Prenatal supplements are meant to help optimize nutrition before, during, and even after pregnancy. Though food should always be our first source of nutrition, the reality is that most of us have nutrient deficiencies or suboptimal levels of nutrients necessary for a healthy pregnancy. Prenatal supplementation helps us ensure that we meet nutrient requirements to support mom’s health, the baby’s growth and development, and overall reduce risk of pregnancy-related complications.
In an ideal situation, a woman should begin taking a prenatal multivitamin 3-6 months before conceiving but in reality, most pregnancies are unplanned and prenatal supplementation is not started until after getting a positive pregnancy test result. So, you are right away tasked with the challenge of trying to choose the best prenatal supplement. Remember, not all supplements are high quality and meeting the Percent Daily Value does not mean it meets optimal levels for pregnancy needs.
Here are 5 essential nutrients you should look for in a prenatal supplement:
1) Methylfolate
The methylenetetrahydrofolate reductase (MTHFR) gene codes for the enzyme that plays a role in the body’s ability to process folate (vitamin B9) and break down homocysteine, which is associated with inflammation and increased risk for miscarriage. MTHFR gene mutations are not uncommon and can interfere with methylation processes, resulting in impaired ability for our body to utilize B vitamins and can contribute to fetal abnormalities in pregnancy. For this reason, the fully bioactive form of folate, methylfolate, is the preferred form in a prenatal supplement.
Folate supports DNA synthesis, nervous system development, and helps prevent neural tube defects. The recommended dose of methylfolate or 5-MTHF, is 400 mcg daily for at least one month before conception, 600-800 mcg/day during pregnancy, and at least 500 mcg/day if breastfeeding.
Some foods that are high in folate include: dark leafy greens, broccoli, asparagus, citrus fruits, beans, lentils, peas, walnuts, flax seeds, eggs, and fortified grains.
2) Vitamin B6
Oral contraceptives are associated with deficiencies in vitamin B6, B12, and folate, making supplementation strongly recommended for women who become pregnant after coming off birth control. Vitamin B6 helps support hormone balance and adequate levels of progesterone, the hormone necessary for a healthy uterine lining and for the implantation of the fertilized egg into the uterus.
The active form, pyridoxal-5-phosphate, is recommended at a dose of 8-10 mg daily. Research studies have also shown effectiveness of vitamin B6 in preventing morning sickness, with the American College of Obstetrics and Gynecology recommending 10-25 mg of vitamin B6 three to four times per day to treat nausea and vomiting in pregnancy.
Food sources of vitamin B6 include: tuna, salmon, beef, chicken, chickpeas, potatoes, bananas, and fortified cereals.
3) Choline
Choline is an essential nutrient supporting cell membrane synthesis, neural tube formation, and brain development. Ensuring adequate levels of choline during pregnancy helps prevent neural tube defects, enhances cognitive development, and supports overall fetal and maternal health.
The recommended dose for choline is 450 mg daily and up to 550 mg per day after week 12 of pregnancy. Dietary sources include: egg yolk, broccoli, Brussels sprouts, salmon, cod, beef, chicken, quinoa, legumes, and nuts.
4) Vitamin D
Vitamin D plays a role in fertility, pregnancy outcomes, and lactation. Research studies have shown that maternal serum vitamin D [25(OH)D] progressively decreases throughout pregnancy due to the demands of the growing fetus. Supplementation with vitamin D3 in women with low levels showed improved fetal growth, decreased risk of preeclampsia and preterm birth, and decreased risk of offspring with ADHD and autism.
Dietary sources and sunshine are not enough to meet fertility or pregnancy needs, especially if you live in a region with long winters and limited sunshine. It is recommended to have vitamin D levels tested but for most pregnant women, 2000-4000 IU daily of vitamin D3 supplementation will be sufficient.
5) Omega-3 fatty acids
The two most important omega-3s to look for in a supplement are EPA and DHA. EPA has been shown to support heart health, the immune system, and decrease inflammation while DHA supports brain, nervous system, and eye development during pregnancy. Postpartum, omega-3s are important for mood regulation, lactation, and overall health of the mother.
Good quality fish oil or algae oil is safe during pregnancy. The recommended dose of DHA for pregnancy is 300 mg daily. Some prenatal supplements may contain both DHA and EPA in a 2:1 ratio. Our body cannot produce fatty acids so it’s important to consume them through diet or supplementation. Dietary sources: wild-caught salmon, tuna, sardines, and herring.
Can't find one prenatal supplement that meets all your needs? It's okay to take more than one supplement! For example, if you are starting off with low levels of vitamin D, you may need an additional bottle of vitamin D3 to meet your daily requirement, or a separate bottle of fish oil if your prenatal multivitamin does not include omega-3s.
If you have questions or concerns about which prenatal supplement is right for you, consult with your doctor to make sure you are meeting optimal levels for pregnancy or fertility.