In pregnancy, understandably mothers want to nourish their bodies as well as possible to ensure a smooth sailing pregnancy, and a healthy little angel at the end of that 9 months. There are some key vitamins and minerals that are essential in pregnancy, and a wide variety of supplements available out there. A woman can also look to improve her diet and nutrition to ensure some of these nutrition needs are met. However, the increased demands of the body may not be met through diet alone in some cases.

Here, we look at determining the essential vitamins and minerals, what levels are needed in pregnancy and breastfeeding. Of course, it goes without saying that you should speak to your doctor, dietitian or nutritionist before choosing a pregnancy or pre-natal vitamin supplement, to be really sure you have selected the one that is right for you. 

The essential vitamins and minerals during pregnancy are:

• Folate/Folic acid – most people would know that supplementation with folate or folic acid prevents the risk of your baby being born with a neural tube defect such as spina bifida. It is recommended that women take a supplement containing 500 mcg of folic acid every day, starting 12 weeks prior to conception and continuing until the end of the first trimester of pregnancy (or 3 months). In special cases, a higher dose of 5 mg per day is needed (e.g. pre-existing diabetes, taking anti-convulsant medications, malabsorption syndromes and others).

Dietary sources of folate include asparagus, broccoli, Brussels sprouts, spinach, chickpeas and lentils. 

(Note: Folate is the natural form, and folic acid is the synthetic form found in supplements). 

Important – some people have a gene mutation that leads to a folate deficiency, as the body cannot convert folate to the activated form. Only those who have had genetic testing will know if they have this gene mutation. So, you could be cautious and select a supplement that contains activated folate, labelled as L-methylfolate or follinic acid.

• Iodine – is an essential nutrient for the baby’s brain and nervous system development. It is essential for the production of thyroid hormone in the body and low intake during pregnancy may lead to an increased risk of mental impairment. It is recommended to take 150 mg of iodine 3 months before, and during pregnancy and breastfeeding. Dietary sources include: seafood, seaweed, eggs, meat and dairy products. 

• Iron – during pregnancy your body will have an increased demand for iron. This is because the foetus draws iron from the mother so that it can utilise this iron during the first 6 months of life. Usually, the increased consumption of iron-rich foods will be enough to meet this need, without the need for iron supplements, but that will vary on a case-by-case basis. During pregnancy the recommended daily intake of iron is 27 mg per day (9 mg more than for non-pregnant women). Dietary sources include: meat, chicken, seafood, lentils and leafy green vegetables. 

• Vitamin D – pregnant women will usually have their Vitamin D levels checked at their first antenatal screening and appointment. It is recommended that all pregnant women take 400 IU of Vitamin D daily as routine supplementation. 

There is some emerging evidence that choline supplementation has benefits in pregnancy supplements. It has been shown that choline is beneficial in the prevention of neural tube defects along with folic acid. However, based on my research, no public health recommendation exists in Australia for choline supplementation in pregnancy, so at this stage I would recommend boosting choline intake through eating foods such as eggs, salmon and mushrooms. 

It is also important to review the essential nutrients in demand during breastfeeding. This is particularly interesting as many supplements are bundled as a pregnancy and breastfeeding support product that can be used before, during and after pregnancy. 

When breastfeeding the body burns a lot more energy, and the woman will need to consume extra snacks to meet their increase energy demands. This is where a qualified dietitian or nutritionist becomes can help tailor a diet plan to ensure energy needs are met. 

• Of all the essential nutrients when breastfeeding, there is the most compelling evidence that iodine may require supplementation in addition to changes to the diet, which can usually meet all the additional nutritional needs in most cases.

It is recommended to take 150 mg of iodine 3 months before, and during pregnancy and breastfeeding. Dietary sources include: seafood, seaweed, eggs, meat and dairy products.

Bottom line

There are a variety of pregnancy and pre-natal vitamins available. Upon a review of the science, there are only a small number of essential vitamins and minerals that are likely to require supplementation. Most other nutrients that have an increased demand can be met through a modified diet, that can be developed and tailored for the individual woman by a qualified dietitian or nutritionist. However, each person will be different and may require some additional nutrient supplementation for specific reasons. 

Many of the available supplements contain many other ingredients which can be helpful to reach increased nutrient demands of pregnancy and breastfeeding, but these are not always necessarily needed. 

Tips:

1. Choose a supplement that contains the recommended levels of iodine, folic acid and Vitamin D.
2. Speak to your dietitian or nutritionist about iron supplementation and, if based on your diet you need to seek the full 27 mg per day supplementation, or if you can change your diet to improve iron intake, so can choose a lower strength iron supplement. Bear in mind that higher levels of iron may cause constipation, although some brands contain less constipating form of iron also. 

Note: This is my independent review and opinion. I have not worked with any supplement companies as part of this review.

References

. National Health and Medical Research Council (NHMRC). Public Statement Iodine supplementation for pregnant and breastfeeding women. January 2010. Available from URL: http://www.nhmrc.gov.au/_files_nhmrc/file/publications/synopses/new45_statement.pdf 

Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG). Vitamin and mineral supplementation in pregnancy. RANZCOG College Statement: C-Obs 25 2014. Available from URL: http://www.ranzcog.edu.au/college-statements-guidelines.html 

https://www.betterhealth.vic.gov.au/health/healthyliving/pregnancy-and-diet\https://daa.asn.au/smart-eating-for-you/smart-eating-fast-facts/pregnancy/nutrition-for-pregnancy/