
4 Vitamins to Take While Pregnant
The most notable nutritional change that women should make during pregnancy is the addition of certain micronutrients to their daily routine. Simply put, micronutrients are small food nutrients such as vitamins and minerals.
Here’s a look at the best vitamins for pregnant women.
1. FOLIC ACID
If you’ve done preliminary research on any pregnancy musts, then you’ve likely come across folic acid. Since folic acid is a critical vitamin for pregnant women, we won’t gloss over it too quickly.
Why it’s important: Folic acid is a B vitamin essential for the development of the fetus’s neural tube, an early structure of the brain and spinal cord. For reference, the neural tube typically begins forming within three to four weeks of conception. Hence, folic acid can play a significant role to support healthy brain and spinal development.
Sources + dosage: Many women already get folic acid from food sources, such as:
- fortified grains
- leafy greens
However, experts at the American College of Obstetricians and Gynecologists (ACOG) recommend that pregnant women take 600 micrograms of folic acid each day via a prenatal vitamin. That said, many prenatal vitamins are likely to have upwards of 800 micrograms per serving to cover any potential nutrient gaps.
Experts advise that women begin supplementing with folic acid as soon they learn they’re pregnant. However, some doctors recommend that their patients start supplementing two to three months before conceiving. (In any case, remember to always consult your doctor.)
2. VITAMIN D
Vitamin D status is important for everyone. However, because the fetus relies on maternal vitamin D intake, getting enough of this vitamin during pregnancy is critical. In fact, anywhere from 40 to 98 percent of pregnant women around the world are vitamin D deficient.
Why it’s important: Vitamin D plays a key role in fetal bone and teeth development. A 2014 systematic review reveals that maternal vitamin D status is “modestly” associated with:
- infant birth weight
- bone mass
- calcium levels
Perhaps surprisingly, it’s also critical for eye and skin health.
During the early stages of pregnancy, we see higher levels of vitamin D in the body. These levels continue to increase two-to-threefold until delivery. Eventually, vitamin D levels can reach amounts that may normally be toxic in a non-pregnant woman. So naturally, So naturally, ensuring that you have healthy vitamin D levels should be a priority.
Sources + dosage: There are a number of ways to get your vitamin D intake, including through:
- fortified foods
- vitamin D supplements
Additionally, if you’re taking a prenatal vitamin, ensure that it includes adequate amounts of vitamin D. The ACOG recommends that pregnant women (and all women for that matter) get 600 IUs of vitamin D daily.
If your doctor detects that you have low vitamin D levels, they may recommend additional supplementation.
Fun fact: The American Medical Association calls choline the “brain-building” nutrient.
Why it’s important: This recently discovered nutrient is praised for its potential to improve improve fetal brain development. More specifically, choline is a main player in several critical processes that occur during pregnancy.
To name a few, choline helps with cell and tissue growth, as well as gene expression. Further, studies show that adding choline to the maternal diet can help protect against certain neural and metabolic abnormalities.
Sources + dosage: A pregnant woman’s body requires more choline than it can make. For this reason, food sources are usually the best way to get enough choline.
Dietary sources of choline include:
- soy products
Despite the benefits of choline, a 2019 study reports that most pregnant women in the US don’t get adequate amounts of it per day. This is an alarming statistic, especially since the demand for choline increases throughout pregnancy.
Experts suggest that pregnant women intake 450 milligrams of choline daily. In addition to the food sources above, some prenatal vitamins provide small doses of choline.
4. Prenatal Vitamins
Last but not least, you may decide to take a prenatal vitamin.
Here’s a list of nutrient recommendations to look for, according to the ACOG:
- choline: 450 mg
- iodine: 220 mcg
- iron: 27 mg
- vitamin A: 770 mcg
- vitamin B6: 1.9 mg
- vitamin B12: 2.6 mcg
- vitamin C: 85 mg
- vitamin D3: 600 IU
If you decide to breastfeed, your OB-GYN or doctor may recommend that you continue taking your prenatal vitamin.
Supplements to Take During Pregnancy
In addition to the vitamins and nutrients discussed above, here are two of the best supplements to take while pregnant.
OMEGA-3 FATTY ACIDS
Doctors will often encourage their pregnant patients to take a fish oil supplement. Here’s why.
Why they’re important: Omega-3 fatty acid stores tend to deplete quickly throughout pregnancy. Fortunately, omega-3 fatty acids provide DHA, one of its most biologically active acids.
DHA can help ease the risk for an early preterm birth by over 40 percent. Additionally, low DHA levels can influence changes in brain function. Consequently, this can lead to genetic variations, decreased learning abilities, and impaired vision.
The benefits of taking omega-3 fatty acid extend to postnatal nutrition, too. Researchers suggest that rapid depletion of fatty acids during pregnancy and breastfeeding can contribute to the baby blues. In turn, taking this healthy omega can have a positive influence on maternal well-being.
Sources + dosage: Food sources of omega-3 fatty acids include:
- cold-water fish
- plant oils
The ACOG recommends that pregnant and breastfeeding women eat at least two servings of fish or shellfish per week. However, pay special attention to avoid raw or undercooked fish. Additionally, you should also avoid fish with high mercury levels while pregnant.
Most prenatal vitamins contain about 200 milligrams of DHA. However, the American Pregnancy Association recommends looking for a prenatal vitamin with a minimum of 300 milligrams of DHA. For reference, HUM’s OMG! Omega the Great packs a healthy 400 milligrams of DHA.
That said, talk to your doctor about incorporating a high-quality fish oil supplement into your prenatal plan if you suspect you’re getting enough DHA.
Probiotics are gut-friendly bacteria that help balance the microbiome.
The gut microbiota—or the collection of bacteria and other microorganisms in the gut—influences many areas of health. In fact, it’s commonly referred to as the forgotten organ. The gut microbiome can play a role in processes ranging from immunology to digestive health, as well as pregnancy.
Why they’re important: An infant’s gut microbiota forms throughout the entire pregnancy and is believed to continue colonizing until the first year of life.
For this reason, there’s an increased interest in the efficacy of prenatal probiotic supplementation. Research suggests that taking probiotics is generally safe for pregnant and nursing mothers.
Additionally, in 2015, the World Allergy Organization recommended prenatal probiotic supplementation for both:
- pregnant women at risk of having an infant with allergies
- women who nurse an infant who’s at risk for allergies
Sources + dosage: There are a number of fermented and probiotic foods you can add to your diet. Additionally, HUM’s Gut Instinct probiotic includes strains like Bifidobacterium Breve and Bifidobacterium Longum to diversify the gut microbiome.
Further, the American Pregnancy Association doesn’t provide a specific probiotic dose.
However, remember that pre and postnatal probiotic supplementation is an ongoing research topic. For that reason, be sure to consult your doctor before adding probiotics to your pregnant or nursing regimen.
Additional Prenatal + Postnatal Nutrition Needs
As we’ve gathered so far, a woman’s nutrition needs increase during pregnancy—but in terms of diet, it’s not as much as you might think.
On average, most pregnant women will need to consume an extra 340 extra calories per day. (Healthy snack ideas to meet this daily quota include a bowl of yogurt with granola or a PB&J sandwich.)
Additionally, the CDC recommends that breastfeeding mothers consume an additional 450 to 500 calories daily. However, this number can vary depending on your:
- body mass
- activity level
- breastfeeding frequency
During pregnancy, there’s also an uptick in certain macronutrient needs. Macronutrients are large food nutrients such as protein, carbs, and fats.
The American Pregnancy Association recommends increasing protein intake to 75 to 100 grams per day while pregnant. In addition, they should strive to consume complex carbohydrates and unsaturated fats whenever possible.
Supplements to Avoid While Pregnant or Breastfeeding
While the vitamins and supplements above are generally considered safe for pregnant and nursing mothers, others should be avoided.
Certain vitamins, plants, and herbs can potentially be harmful while pregnant or breastfeeding. That’s why you must always let your doctor know about any supplements you take.
Vitamins A + E
During pregnancy, getting too little of certain nutrients can have negative effects. Similarly, getting too much of others can equally be dangerous.
The two main vitamins to avoid during pregnancy are vitamins A and E.
In healthy doses, vitamin A plays an integral role in the development of fetal organs and skeleton. However, too much vitamin A can be toxic for pregnant women. That’s because vitamin A is fat-soluble, meaning whatever isn’t absorbed will consequently be stored in the liver. Some experts suggest that excess vitamin A can also lead to birth abnormalities.
For these reasons, most pregnant women should not supplement with vitamin A outside of their prenatal and daily foods.
Similarly, excess fat-soluble vitamin E is also stored in the liver. In healthy amounts, this vitamin helps protect cells from free radicals. However, large amounts of vitamin E can increase the risk for a low birth weight.
PLANTS + HERBS
Sometimes, plants and herbs are falsely believed to be harmless during pregnancy because they’re natural. But unfortunately, there are several unsafe botanicals to steer clear of.
According to the American Pregnancy Association, avoid these plants and herbs while pregnant or breastfeeding:
- saw palmetto
- dong quai
- pau d’arco
- passion flower
- black cohosh
- blue cohosh
- roman chamomile
The BOTTOM LINE
To circle back to the original questions, it’s generally safe and recommended to take certain supplements and vitamins while pregnant or breastfeeding.**
Expecting mothers have unique nutrient needs that are necessary to optimize prenatal care. For most pregnant women, taking a well-rounded prenatal supplement is a great place to start.
**As a reminder, the information in this article is for educational purposes only. Pregnant and nursing women should always consult their OB-GYN and/or primary care physician before adding any vitamins or supplements to their routines.