Prenatal Vitamins: A Primer
Prenatal Vitamins: A Primer
By: Dr. George Obikoya
A prenatal supplement is a vitamin and mineral
supplement you can take daily to make sure you're getting the right
amount of certain important nutrients during pregnancy. Unfortunately,
though, since the Food and Drug Administration doesn't regulate
what goes into supplements, there are no set standards for what
should be in them. It is, therefore, up to you and your doctor to
make sure you choose one that's safe and appropriate for you. A
high-quality liquid multivitamin will provide you will all the vitamins
and minerals needed for you and your baby.
Do you really need prenatal vitamins? Fifty percent of birth defects
can be prevented by pregnant women taking prenatal vitamins before
pregnancy. The quantity of folic acid required by the fetus cannot
be obtained by diet alone. By taking vitamins as early as three
months prior to becoming pregnant, you are ensuring the health and
well being of your future baby.
What should you look for in prenatal vitamins? You should in general
look for one that has more of folic acid and iron than you can get
from your diet. Just as important is that it should not have more
than the recommended amounts of other nutrients. This is particularly
so of vitamin A. Too much vitamin A made from animal products can
cause birth defects. Ensure you are taking a prenatal vitamin or
a multi-vitamin with under 10,000 IU of vitamin A.
This is one reason that most prenatal supplements contain vitamin
A at least partly in the form of beta-carotene, a nutrient that
you get from fruits and vegetables that converts to vitamin A in
the body. Unlike vitamin A from animal products, which has been
known to cause birth defects when taken in high doses just before
conception or during pregnancy, beta-carotene is not toxic in high
doses.
Also too much iron in a prenatal vitamin will be poorly absorbed.
So, check on its amount in the supplement you plan to buy too. When
considering absorption, know that liquid vitamins absorb 5 times
better than do pill vitamins.
Your doctor may recommend that you start taking a prenatal supplement
at your first prenatal checkup. If so, you may be given a prescription
for a particular prenatal vitamin or just suggest that you buy a
particular over-the-counter brand at the drugstore. If you do take
a prenatal supplement, make sure you're not taking any other vitamin
or mineral supplement along with it unless your doctor so recommends.
Ask your doctor to prescribe a daily prenatal multivitamin that
contains the recommended amounts of vitamins and minerals you need
for a healthy pregnancy. Folic acid is especially important. You
need 600 micrograms daily, because it helps prevent neural-tube
defects such as spina bifida. Consider raking calcium supplements
if you can't make the quota of at least 1,000 milligrams a day.
And steer clear of herbs and other botanicals, as their safety remains
to be proven during pregnancy and lactation.
If you're taking vitamin supplements to try to prevent birth defects,
you may not be getting what you pay for. Back in 1997, a researcher
at the University of Maryland at Baltimore found that just three
of nine prenatal multivitamins he tested released enough folic acid
to meet recommended standards, and some greatly missed the mark.
To be sure you get enough folic acid daily, buy supplements with
a USP symbol on the label and take them with food to enhance absorption
unless directed otherwise by your doctor.
The use of 0.4 mg folic acid from 3 months before conception has
been shown to reduce the risk of neural tube defects by 73%. No
reduction has been shown in women who start folic acid after 6 weeks'
gestation. It is, therefore, important that you start folic acid
supplementation well before you become pregnant.
If you're healthy and you eat a very balanced diet and has no specific
risk factors, some will say you need not take a prenatal supplement
but that you need to take 400 micrograms (mcg) of folic acid a day
plus that you get in your diet is not contended. Indeed, it is recommended
that you start doing so at least a month before you become pregnant
and during your first trimester.
Since half of all pregnancies are unplanned, the U.S. Public Health
Service recommends that all women of childbearing age take 400 mcg
of folic acid a day because there is research evidence research
that this can reduce the risk of neural tube defects in your baby
by up to 70 percent.
Most prenatal supplement contain between 600 and 1,000 mcg of folic
acid. You can get your folic acid from a separate folic acid supplement.
If you've previously had a baby with neural tube defects, you'll
need to take 4,000 mcg, or 4 milligrams, of this vitamin each day
starting at least a month before you become pregnant.
Because most women don't get enough iron in their diet, prenatal
vitamins can ensure that you do. You need to have enough iron in
your body to meet its increased needs during pregnancy. It is recommended
you take 27 mg of iron per day during pregnancy, 50 percent more
than you need when you're not. Most prenatal supplements contain
between 27 and 60 mg.
Your body makes a lot more blood when you're pregnant to support
your growing baby, and as a result, the iron stores in your blood
can get quite low. To avoid getting iron-deficiency anemia during
pregnancy, most women need to take a supplement. For some women,
the amount in their prenatal supplement is enough, but others may
need to take even more during pregnancy. Ask your doctor to tell
you just how much you need. Your prenatal blood work will guide
your doctor in doing so.
Unlike with folic acid, except you are anemic before getting pregnant,
you should wait until you are pregnant or even until you're through
your first trimester to take extra iron, since high doses of the
mineral can make nausea and constipation worse. Women with iron-deficiency
anemia are usually advised to take between 60 and 120 mg of supplemental
iron each day in addition to a prenatal supplement.
Women with certain health issues, dietary restrictions, or pregnancy
complications need to take a prenatal supplement, including folic
acid and iron. This group of women includes vegetarians and vegans,
women who are lactose-intolerant or have certain other food intolerances,
smokers and women who abuse other substances, women who are having
twins or higher multiples, and women with certain blood disorders
and certain chronic illnesses.
A good multivitamin is the foundation of health
and nutrition. Take a look at our scientific reviews of many of
the popular brands for factors such as ingredients, areas of improvement,
quality level, and overall value. If you are looking for a high
quality liquid multivitamin, we suggest that you take a look at
the Multivitamin
Product Comparisons.
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