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Supplements During Pregnancy: What to Take and What to Avoid

May 11, 2020
Medically reviewed by Susan Kerrigan, MD and Marianne Madsen

Healthy nutrition is particularly important during pregnancy. The body is helping to develop a fetus and preparing for the breastfeeding process, the womb tissues and the placenta are developing, and the blood supply is increasing. Adequate weight gain benefits the woman and fetus’s health, reduces the risk of complications, and contributes to the newborn’s health. Recent research proves that a woman’s nutritional condition during pregnancy, the rate of her gaining weight, and her nutritional habits can have a marked impact on the fetus. 

 

Nutrient requirements increase during periods of growth and development such as pregnancy and lactation. In response, many clinicians recommend dietary supplements during these important periods of the life cycle. Although there exist some recommendations concerning the need for a limited number of nutrients in supplemental form (e.g., iron, folic acid, and iodine), there is very little data concerning the use of dietary supplements during pregnancy and lactation. Although most pregnant women are advised to take multivitamin and multimineral supplements, their use during pregnancy is not well documented. Some research suggests that prenatal vitamins decrease the risk of having a baby who is small for his or her gestational age.

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Folic Acid

 

During the fertile years, it is recommended for each woman to consume 400 mcg of folic acid as a supplement, starting at least one month prior to conceiving. Even during pregnancy, it is recommended to continue consuming folic acid for fetus development and adequate growth and also for preventing anemia. In addition to the folic acid, it is recommended to consume natural folic acid-rich foods (folate) such as legumes, citrus fruits, and leafy green vegetables. However, naturally occurring folate does not meet the body’s requirements leading up to and during pregnancy and that is why folic acid as a supplement is to be consumed. Consumption of folic acid is particularly important during the first three months prior to conceiving and during the first three months of the pregnancy, since it reduces the risk for Neural Tube Defect (NTD)–a defect in the neural tube, out of which the brain and the spine develop that may cause injury, permanent disability, and even the death of the fetus. The neural tube closes approximately three to four weeks following fertilization, and this is where the importance of consuming folic acid prior to conceiving and during the first three months stems from.

 

Iron

 

During pregnancy the woman requires larger amounts of iron than normal due to the rise in blood volume and to meet the growing fetus’s requirements. Iron deficiency may cause anemia in a pregnant woman and symptoms such as fatigue, weakness, headaches, difficulty breathing, and rapid heart rate. In addition to that, during pregnancy the fetus’s iron reserves are created to be used by the infant in its first months of life. It is recommended to consume iron supplements as of the end of the third month of pregnancy and up to six weeks following delivery (30 mg daily).

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Vitamin D Importance

Vitamin D Importance

Vitamin D

 

All throughout the pregnancy and the breastfeeding period it is recommended to take 200-400 IUs of vitamin D (an amount equivalent to 5-10 micrograms). Vitamin D is a fat-soluble vitamin produced in our body while being exposed to the ultraviolet rays of the sun. The vitamin is naturally occurring in a few foods. Natural sources of vitamin D include fatty fish such as salmon, mackerel, and sardines. Red meat and egg yolks contain little vitamin D while enriched foods such as some of the dairy products are good and are roughly the only source today for vitamin D. Vitamin D deficiency is well-known and has been documented in the general population and in women at relatively high rates in recent years. It is also known that vitamin D requirements increase with pregnancy. Vitamin D is also important for absorption of calcium. 

 

Caffeine

 

Caffeine crosses the placenta and affects the fetus. Caffeine is also passed on to the breastfed infant through the mother’s milk. Pregnant women are encouraged to avoid (or at least minimize) their consumption of caffeine. Most mothers know that coffee, tea, energy drinks, and some soft drinks contain caffeine, but it is also a hidden ingredient in many products. Dietary supplement ingredients that contain caffeine include guarana, yerba mate, kola or kola nut, cocoa, tea, coffee or coffee beans, and citrus aurantium or bitter orange. These ingredients and the products containing them should be avoided during pregnancy.

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Prenatal Vitamins

 

When choosing a supplement, the first thing consumers need to know is what constitutes a dietary supplement. A dietary supplement is a product that is intended to supplement the diet, contains one or more dietary ingredients (including vitamins, minerals, herbs or other botanicals, amino acids, and other substances) or their constituents. It is intended to be taken by mouth as a pill, capsule, tablet, or liquid and is labeled on the front panel as being a dietary supplement. Prenatal vitamins typically contain more folic acid and iron than do standard adult multivitamins. 

 

Prenatal vitamins are available over-the-counter in nearly any pharmacy. Your healthcare provider might recommend a specific brand of prenatal vitamins or leave the choice up to you. Generally, pregnant women should look for a prenatal vitamin that contains folic acid, calcium, iron, and vitamin D. It also might be beneficial to look for a prenatal vitamin that contains vitamin C, vitamin A, vitamin E, zinc, iodine, and copper.

 

It is important to remember that prenatal vitamins are a complement to a healthy diet and not a substitute for good nutrition. Prenatal vitamins won’t necessarily meet 100% of your vitamin and mineral needs.

 

Herbal Products

 

Pregnant women should be extremely cautious about taking herbal products or any other supplements (except their prenatal vitamins). These products are often unregulated. That means the concentration or dosage of ingredients in different products and what contaminants are in the product are unknown. Additionally, known and unknown effects of herbal products can be dangerous to the pregnant woman and to her developing fetus. Studies of safety are not conducted on pregnant and lactating women. Therefore, without specific directions from their healthcare provider, expectant mothers are advised to avoid the use of herbal products during pregnancy and lactation. 

 

The safest course for pregnant women is to avoid supplements other than prenatal vitamins during pregnancy and lactation. Getting the nutrients needed with a balanced diet is the best way to meet both their own and their developing fetus’s nutritional needs.

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