A simple Amazon.com search for “prenatal multivitamins” yields over 250 unique results. Prenatal vitamins come in every form, shape, and size — with varying nutrient profiles. While some truly are better than others, there is no universally perfect supplement, as you need to consider your own diet, lifestyle, and preferences. At the very least, choose a vitamin that has at least 400 micrograms of folic acid, and no artificial ingredients. Beyond this, however, follow the guidelines below from prenatal and family nutritionist Nicole Silber, RD, CSP to find the right prenatal vitamin for your body’s needs.
All-Around Pregnancy Health
There are 5 key nutrients all pregnant women need, whether from diet or a supplement:
- Folic acid (400 mg/day): Supports neural tube development
- Iron (27 mg/day): Helps oxygen delivery to the baby
- Calcium (1,000 mg/day):Maintains bone growth
- Vitamin D (600 IU/day): Works with calcium to maintain bone growth
- Omega 3: Promotes brain development
Do a quick review of your personal diet to find where you may have gaps that your prenatal vitamin will need to fill. If you’re unsure of your diet, you can always get your levels checked for some peace of mind, or consult a Registered Dietitian who can guide you. Because your nutrient levels and absorption may change during pregnancy, it is always an option to get your levels checked in the beginning, and throughout pregnancy, to see where you stand.
If you are iron deficient, vegan, vegetarian, or just not a big carnivore, select a supplement with at least 20 mg of iron, which will provide at least 75% of your iron requirements.
In addition to the above consideration for iron, also choose a supplement with calcium, DHA sourced from algae, and vitamins B12 and zinc. Note the consideration below under “Dairy Free” for calcium requirements. Also, many prenatal supplements are made with gelatin, so be sure to check for this if you choose to avoid it.
If you have a very sensitive stomach, are prone to severe constipation, or if you are not tolerating your current prenatal vitamin, you may want to try an iron-free supplement. Though be sure to increase your intake of iron-rich foods like beef, lentils and blackstrap molasses.
For those avoiding dairy and milk, choose a supplement that will give you 1,000 mg of calcium per day. However, because your body can only absorb up to 500mg of calcium at a time, you will likely need at least 2 supplements per day to achieve your 1,000 mg requirement.
Vitamin D Deficiency
Our bodies actually produce vitamin D from exposure to sunlight. Since most of us are now conscious of staying out of the sun, vitamin D deficiency has become quite common. If you tend to avoid sunlight and dairy, or if you know you are vitamin D deficient (a quick blood test to find out), choose a vitamin with at least 1,000 IU of vitamin D.
Low DHA Intake
DHA is an essential nutrient for your growing baby’s brain. If you do not eat fatty fish 3x a week, or if you do not get DHA from other sources like chia seeds or walnuts, choose a supplement with at least 200 mg DHA. If you do get sufficient DHA from foods, however, it is not harmful to take additional from your prenatal vitamin.
Things To Avoid!
There are a few key things you want to avoid when choosing your supplement:
- Artificial colors and flavors (FD&C Red #40, Yellow #6)
- Sugar alcohols (sorbitol, xylitol)
- Unsubstantiated claims: Vitamins and supplements are not regulated by the FDA, which unfortunately means manufacturers can claim a lot of things without the research to support them. Ditch the bottles with claims that seem too good to be true (i.e. promises of breast enhancement….seriously you can’t make this stuff up!).
- Non-prenatal vitamins: Regular multivitamins may contain mega dosages of certain nutrients — especially vitamin A — that may not be safe for the baby. So, it is best to stick with a supplement formulated for pregnancy.
- Laxatives: Some prenatal supplements contain laxatives, but because laxatives can cause cramping, it is best to start with a vitamin that does not contain these.
- If you are prone to gas or bloating, avoid supplements with prebiotics. These are the fibers that fuel gut bacteria (which can promote bowel regularity), but they can actually aggravate your bloating.
Final Considerations…Pills vs. Alternative Forms
Prenatal multivitamins come in many forms, including softgels, tablets, capsules, chewables, gummies, powders, and even juice preparations. This is when want to choose a form you are most comfortable with. Some supplements require you to take up to 6 pills per day! So, before grabbing a bottle, check what the recommended dosage is. If you are the busy or forgetful type, a one-a-day vitamin may be a better option for you. Generally, if you can swallow pills, then soft-gels, tablets, and capsules are better options since they do not contain the added calories and sugar commonly found in gummies, powders, and juices.
Remember, that your body is changing by the week, so keep an open mind. The benefit of having so many options is that there is room to experiment and find what works best for you. Ultimately, while prenatal multivitamins are important, you should feel confident that you are able to nourish your body, and baby, with a well-balanced, nutritious diet.
Nicole Silber, RD, CSP, CLC is a registered dietitian, board-certified specialist in pediatric nutrition, and certified lactation counselor. Nicole has worked with hundreds of children, mothers and families with chronic medical conditions, pre, and post-natal nutrition, gestational diabetes, food allergies, picky eating, oral-motor and sensory processing disorders, infant nutrition, breastfeeding, gastrointestinal conditions, prematurity, underweight and obesity. Currently, she manages her private practice and frequently teaches Tiny Tasters Workshop series. Prior to her current roles, she served as a clinical nutritionist at the Morgan Stanley Children’s Hospital at NewYork-Presbyterian/Columbia, where she covered the antepartum and postpartum units, and at NYU Langone/Fink Children’s Ambulatory Care Center. Nicole lives in NYC with her husband and her daughter, Lily!