The trouble with the supplement market is that it is highly unregulated. As a result, it is very crowded with hundreds of products and brands and very confusing. Pick up two of the same ‘nutrient’ and you’re likely going to find conflicting amounts. You may even see nutrients advertised that the body cannot even absorb! Plus it is NOT a one size fits all. Different people have different needs. Despite what these companies may suggest.
Even worse, many brands are likely to advertise various wonderful benefits without much substance. It’s a minefield! Supplements are no substitute for a good diet but the extra requirements on the body during pregnancy and breastfeeding do require some additional help. Once again prenatal vitamins are likely to have highly variable ingredients depending on brands. Here are some of the the key ingredients (plus evidence backed amounts) that may be missed from some prenatal supplements. These are all ingredients where there is interesting science backing their ability to support a healthy conception, pregnancy and breastfeeding journey:
Here are our favourites and some key things to know:
- Folate (not Folic Acid) – 400 micrograms pregnancy
- Iron – this is where you need your blood tests!
- Choline – 450mg pregnancy, 550mg breastfeeding
- Vitamin D – a baseline minimum of 400iu/day
- Iodine – 250 micrograms/day
- Lactobacillus
- DHA/EPA
Why it’s all about Folate not Folic Acid in your prenatal supplement. Despite most containing the synthetic form!
The reality is that most prenatal supplements contain Folic Acid. This the synthetic version of the crucial nutrient Folate which is required for neural tube development. It is also crucial for helping protect and support our all important egg quality.
Folic Acid is actually fine for some people. However, by definition of being synthetic, it is less easily absorbed by the body than the food based form Folate. Particularly if you have a genetic difference known as MTHFR which means your body cannot absorb the synthetic form. Best to be on the safe side and go with Folate or Methyl folate. Alternatively ask your doctor to do a test. During pregnancy the recommended dose is 400 micrograms. For egg quality studies have suggested a level of around 800 micrograms.
We are big believers in getting nutrients closest to how the body would naturally absorb them. This is no exception.
Iron supplements: how to avoid malabsorption…
We are huge believers in the fact that every person is individual. With very individual needs. This is why ensuring you get regular blood tests are SO important through your pregnancy. This is particularly the case for iron. You don’t want too much or too little. Ask for regular red blood cell counts, haemoglobin levels and MCV tests. Your needs and levels will likely fluctuate through your pregnancy.
Iron deficiency is very common during pregnancy (up to 50% of people!). However, it is crucial not only for your own health (deficiency can cause things like dizziness, headaches and fatigue amongst other things). It is also key for things like a baby’s neurological development. You may need support not only through pregnancy but postnatal too.
Once again your needs are likely to be very individual. Get properly tested by your doctor.
Iron absorption can also be impacted by tannins (found in tea and coffee) and by phytic acid (found in uncooked, un-soaked grains like oats). It is also best taken on an empty stomach. It can cause stomach upsets going for iron chelate can help ease this.
Choline: often left out of prenatal supplements but crucial for immune systems and brain development:
Recent research has shown that women who have adequate levels of Choline in their blood appear to be protected from the worst inflammatory effects of COVID.
Research has also shown that this is a crucial nutrient for many areas of development but getting enough is also key for neurodevelopment of a baby. Placental function (delivery of nutrients to the baby) is also impacted.
The good news is that it is widely found in many foods (lean meats, mushrooms and eggs being prime examples). However, are you getting enough? The recommended amount for pregnancy is 450 mg/day and breastfeeding is: 550mg/day. Make sure you check whether your prenatal includes it. Especially important in these uncertain times!
Vitamin D: crucial for brains, immune systems and most of us are deficient!
Many of us are Vitamin D deficient. There is mounting evidence that this important vitamin (it is also a steroid hormone by the way) plays a role in immune development (reducing risks of infection), brain development (reducing risks of ADHD) and fertility. Getting enough is key. Particularly during breastfeeding and pregnancy. How much is enough? Well once again getting your level tested is smart as people’s levels vary depending on lifestyle, skin colour (the darker your skin the harder it is to absorb) and even your genetics. The guidelines recommend minimum intake of 400 iu per day for pregnancy and breastfeeding. However, you may require more/less depending on your own individual needs.
The other crucial thing to be aware of is that you need it in the form of D3 and ideally with a fat as it is fat soluble.
Iodine: crucial for your thyroid and a baby’s developing brain:
Good thyroid health is crucial for pregnancy but also for fertility. In fact, subclinical thyroid issues (where the symptoms are not obvious) are a common cause of infertility and miscarriage. It can also go undiagnosed. Full Thyroid testing is crucial during both stages – this means testing more than just TSH (you ideally need a full panel done plus a check for Thyroid antibodies).
Iodine is a crucial nutrient to support your Thyroid. Plus avoiding toxins as the Thyroid is particularly vulnerable. Your needs increase during pregnancy and the recommended amount to be included in your prenatal supplement is 250 micrograms/day. However, once again ensure your Thyroid health is being monitored.
Another good source? Algae (Chlorella and Spirulina) as well as sea vegetables and table salt. As always it’s about Goldilocks. Not too much and not too little. The good news is that most prenatal supplements DO contain Iodine. Just check on the amount and your own Thyroid levels.
Lactobacillus: the emerging hero of the prenatal supplement world?
The microbiome and probiotic market is ‘hot’. However, the jury is out when it comes to many OTC brands. Once again the reality is there are so many different brands, strains and particularly when it comes to the microbiome (collection of bacteria, fungi and viruses in the body) there is so much we don’t know. It is also highly individual.
However, targeted use is looking more interesting. Particularly when it comes to the vaginal microbiome and the role it can play reducing risk of preterm birth and increasing risks of a successful conception/implantation.
Emerging research shows that having a vaginal microbiome which is heavily dominated by Lactobacillus is the way forward. Your prenatal is unlikely to contain specific Lactobacillus strains) so may be worth buying one as an add on.
DHA/EPA: why the Omega 3s are key:
Not only are Omega 3s (DHA/EPA) key for fighting chronic inflammation which can cause damage to cells – particularly highly developing or vulnerable ones. They are also key for many functions such as brain development in a baby as well as regulating our immune systems. Plus potentially reducing risks around preterm birth and other pregnancy complications.
Research shows that it gets increasingly accumulated in the body towards third trimester. Getting enough during breastfeeding is also key.
Some prenatal supplements contain these, some don’t. Ideally you want those sourced from wild fish low down the food chain. This is where they are most commonly derived. If you’re vegan you can seek alternatives including Algae although the dosage will perhaps be tricker.
The Academy of Nutrition and Dietics recommends approx 500mg/day of DHA specifically in the prenatal diet. For reference a serving size of omega 3 rich fish contains between 650mg up to 3,000 and two servings per week are recommended.
Bottom line: what to look for in your ideal prenatal supplement:
It can be a minefield. But research shows that the elements above are a key helping hand for conception, pregnancy and breastfeeding. However, they are not always included in prenatal brands. As always it is CRUCIAL to talk to your doctor and get your own individual levels checked. Knowledge of your own body is power after all!
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This article is for informational purposes only. This article is not, nor is it intended to be, a substitute for professional medical advice, diagnosis, or treatment and should never be relied upon for specific medical advice. The information on this website has been developed following years of personal research and from referenced and sourced medical research. Before making any changes we strongly recommend you consult a healthcare professional before you begin.
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