Supplements During Pregnancy

For many women, being pregnant and considering supplements can be overwhelming and confusing. Most of the women I see who are pregnant, trying to conceive or breast-feeding come with similar concerns: Do I need to take supplements? Which supplements should I take?

In this two-part article, we will address both what to take and what to avoid before, during and after pregnancy.

Do I need to take supplements?
Yes. Nutrient needs are increased during pregnancy and breast-feeding and it is very difficult to meet these needs through diet only. Nearly all women can benefit from nutritional and multivitamin supplementation one year before and during pregnancy, labour, delivery and breast-feeding. The risk of birth defects increases with poor nutritional status as well as with poor dietary habits typical of the Western diet, which tends to be high in white flour, sugars and refined foods.

Which supplements should I take?
Supplementing in pregnancy is actually quite simple and easy. You just have to stick to a few essential products and avoid the rest unless you are under a doctor’s guidance. It is not necessary to take anything above and beyond the few items I have described below unless specific conditions arise that are common in pregnancy, such as heartburn, constipation or urinary tract infections. When these situations arise, see your MD or ND.

Dr. Turner’s Basic Prenatal Vitamin Plan after the jump.

1. A good prenatal vitamin — Look for a prenatal vitamin that has at least 1 mg of folic acid, good levels of B vitamins and minerals in the most absorbable citrate form (as compared to carbonate). Ensure your prenatal contains iron to avoid anemia. An optimal amount of iron citrate per day is 30 to 45 mg. Iron citrate is non-constipating and easier on the stomach. Look for a multivitamin that is free of additives, binders, fillers and artificial colors (not a big pink pill) and that does not provide more than 10,000 IU of vitamin A per day. I think it is also useful to take a prenatal three times per day, one pill with each meal. The Thorne Basic Prenatal is one of my favorites.

2. Fish oils high in DHA — Healthy types of oils are necessary for the formation of every cell in the body. Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), the components of essential fatty acids, are natural anti-inflammatory agents. Omega-3 fats, especially DHA, are necessary for the complete development of the human brain during pregnancy and the first two years of life. Studies have shown that women who supplement their diets with fish oils have children with higher IQs. DHA is essential for a healthy nervous system and immune system. If deficiency occurs in pregnancy, it can cause a lifetime of unexplained emotional, learning and immune system disorders. The part of the brain affected by omega-3 fats is that concerned with learning ability, anxiety/depression and auditory and visual perception. Omega-3 fats also aid in balancing the immune system, which may assist in the prevention of allergies, colic and skin problems later in life. Omega-3 and omega-6 fats, like those in flax oil, also help to improve milk production and to reduce the risk of breast engorgement.

3. Calcium, magnesium and vitamin D3
— A combination of calcium and magnesium with vitamin D3 is recommended for bone health and the treatment and prevention of muscle cramps that typically occur in the legs during pregnancy. Excessive hair loss and dental problems that sometimes accompany pregnancy may also be avoided or lessened with calcium and magnesium supplements. Studies reveal that women who supplement with calcium during pregnancy have a reduced incidence of high blood pressure and preeclampsia.

During pregnancy, calcium helps the baby’s bones and teeth develop, helps make breast milk and helps to regulate blood pressure, heartbeat, water balance in the cells and muscle contractions. Studies also show that postpartum women getting sufficient calcium reclaim their pre-pregnancy weight more easily. Ensure you reach the optimal amount of 1,200 mg each day between your prenatal multivitamin and a separate calcium-magnesium supplement.

4. Vitamin D3 — The new guidelines for pregnancy are 2000IU per day. Sufficient vitamin D3 during pregnancy has been found to reduce the future risk of the child developing diabetes.

5. Folic acid and Vitamin B12 — 5 mg per day is the new guideline for folic acid and recent research has discovered vitamin B12 to be just as important for the baby’s development as folic acid. Consume 1000 mcg per day, in lozenge or drop form.

Dr. T’s Advanced Prenatal Plan

You can add the following supplements to my basic plan. It is a bit more costly, but worth it. Your baby’s brain and eyes will thank you for it!

Phosphatidylcholine — According to Patrick Holford, author of ‘Optimum Nutrition for the Mind,’ phosphatidylcholine (a naturally occurring phospholipids nutrient that gives cell membranes structure and continuity) is an important nutrient to take during pregnancy to promote healthy brain formation in the fetus.

Chlorophyll — The substance responsible for the green color in plants, chlorophyll has been used traditionally to ameliorate bad breath. Chlorophyll has anti-inflammatory, antioxidant and wound-healing properties. Chlorophyll can also be used for gastrointestinal problems, such as constipation, and to stimulate blood cell formation in anemia. Chlorophyll is a rich source of vitamin K and iron. It is a good blood-building formula and energy tonic for pregnancy.

Mixed vitamin E — There are eight antioxidants called tocopherols that make up the vitamin E family. A good vitamin E supplement contains all eight types, whereas many vitamin E supplements only contain alpha tocopherol. Studies completed by Dr. Robert Acuff at East Tennessee State University have found that the human placenta can deliver natural vitamin E to the fetus in much higher concentrations than it can the synthetic form.

In the third trimester, add red raspberry leaf tea and evening primrose oil.

Red raspberry tea is the most widely used, and safest, of all uterine and pregnancy tonic herbs. It contains a rich concentration of vitamin C, vitamin E as well as vitamin A and B complex and easily assimilated calcium, iron, phosphorous and potassium. It contains fragrine, an alkaloid which gives tone to the muscles of the pelvic region, including the uterus itself, which helps to prevent miscarriage and postpartum hemorrhage. Some women report an alleviation of morning sicknesswith red raspberry tea.

Evening primrose oil (EPO) is a source of the essential fatty acid gamma-linolenic acid (GLA). The body needs fatty acids to produce prostaglandins, whose functions include metabolizing cholesterol, dilating blood vessels and preparing the pregnant body for labour. Evening primrose oil is suggested to help prepare the cervix for delivery.

About Author:

Natasha Turner, N.D. is a Toronto-based naturopathic doctor. She is the founder of the Clear Medicine wellness boutique and author of the bestselling book The Hormone Diet.