By Dr Mahalia Freed, ND
Why do you take a prenatal multivitamin?
Does it have everything you need to stay healthy during pregnancy? (No!)
Does it contain all the nutrients your baby needs for optimal growth? (No!)
Multivitamins are sometimes described as a supplement “insurance policy”. Do you have the right insurance?
People don’t question whether or not to take a prenatal multivitamin. Even those who wouldn’t think to take a vitamin when not pregnant or trying to conceive assume they should take a prenatal. The intention behind this is noble, if somewhat symptomatic of the health concerns I see in practice: when nurturing another life, people are way more responsible than they are for themselves alone. Riding this trend, I encourage you to use the motivation of pregnancy or pregnancy preparation to enhance your own health. I also encourage you to work with a practitioner to determine what nutrients YOUR body needs, and in what dose.
Fact: nutritional needs change during pregnancy.
You need more protein, more calories, and more of a variety of specific nutrients (for those of you who like the details, see chart below for an incomplete list of top nutrients).
Building on dietary counselling, and individualized naturopathic support, I do recommend prenatal multivitamins in my practice, but not for every pregnant/trying to be pregnant person. I am also very specific about which brands are effective and toxin-free, as they aren’t all equal by any means. The top-selling prenatals at pharmacies are loaded with food colourings (known neurotoxins) as well as unnecessary fillers and binders with detrimental effects, from sodium lauryl sulfate (skin and membrane irritant, possible mutagenic) to talc (carcinogenic). And that is in addition to often not having sufficient quantities of the vitamins that are known to support healthy pregnancies that continue to term! One of the foundational principles of medicine is, “First, do no harm”. At what time is it more important to follow this guidance than when nourishing another life within our body? Make sure you know what is in your supplements, and whether this is right for YOU. For more about the effects of these “nonmedicinal” ingredients, see http://www.ewg.org/skindeep/. For more about nutrient needs in pregnancy, see below.
More questions? Contact me online or call 416-856-4682.
What nutrients do I need in pregnancy, and why?
(* = a nutrient that is commonly taken in supplement form during pregnancy.
Ask your ND if this is necessary for you!)
|Nutrient||Function||Sources||Daily Needs in Pregnancy (conservative #s)||Notes|
|*Iron||Energy, pregnancy maintenance, fetal & parental red blood cells, prevention of preterm labor/low birth weight||Red meat, some dark green leafies, nettles, molasses, some dried fruits||18 – 60 mg||Take separately than Calcium and Magnesium|
|*Folic Acid||Healthy cell division, prevention of neural tube defects||Leafy greens, whole grains, fortified cereals, salmon, organ meats||800 mcg – 5 mg||Current guidelines = 5 mg per day during preg|
|*B6||Hormone metabolism, mood; used to treat nausea in pregnancy||Meat, organ meat, leafy greens, blackstrap molasses, brown rice…||25-100 mg|
|*Vit C||Healthy vessels and tissues (helps prevent varicose veins & hemorrhoids, premature rupture of membranes)||Vegetables (broccoli, potato, peppers), some fruits||100 – 2000 mg||Also immune supportive!|
|Calcium||Healthy baby bones, maternal muscle tone (including uterus)||Tahini/sesame seeds, almonds, broccoli, kale, collards, milk products||1200 mg||Ensure you have enough Mg before supplementing Ca|
|*Magnesium||Preventing muscle cramps, constipation; helps w sleep, blood sugar balance||Green veggies, beans, nuts, seafood||450 -1000 mg|
|B1 (thiamine), B2 (riboflavin), B3 (niacin), B5, B12||All essential for various functions. Food sources may be adequate||Whole foods; Note that B12 is ONLY present in animal foods||2-100 mg||Part of multi or multi-B complex|
|Zinc||Immune system function, healthy fetal growth & development||Seafood, mushrooms, organ meats, spinach, sunflower seeds||20 -50 mg||If needed, take in small doses, with food, to avoid nausea|
|*Probiotics||Digestive & immune system health, Prevention of GBS + status in labor, prevention/reduction of allergies & eczema in infants||Fermented foods||15 billion good quality, strain-specified units per day||Supplement esp in third trimester|
|*EPA/DHA (Essential Omega 3s)||Fetal brain development (DHA), decreased allergies for infant/child, maternal mood, heart health, decreasing inflammation, blood sugar regulation (EPA)||FISH, fish oil||~600 mg EPA, ~3-400 mg DHA||Source matters! Ask for advice re clean, stable, pure fish oil brands|
Other nutrients to consider: Iodine (found in seaweeds, essential for healthy thyroid function), Beta- carotene (richly colored vegetables, esp orange & red, needed for eye development & various other functions), chromium, selenium…
Mahalia Freed is a naturopathic doctor happily practicing in Toronto. In her family practice, Mahalia has a special focus in endocrinology (including PMS, PCOS, thyroid concerns), mental health, oncology, fertility, and perinatal care.