What Do Pregnancy Vitamins Do And Do I Really Need Them?

SHOP PRENATAL + DHA

If you’re planning on hearing the pitter-patter of little feet any time in the near future, you’re probably also looking into a prenatal vitamin. Pregnancy is one of the most nutrient-demanding periods of a woman’s life. Given that most Americans already struggle to consume enough nutrients, this increased demand on a woman’s body presents a unique challenge. A prenatal vitamin is often recommended to ensure both mom and fetus get the right amounts of nutrients. Let’s take a look at what prenatal vitamin benefits are and which nutrients should be in these pregnancy vitamins so we can gain a better understanding of the big picture question: what do pregnancy vitamins do?

WHAT ARE SOME PRENATAL VITAMIN BENEFITS?

The vitamins and minerals in prenatal vitamins are “essential” nutrients. Both mom and baby need these nutrients to live and to thrive, and they can’t be made in the body alone. These essential nutrients must be obtained through the diet or through dietary supplements, such as a prenatal vitamin.

The specific benefits of each prenatal vitamin depend on which nutrients it contains. Nutrient needs increase during pregnancy to support the fetus while also supporting mom’s health.¹ In some cases, nutrient needs increase by 40–50% such as with iron, iodine, and folate.¹ In general, prenatal vitamins help address many of these key nutrient needs during pregnancy, although the nutrients and their quantities will vary from brand to brand. Here are a few examples of prenatal vitamin benefits for specific nutrients especially needed during pregnancy.

FOLATE
Folate in the body during pregnancy
Folate is a B vitamin the developing fetus needs to form new cells, tissues and organs—especially of the brain and spine.² Supplementing with folic acid (synthetic folate) is shown to help prevent birth defects of the brain and spine which are also called neural tube defects.³

Folate in your diet
Folate can be found in spinach, asparagus, lentils, lima beans, citrus fruit juices, and fortified foods.⁴ Fortified foods contain folic acid, which is also the form found in many prenatal supplements.

Folate as a common nutrient gap
In the United States, 29% of pregnant women don’t consume enough folate.⁵ It’s recommended that women who are pregnant or looking to become pregnant consume 400–800 mcg/day of folic acid (680–1,360 mcg/day of folate DFE*) and to eat foods with folate from a varied diet.^3,6,7

*Dietary Folate Equivalents

IRON
Iron in the body during pregnancy
Iron is an essential mineral the fetus needs to grow and develop all tissues and organs.² Moms need more iron during pregnancy to support the increased red blood cell demand which transports oxygen to the developing fetus.²

Iron in your diet
Iron is found in food in two forms: heme and non-heme. Heme iron comes mostly from meat, poultry, and fish. Non-heme iron is found mostly in plants, like whole grains, nuts, seeds, legumes, and leafy green vegetables. Heme iron is more readily absorbed by the body, but there are tricks you can do to enhance absorption of non-heme iron, like pairing with vitamin C rich foods.⁸

Iron as a common nutrient gap
Iron status in a woman at the time of conception is important for a healthy pregnancy, but almost 25% of pregnant women are iron-deficient.⁹ Inadequate intake remains a serious health concern for both mom and baby.¹⁰ To meet the iron demands of a growing fetus, pregnant women are recommended to take at least 27 mg/day of iron.¹

IODINE
Iodine in the body during pregnancy
Iodine is a major player in thyroid hormones and is especially important during pregnancy. This mineral is essential for normal brain development and helps support the central nervous system.² Iron is also an essential part of hemoglobin, the protein which enables red blood cells to carry oxygen throughout the body. If you don’t have enough iron, your body can’t make enough healthy oxygen-carrying red blood cells. When your cells don’t have enough oxygen, they can’t function properly which can lead to fatigue.

Iodine in your diet
Most foods are relatively low in iodine content, but it can be found in iodized salt, seaweed, cod, shrimp, milk, navy beans, and baked potatoes.¹¹

Iodine as a nutrient gap
It’s recommended pregnant women consume 220 mcg/day.¹ But 25% of pregnant women in the U.S. have insufficient iodine status.¹² To fill this nutrient gap, it’s recommended prenatal multivitamins contain at least 150 mcg/day of iodine to help support brain development in babies.¹³

VITAMIN D
Vitamin D in the body during pregnancy
Vitamin D works with calcium to help build new bones and teeth.² But this critical nutrient is not just for bone health. Inadequate vitamin D status during pregnancy may impact immune health and glucose metabolism later in childhood and adulthood.¹⁵

Vitamin D in your diet
The best source of this famous “sunshine” vitamin can be found in 15 minutes of sunshine every few days (without sunscreen). Some foods do contain it as well, including salmon, eggs, and fortified milk.

Vitamin D as a common nutrient gap
In the US, 90% of pregnant women do not get enough of this critical nutrient.⁵ It’s recommended that pregnant women at least 1000–2000 IU/day.¹⁶

OMEGA-3 FATTY ACIDS
Omega-3s in the body during pregnancy
DHA is a type of omega-3 and it’s the primary fatty acid found in the brain. It’s a critical building block in the development and functioning of a baby’s brain, eyes, and nervous system.¹⁷

Omega-3s in your diet
The Dietary Guidelines for Americans (DGA) recommends women who are pregnant, or breastfeeding consume fish rich in omega-3 fatty acids twice per week, from choices that are lower in mercury, such as salmon, sardines, freshwater trout, and light canned tuna.¹⁸

Omega 3-s as a common nutrient gap
Studies show that up 95% of childbearing age and pregnant women do not meet the DGA recommendations for EPA + DHA intake.¹⁹ This gap is concerning because of the impact DHA has on fetal development. In the U.S., several medical organizations recommend pregnant women consume fish or omega-3 fatty acids, which is about 200 mg/day of DHA.¹⁷

Read more about Omega-3 fatty acids

HOW TO CHOOSE THE BEST PRENATAL VITAMINS

Prenatal vitamins address a range of needs and they all contain different quantities and types of nutrients. There are a lot of prenatal vitamins to choose from, so make sure to pick one that meets quality guidelines, such as manufactured by USP standards, and provides most of the Recommended Dietary Allowances (RDA) in key essential nutrients. Here’s a quick review of the recommended dosages on critical nutrients during pregnancy. Your prenatal vitamin should contain at least:

• 400–800 mcg/day of folic acid (680–1,360 mcg folate DFE*)^3,6,7
• 27 mg/day of iron¹
• 150 mcg/day of iodine¹³
• 1000–2000 IU/day of vitamin D3¹⁶
• 200 mg/day DHA¹⁷

*Dietary Folate Equivalents

WHAT IS THE BEST TIME TO TAKE PRENATAL VITAMINS?

When should I take my prenatal vitamin? Should I take it with or without food? Is it okay to take at night?
For optimal absorption, it’s best to take your prenatal vitamin with food. If prenatal vitamins cause nausea or stomach upset, try taking at the time of day when you’re least nauseated. Some find taking it before bedtime may help. The extra iron in prenatal vitamins may cause constipation or stomach distress, so make sure to eat plenty of high fiber foods such as fruits, vegetables, and whole grains—and drink plenty of fluids. If diet and lifestyle changes do not help to manage your symptoms, talk to your physician about switching to other prenatal vitamin options.

How long does it take to work?
It is best to take a prenatal vitamin one to two months before trying to become pregnant to ensure adequate nutrients for the baby. The key is to be consistent and a prenatal vitamin daily. Studies show taking a prenatal vitamin every day makes a big difference to your health and your baby’s.⁶

Can I take it before I’m pregnant?
Yes, and you should! The baby’s brain and spinal cord are starting to form before most women even know they’re pregnant, so it is best to take a prenatal vitamin one to two months before trying to become pregnant. The sooner you can start building a body that’ll support your fetus, the better.

Can I take it if I am breastfeeding?
After your baby arrives, it is important to keep nutritional care top of mind. Breastfeeding mothers and babies have unique nutrient needs that are similar to what’s found in a prenatal vitamin, but there is some difference in the recommended amounts of some of these key nutrients, such as lower in iron and folic acid, but higher in vitamin A, C, D, E.¹ A postnatal vitamin with DHA is a great option for breastfeeding moms.

What happens if I have a deficiency?
In the US, pregnant women are at a higher risk for nutrient shortfalls in several key nutrients such as iron, folate, iodine, vitamin D, and DHA.^5,12,19 Most of these nutrient gaps can be filled with a prenatal vitamin supplement, along with a healthy diet. If you have a diagnosed blood nutrient deficiency, you may have higher nutrient needs, so it’s important to work with a health care professional to ensure adequate nutrient intake for those specified nutrients.

What happens if I take too much? Can I have too much?
In general, reputable and high-quality prenatal vitamins are formulated to meet the specific nutritional needs of women who are pregnant or planning on it. Make sure the prenatal vitamin you are taking meets the recommendations for pregnant women. Always follow label instructions and take as recommended or as prescribed by your doctor. If you have any concerns or questions about your prenatal vitamin, consult with a physician or healthcare professional.

Is this available over the counter or do I need a prescription?
Prenatal vitamins are available over the counter as well as with a prescription and both can be good choices. Nutrients and dosages in prenatal vitamins in both options can vary, so it’s important to check the label to make sure the one you choose is providing the recommended daily nutrient requirements for pregnant women.

SO, WHAT DO PREGNANCY VITAMINS DO?
The best prenatal vitamins keep mom well-stocked with the crucial nutrients she needs to support the fetus’ growth and development before, during, and even after pregnancy. But the specific benefits of each prenatal vitamin will vary depending on which nutrients they contain. The important thing is that you at least start a prenatal vitamin if you’re pregnant or if you’re planning to be. There are always more ways to optimize our nutritional routines, but a healthy diet and trustworthy prenatal vitamin is a huge step in the right direction toward supporting you and your soon-to-be-baby during this once-in-a-lifetime journey together.

References

1. US Department of Health and Human Services. “Nutrient Recommendations: Dietary Reference Intakes (DRI).” National Institutes of Health. Accessed on: May 13, 2020. https://ods.od.nih.gov/Health_Information/Dietary_Reference_Intakes.aspx
2. Oregon State University. “Pregnancy In Brief.” Linus Pauling Institute, Micronutrient Information Center. Accessed on: May 13, 2020. https://lpi.oregonstate.edu/mic/health-disease/pregnancy-in-brief
3. US Department of Health and Human Services. “Folic Acid.” Centers for Disease Control and Prevention. Accessed on: May 13, 2020. https://www.cdc.gov/ncbddd/folicacid/index.html
4. Oregon State University. “Folate.” Linus Pauling Institute, Micronutrient Information Center. Accessed on: May 13, 2020. https://lpi.oregonstate.edu/mic/vitamins/folate#food-sources
5. Saldanha L, et al. “Is Nutrient Content and Other Label Information for Prescription Prenatal Supplements Different from Nonprescription Products?” Journal of the Academy of Nutrition and Dietetics. 2017; 117 (9): 1429-1436. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5573647/
6. US Preventative Services Task Force. “Folic Acid for the Prevention of Neural Tube Defects: Preventative Medication.” Accessed on: May 13, 2020. https://www.uspreventiveservicestaskforce.org/uspstf/document/RecommendationStatementFinal/folic-acid-for-the-prevention-of-neural-tube-defects-preventive-medication
7. US Preventative Services Task Force. Folic Acid Supplementation for the Prevention of Neural Tube Defects: Recommendation Statement. Am Fam Physician. 2017; 15;95(10). https://www.aafp.org/afp/2017/0515/od4.html
8. Oregon State University. “Iron.” Linus Pauling Institute, Micronutrient Information Center. Accessed on: May 13, 2020. https://lpi.oregonstate.edu/mic/minerals/iron
9. Mei Z, et al. Assessment of iron status in US pregnant women from the National Health and Nutrition Examination Survey (NHANES), 1999-2006. Am J Clin Nutr. 2011;93:1312-20. https://www.ncbi.nlm.nih.gov/pubmed/21430118?dopt=bAbstract
10. Department of Health and Human Services. “2015­–2020 Dietary Guidelines for Americans.” 2015. 8^th U.S. Department of Agriculture. Accessed on: May 13, 2020. https://health.gov/dietaryguidelines/2015/
11. Oregon State University. “Iodine.” Linus Pauling Institute, Micronutrient Information Center. Accessed on: May 13, 2020. https://lpi.oregonstate.edu/mic/minerals/iodine
12. Caldwell KL, et al. Iodine status in pregnant women in the National Children's Study and in U.S. women (15-44 years), National Health and Nutrition Examination Survey 2005-2010. Thyroid. 2013; 23(8): 927-937.  https://www.ncbi.nlm.nih.gov/pubmed/23488982
13. Leung AM, et al. AAP recommendations on iodine nutrition during pregnancy and lactation. Pediatrics. 2014; 134(4): e1282. https://www.ncbi.nlm.nih.gov/pubmed/25274837
14. Oregon State University. “Vitamin D.” Linus Pauling Institute, Micronutrient Information Center. Accessed on: May 13, 2020. https://lpi.oregonstate.edu/mic/vitamins/vitamin-D
15. Cyprian F, et al. Immunomodulatory Effects of Vitamin D in Pregnancy and Beyond. Front Immunol. 2019; 10:2739. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6883724/
16. Committee on Obstetric Practice. ACOG Committee Opinion No. 495: Vitamin D: screening and supplementation during pregnancy. Obstet Gynecol. 2011; 118(1):197 https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2011/07/vitamin-d-screening-and-supplementation-during-pregnancy
17. Devarshi, Prasad P et al. “Maternal Omega-3 Nutrition, Placental Transfer and Fetal Brain Development in Gestational Diabetes and Preeclampsia.” Nutrients. 2019; 11(5): 1107. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6567027/
18. US Food and Drug Administration. “Advice About Eating Fish: For Women Who Are or Might Become Pregnant, Breastfeeding Mothers, and Young Children.” Accessed on: May 13, 2020. https://www.fda.gov/media/102331/download
19. Zhang Z., et al. Dietary Intakes of EPA and DHA Omega-3 Fatty Acids among US Childbearing-Age and Pregnant Women: An Analysis of NHANES 2001-2014. Nutrients. 2018; 10:416. https://www.ncbi.nlm.nih.gov/pubmed/29597261