Choosing a Prenatal Vitamin Supplement

Most health care providers recommend that women take prenatal supplements for vitamins and minerals even before they conceive. These supplements provide extra nutrients for a usually healthy diet and big nutritional boosts when for women who suffer nausea and vomiting due to morning sickness. Think of a prenatal supplement as an insurance policy--a way to ensure you and your unborn baby are getting the key nutrients needed during preconception, pregnancy, and breastfeeding.

With myriad prenatal supplements available, how do you make the right choice? By working closely with your health care provider and following this checklist, you can choose the best prenatal supplement to meet your needs.

First, ask your health care provider if he or she recommends a specific brand or type of prenatal supplement. Your caregiver may prescribe a prenatal supplement as a prescription, which your insurance may or may not cover. Sometimes this prescription will take the guesswork out of choosing a supplement on your own, but they are not much different than what you can buy over-the-counter, which may also be cheaper, depending on your insurance coverage.

If your health care provider indicates that an over-the-counter prenatal supplement is adequate, the following checklist will help you choose the best supplement to meet your needs. Read the nutrition label and select a supplement that contains all of the following vitamins and minerals in these approximate amounts:
Vitamin A: 4,000 to 5,000 International Units (IU)
Folic Acid (Folate): 600-1000 micrograms (mcg)
Vitamin D: 200-400 IU
Calcium: 200-300 milligrams (mg)
Vitamin C: 85 mg
Thiamin: 1.4 mg
Riboflavin: 1.4 mg
Vitamin B-6 (Pyridoxine): 1.9 mg
Vitamin B-3 (Niacin): 18 mg
Vitamin B-12: 2.6 mcg
Vitamin E: 15 mg
Zinc: 11 mg
Iron: 27-60 mg

Ask your health care provider if you should take an additional calcium supplement. You need about 1,000 milligrams of calcium each day to keep your bones and teeth strong, and for your baby's developing bones. Most prenatal supplements contain between 100 and 300 milligrams. Typically, a supplement does not contain more calcium because it would make the bulk and size of the tablet too large. If you are not eating at least three servings of calcium-rich dairy products daily ask your caregiver if you need an additional calcium supplement.

Ask your health care provider if you should take additional iron. Your body is making more blood throughout pregnancy to support your growing baby, who is storing iron as well. To meet these needs, pregnant women need at least 27 milligrams of iron daily. Your prenatal supplement should contain between 27 and 60 milligrams.

However, some pregnant women's blood tests will reveal that they need even more iron. Your caregiver will let you know if you have iron deficiency anemia. If this is the case, he or she will probably advise an additional iron supplement, usually containing 60 to 120 milligrams. Research suggests that iron may also help you bond with your baby, and prevent postpartum depression.

Ask your health care provider if you should take additional folic acid. Research shows that folic acid can reduce your baby's risk of serious brain and spinal cord defects, known as neural tube defects. Medical authorities recommend a daily intake of 400 micrograms, starting at least one month before you begin trying to conceive, and at least 600 micrograms daily once you know you are pregnant. Most prenatal supplements contain between 600 and 1000 micrograms of folic acid.

If you have previously given birth to a child with a neural tube defect, discuss your folic acid needs with your physician before getting pregnant. Studies have shown that taking a larger daily dose (up to 4,000 micrograms) at least one month before and during the first trimester of pregnancy may reduce your risk of having another baby with neural tube defects.

Ask your health care provider if you should take any essential fatty acids. DHA (Docosahexaenoic acid) is an omega-3 fatty acid that is important in the development of your baby's brain, nerves, and eye tissue. A recommended daily intake for DHA has not been established, but many health professionals suggest 300 milligrams a day during pregnancy. You can meet this need by eating about five to ten ounces of cold water fish each week. Since very few Americans consume that much fish, your caregiver may feel that you would benefit from a supplement that also contains DHA or an additional omega-3 fatty acid supplement. Discuss this with your physician.

Once you have chosen your prenatal supplement, follow these additional tips for safety and effectiveness:

Safely store ALL of your supplements out of reach of children. When taken inappropriately, supplements (especially iron) can be fatal to children.
Take your supplement daily, following the directions of your health care provider or the directions on the label.
Do NOT take any additional vitamin, mineral, or herbal supplements unless prescribed by your caregiver.
If you experience difficulty swallowing your prenatal supplement, notify your health care provider. Prenatal supplements can be large and some women find them difficult to swallow. Your practitioner may be able to prescribe a smaller pill or one with a slick coating that goes down easier. Chewable and liquid versions are also available.
Notify your health care provider if your prenatal supplement upsets your stomach. Certain nutrients (especially iron) in your supplement can upset the stomach. Iron supplements can cause nausea, belching, constipation, or diarrhea. If you think your supplement is causing distress, tell you practitioner. He or she may recommend a different formulation or a smaller amount. You may be advised to take your supplement with meals or earlier in the day, or given suggestions on how to deal with constipation.