How to Choose a Vitamin for Pregnant Women

Choosing a prenatal baby is one of the first decisions that expectant mothers make, and it’s not easy. The list of ingredients can be confusing, the tablets themselves are large and they come in incredibly varied forms. A search on Amazon brings up 507 results for “vitamins for pregnant women,” and there are also brands that are meant to be consumed directly. While there is a core nutrient profile that is the same for all prenatal periods, some contain more of certain ingredients, others contain ingredients in excess of what is required, and many have different nutrient chemistries. To make it easier to choose prenatal vitamins, here are a few factors that experts recommend considering.

Who should take prenatal vitamins?

Ideally, you should start taking prenatal vitamins before you get pregnant, – says Emily Oken, MD, a professor of nutrition at the Harvard School of Public Health them. T. Chan. “Most of the nutrients we need increase during pregnancy, so it is beneficial for all women to take prenatal vitamin and mineral supplements to add them to the nutrients we get in our diet,” says Marie Caudill, Ph.D., professor of nutritional science at Cornell University.

DHA, iodine, choline and biotin: not in all antenatal but worth considering

“Fish is an important source of docosahexaenoic acid (more commonly referred to as DHA),” says Emily Oaken, M.D., professor of nutrition at Harvard School of Public Health. T. Chan. She advises women to eat two servings a week of fish that are high in DHA and low in mercury, such as trout, salmon, or sardines. If the thought of fish turns your stomach away, “then there is absolutely no harm [adding prenatal drugs containing] DHA,” says Dr. Oken.

Fish also contains iodine, a deficiency of which is common in the United States, according to Dr. Oken, and can lead to thyroid dysfunction and cognitive and developmental delays in children. She recommends choosing iodized salt as well as taking a prenatal vitamin that contains 150 micrograms of iodine, an ingredient Dr. Oken says is found in only half of the prenatal vitamins.

Choline and biotin are also not present in every prenatal period, but Dr. Caudill recommends both. “Choline is known for its role in brain and eye development,” says Dr. Caudill, and biotin is also needed for fetal growth. They are “out of sight” of nutrients, she says, because there is a lot of new research about them and they are not yet on the prenatal vitamin recommendation lists. In addition, Dr. Oken advises women to discuss with their healthcare provider if they have special needs: “For example, a woman may need more iron based on a blood test that indicates anemia, or more vitamin D if a blood test shows that their not enough. … “

B12 and folic acid: in different forms in each prenatal period

Although vitamin B12 is present in every prenatal period, it is especially important for women on a vegetarian or vegan diet as it is naturally found in animal products. Dr. Oken explains that “low B12 levels have been linked to poor fetal growth, premature birth and certain birth defects.” Look for a prenatal drug that contains at least 2.6 mcg of B12. Dr. Caudill additionally recommends the methylated form of vitamin B12, which is the “bioactive” form most commonly used by the body.

Dr. Caudill says choosing a nutrient that is biologically active is always a good idea, except when it comes to folate. Folic acid is the only form of folate with strong evidence of its effectiveness in reducing neural tube defects such as spina bifida. “Other forms of [folic acid] can also reduce neural tube defects, but we have no evidence,” explains Dr. Caudill.

Some vitamin manufacturers are replacing folic acid with L-methylfolate, citing concerns about common variations in a gene involved in the folate pathway. Stuart Shapira, M.D., associate director of science and chief physician at the CDC’s National Center for Birth Defects and Malformations, says folic acid reduces neural tube defects even in women with these gene variations. “If women with or without [common MTHFR gene variants] consume the recommended 400 milligrams of folate every day, then everyone will have enough folate in their blood to protect their pregnant women from having a neural tube. defect, ”says Dr. Shapira.

Folic acid is especially important before and during pregnancy because the neural tube closes between the fourth and sixth weeks of pregnancy – even before many people know they are pregnant. “I think anyone planning a pregnancy should think about the prenatal period so that they have everything they need to support this pregnancy … and continue until the end of lactation,” says Dr. Caudill.

How much is too much?

When it comes to the amount of each nutrient, more is not always better. “It is not necessary for the vitamin to contain more than 100% of the recommended amount for a pregnant woman. “Providing too much of a given nutrient can create imbalances,” says Dr. Caudill. However, the recommendations differ slightly between expert organizations such as the FDA and the American College of Obstetricians and Gynecologists (ACOG). For example, the FDA recommends 800 micrograms of folate, double what ACOG recommends. But “there is no reason to take 1000 micrograms of folate prenatally,” says Dr. Caudill. According to the ACOG recommendation, this would be 250% of your daily value.

What to expect

Should these giant pills be expensive? “Vitamins for pregnant women shouldn’t be very expensive. There are generic generic brands that contain all the recommended nutrients, ”explains Dr. Oken. But Dr. Caudill says it might be worth boosting your prenatal vitamin budget with bioactive ingredients, including “extras” like choline, biotin, and iodine. “But a prenatal vitamin at a lower level will benefit you more than none at all,” she says. Over-the-counter antenatal care costs range from 4 cents a day to over a dollar a day.

If you are concerned about cost, a prescription for pregnant women may be cheaper than over-the-counter leave, depending on your health plan (they are free for those on Medicaid).

Prenatal vitamins sometimes come with a different price tag: they can cause symptoms such as nausea or constipation, “mostly due to iron,” says Dr. Oken. time of day or avoid the first meal in the morning when the nausea is likely to worsen. ” According to her, this is a good time to eat them before lunch.

Narrowing it down

“The most important thing is that a woman discusses with her doctor what her own health needs might be,” says Dr. Oken. Ask your doctor if they have any recommendations based on laboratory tests or your diet, and if price is a concern, ask for a prescription (if that makes them more readily available through your health plan). If you don’t eat a lot of fish, vitamins with DHA and iodine may help. According to the latest research, anyone can think of a choline and biotin supplement. If your budget allows, the more expensive bioactive forms of each nutrient may be better absorbed by your body, with the exception of folate, which has been shown in numerous studies to be safe and effective in preventing birth defects. And don’t let your research drag on – a prenatal vitamin is beneficial when taken long before pregnancy.