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Pregnancy
prenatal vitamins

There is so much to think about when you find out you are pregnant. Even when you are planning for pregnancy, you may be wondering, What do I eat? How much weight should I gain? What prenatal vitamins do I take? Information is everywhere and it can be overwhelming. You need to ensure adequate hydration and to eat enough calories to fuel your changing body. You also need to make sure you take high-quality prenatal vitamins.  Each nutrient in your prenatal vitamins plays an important part in your baby’s development.  In this article, we share the most important nutrients you need in your prenatal vitamins and at which stage in your pregnancy they’re most important.

Prenatal Vitamins for Early Pregnancy

Certain nutrients are important for your baby’s development before you may even know you are pregnant. The first 28 days of pregnancy are a crucial time.  Within four weeks of conception, your baby’s ‘neural tube’ – which will become the baby’s brain and spinal cord -will form and fuse together. Defects (called neural tube defects) can occur when this fusion doesn’t happen correctly. These include anencephaly, where part of the brain or skull is missing at birth, and spina bifida, where the brain and spinal cord do not completely connect. The outcomes of these birth defects to the baby can range from physical and intellectual disabilities to death.

Folic Acid/Folate

Folic acid, or folate, is a B vitamin found in many foods and supplements. It is the key nutrient to ensure proper development of your baby’s brain and spinal column. Your baby’s spinal cord develops during early pregnancy and folate helps to prevent neural tube defects. Women who could become pregnant should consume at least 400 micrograms of folic acid daily. This level increases to 600 micrograms for women who are pregnant. While folic acid is added to many foods (i.e. breads, cereals), the U.S. Preventive Services Task Force reported in 2017 that most women do not consume adequate amounts of folate in their diets and that they should consider supplementation.

Vitamin D

Vitamin D is a fat-soluble vitamin made in our skin in response to sun exposure. Most people don’t get enough sun exposure to maintain adequate levels of vitamin D. It is also difficult to get enough from your diet, as few foods are rich in vitamin D.

Getting enough vitamin D is important during early pregnancy, and even before you are pregnant.  Higher vitamin D levels are linked to better fertility as well as a healthy pregnancy. Women with vitamin D levels above 30 ng/mL have a better chance of getting pregnant and are at a lower risk for miscarriage than those who have low levels.  Normal vitamin D blood levels have also been linked to reduced risk of complications such as preterm birthgestational diabetes, and infant infection.  Taking 2,000 to 4,000 IU of vitamin D3 per day – before and during pregnancy – will help you achieve a normal level.

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Mid to Late Pregnancy

As you continue throughout your pregnancy, the most critical nutrients in your prenatal vitamins begin to change. Read on to learn about the importance of iron, omega-3 fatty acids, and choline during the later stages of your pregnancy.

Iron

As your pregnancy progresses, the blood volume in your body increases by 20 to 30 percent. This ensures both you and your baby have enough oxygen available for your muscles, organs, and tissues. You need iron to make the protein hemoglobin. Oxygen binds to hemoglobin in red blood cells and circulates to all the organs and tissues in the body. Iron needs increase during the second and third trimesters of pregnancy due to this increase in blood volume.

Pregnant women are at increased risk of developing iron-deficiency anemia. If you have low iron levels, you can feel weak, tired, or dizzy. If untreated, iron-deficiency anemia can lead to premature delivery or low birthweight baby. Ensuring you get enough iron in your diet from foods and supplements is essential for all women. However, getting enough iron is especially important for those who are pregnant.

Meat, beans and lentils, dark leafy green vegetables, and fortified and enriched breads and cereals contain good amounts of iron. Women who are pregnant should consume 27 grams of iron a day. Iron supplements can help you reach your iron goals, if you don’t get enough from your diet.

Omega-3 Fatty Acids

DHA (Docosahexaenoic acid) and EPA (Eicosapentaenoic acid) are omega-3 fatty acids. DHA is a key nutrient for brain and eye development in babies throughout pregnancy. In the second and third trimesters, DHA becomes even more important. Fatty acids are an important part of cell membranes, particularly in the brain and retinas.

Omega-3s may also reduce the risk of premature delivery.  A 2018 Cochrane review of 70 randomized trials concluded that omega-3 supplements prevent preterm birth. This review found that the optimum dose of DHA and EPA is likely between 500 and 1000 mg a day, starting at 12 weeks of pregnancy. Lower daily doses may also be effective if they are started earlier during your pregnancy.

Fatty fish is a good source of DHA and EPA. It is especially important during pregnancy to eat fish that is low in mercury (salmon, trout, herring, anchovies are good examples) at least once a week. Yet, fish can often be challenging to eat during pregnancy due to the strong smells and flavors. This can be especially challenging for a woman who experiences nausea throughout her pregnancy. Taking prenatal vitamins that contain at least 300 mg of DHA, or a separate omega-3 fish oil supplement, can help ensure you get the omega-3 fatty acids you need to support your baby’s brain and eye development, and reduce your risk of preterm delivery.

Choline

Choline is a “building block” compound. It helps the body make membranes that form cell structures and substances called neurotransmitters. Neurotransmitters help the body send signals for memory and muscle control. Your body makes choline in the liver, but it is not enough to meet our body’s needs. This makes it essential that we consume choline in our diets or in a supplement.

Choline needs increase during pregnancy, and pregnant women should consume at least 450 milligrams of choline a day. Choline-rich foods include eggs, beef, poultry, fish, soybeans, Brussel sprouts, broccoli, and cauliflower.

Choline has also been identified as an important building block in early brain development – making it another pregnancy power nutrient.  A 2018 Cornell study found cognitive benefits (improved information processing speed and visuospatial memory) in the babies of women who consumed twice the recommended level of choline in their third trimester. More research needs to be done on choline recommendations for women above 450 milligrams. However, the brain-boosting ability of choline seems worth keeping an eye on.


Through regular check-ups, you can monitor your body’s levels of these key nutrients.  A diverse, nutrient-rich diet combined with high-quality prenatal vitamins, can help you and your baby thrive.

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