Larissa Telfer Dietitian
Taking a pregnancy multivitamin is important to ensure you meet the increased nutritional needs of pregnancy. But choosing which brand or which nutrients you need to supplement can be confusing, leaving us to grab whatever is on special. Pregnancy multivitamins often include a large range of vitamins and minerals, but what nutrients are actually crucial to be taking?
The nutrients where supplementation is recommended for all pregnant women are:
Required for healthy cell division and for prevention of neural tube defects, the recommended daily intake (RDI) for folate significantly increases in pregnancy, particularly in the first trimester. Ideally folate supplements should be started at least one month prior to conception. Most pregnancy multivitamins contain 500mcg, which is adequate for most women when combined with dietary intake. However, women with some conditions such as diabetes, require much higher doses of folate up to 5000mcg due to increased risk of neural tube defects.
Required for the regulation of thyroid function and metabolism, also crucial for baby’s brain and nervous system development. Iodine deficiency in pregnancy has been link to poorer academic performance in children. For this reason the RDI for iodine increases in pregnancy to 220mcg from 150mcg prior to pregnancy. Supplementation in pregnancy is recommended to assist meeting these increased needs. Pregnancy multivitamins contain between 150mcg to 250mcg.
In case of nutritional deficiency:
Essential in pregnancy for the regulation of calcium and phosphate levels, important for the development of bone strength in the developing baby. Vitamin D deficiency in pregnancy has been associated with increased risk of preeclampsia, gestational diabetes and low birth weight. Children of mothers with deficient vitamin D in pregnancy have reduced bone size and strength. The amount of Vitamin D in pregnancy multivitamins ranges from 200-1000IU. Vitamin D levels can be checked by a blood test to help determining how much Vitamin D you should be taking.
Iron is a key component in haemoglobin in our blood. The RDI for iron increases from 18mg to 27mg during pregnancy due to the extra blood volume. Routine supplementation is not recommended unless blood levels are low. Pregnancy multivitamins usually contain iron ranging from 7.5mg to 60mg to assist reaching the increased RDI. However, more is not always better as many women experience nausea and GI upset as a side effect of iron supplements.
Other nutrients commonly included in pregnancy multivitamins include Calcium, Magnesium, Vitamin B12, Vitamin B3 (Niacin), Zinc, Omega-3’s, Selenium and Choline. Supplementation is advised when dietary intake is inadequate, for example, women not consuming enough dairy foods should take 1000mg calcium supplement daily.
It is important to remember that multivitamins are a supplement to what we eat and can’t replace a healthy diet. If you are avoiding certain food groups you may need higher doses of some nutrients. However, more is not always better too much of some nutrients can have detrimental effects on baby’s development.
If you want to check which nutrients supplements you should be taking for pregnancy and conception a prenatal Dietitian will be able to tailor a plan for you, taking into account your food intake and individual needs.
RANZCOG, Vitamin and mineral supplementation and pregnancy (C-Obs 25), Nov 2014