If you’re newly pregnant (or ideally when you’re trying to conceive), it’s time to start paying serious attention to nutrition. For most, that means taking a daily multivitamin. But with tons of over-the-counter and prescription options, how does one choose? Read on for our guide to choosing a good prenatal pill.
What should you look for in a prenatal vitamin?
Prenatal vitamins often have a mile-long ingredient list that seems to include a whole alphabet of vitamins, but you should look for the right amounts of a few key nutrients, including:
Perhaps the most important ingredient in a prenatal vitamin is folic acid, a vitamin that can help prevent birth defects of the brain and spine (called neural tube defects, with the most common known as spina bifida). The March of Dimes recommends that women of childbearing age get 400 micrograms of folic acid daily; increase that amount to 600 micrograms of folic acid daily once you become pregnant. Many prenatal vitamins include more, which is fine, says Julie Levitt, M.D., an OB-GYN at Women’s Group of Northwestern in Chicago. That’s because the folic acid found in supplements is more easily absorbed by our bodies than folate, the naturally occurring version.
The American College of Obstetrics & Gynecology and the American Society for Reproductive Medicine have also issued statements that folic acid should be taken when trying to conceive. While many vitamins contain methylfolate with the thought that it may be more easily absorbed by some people, it hasn’t been studied enough to know with certainty that it will prevent neural tube defects.
Prenatal vitamins with iron should be a top priority. You’ll need twice as much of this mineral, now that you’re pregnant, to make extra blood to take care of your baby. Pregnant women should get 27 milligrams of iron each day.
This mineral is vital for the development of your baby’s bones, teeth, heart, muscles and nerves, and expectant mothers should get 1,000 milligrams daily. Getting enough calcium should be a priority: Skimping now could increase your risk of osteoporosis later in life. “What the fetus doesn’t get through the diet, the fetus will take out of the parent’s bones,” says Scott Sullivan, M.D., the director of maternal-fetal medicine at Medical University of South Carolina. “A supplement protects Mom from being the calcium reservoir.”
This vitamin helps you absorb calcium and is important for your baby’s bones, teeth, eyes and skin. The March of Dimes suggests getting 600 IU (international units) of vitamin D a day during pregnancy, and many doctors recommend even more—800 or 1,000 IU—because many people are deficient. Ongoing studies are evaluating if higher doses of Vitamin D may decrease the risk of preeclampsia.
Found in fresh fruits and vegetables, vitamin C helps with the development of a baby’s cartilage, tendons, bones and skin. Aim for 85 milligrams a day.
During pregnancy, you need 220 micrograms of iodine every day to help your baby’s brain and nervous system, according to the March of Dimes. Sullivan recommends your prenatal pill have at least 150 micrograms (foods like fish and dairy can make up the rest) and says the source should be potassium iodide, as iodine from kelp can break down before you get a chance to take it.
How many supplements do you actually need?
A prenatal vitamin will often contain 100% of the recommended dietary allowance for folic acid, and 100% or more of the RDA for iron, but it may have only around 250 mg of calcium, so if you don’t get much in your diet (if you’re vegan, for instance, or lactose-intolerant) consider taking an additional supplement. You’ll want to down it at a different time of day than your prenatal vitamin, as large amounts of calcium can’t be absorbed along with the iron in your prenatal vitamin, says Levitt. You could take your iron supplement in the morning and your calcium supplement at night.
What about side effects?
While taking prenatal vitamins is important, it can be hard for some people—especially when you are experiencing morning sickness. Combat nausea by taking them with smooth-textured foods, like applesauce, smoothies or ice cream. You can also cut your prenatal vitamins in half, according to the National Institutes of Health. Take half in the morning and the other half at night. And switch things up: Some brands may go down easier than others.
While there’s not much risk of over-supplementing, overdosing on vitamin A, however, can cause birth defects. Skip anything that lists more than 100% of the RDA of vitamin A on the back of the bottle, says Levitt.
When in doubt, ask your doctor about your prenatal vitamin and any other supplements you’re taking. You’ll want a vitamin you’re comfortable with, since you shouldn’t necessarily drop the pill after delivery. Most doctors recommend taking a prenatal vitamin as long as you’re breastfeeding, or even longer if you plan to have another baby soon—a decision that makes picking a vitamin seem like a breeze! And if you’re wondering about over-the-counter versus prescription, there’s no clear winner as far as quality, so it’s really up to you.
© Meredith Operations Corporation. All rights reserved. Used with permission.