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
One of my favourite things to do on a slow Sunday morning is make pancakes. This is a great way to use up any over ripe Bananas at the end of the week. Using ripe Bananas with cinnamon gives enough sweetness and flavour without needing sugar. The addition of oats adds more fibre and protein and lowers the GI of the pancakes.
I love to serve pancakes with berries fresh or frozen, Greek yoghurt with maple and some nuts or seeds for crunch.
Makes 6 large or 10-12 small pancakes
2-3 Bananas (riper the better)
½ cup milk
1 cup rolled oats
1 cup spelt (or self raising) flour
Butter or margarine for cooking
per serve 2 large pancakes without toppings
Energy 1600kj (380 calories), 13g protein, 70g Carbohydrate, 7g fibre
To make gluten free, swap self raising flour for almond meal or gluten free flour.
Yes you can!
One of the most common misconceptions I see in practice is the need to avoid seafood during pregnancy. Studies in Australia have shown that many women are unsure about the safety of fish consumption during pregnancy, with many not aware of the health benefits of fish consumption for their babies’ development.
It is true that some species of fish need to be consumed in moderation due to the high level of mercury content. However, most varieties of seafood contain very low amounts of mercury. Generally, the larger the species of fish the higher the mercury content and these need to be eaten in moderation during pregnancy.
Types of fish to limit or avoid:
The recommendations for pregnancy are to include 2-3 serves of fish per week, with 1 serve equaling 150g, or one medium fish fillet.
Types of fish and seafood safe to include:
Nutrition Benefits of fish and seafood:
Fish and seafood are our main dietary sources of omega-3’s, with meat and eggs also containing some omega-3. Omega-3 is an essential type of polyunsaturated fat; there are 3 types of omega-3 eicosapentanoic acid (EPA), alpha-linolenic acid (ALA) and docosahexanoic acid (DHA). Omega-3’s are essential for babies brain and eye development whilst in utero and in the early years of life. Some multivitamins contain sources of omega 3, if you would like to check that you are getting enough omega-3 from your dietary intake and/or prenatal supplements, a dietitian will be able to check this for you.
The recommended amount of omega-3 for women is 90mg/day this increases to 115mg/day during pregnancy and 145mg/day for breastfeeding women. One of the highest dietary sources of omega-3 is salmon with 100g serving containing around 2100mg omega-3.
Fish and seafood is a high quality lean source of protein making a great addition to a balanced diet to assist with achieving healthy weight gain during pregnancy.
In pregnancy ready to eat seafood (for example cooked prawns from the deli), and raw seafood should be avoided. However freshly cooked fish and seafood are safe to eat.
Make sure all seafood is cooked to at least 63°C. Tinned tuna and salmon are also safe to eat during pregnancy, and are a convenient source of protein to have in your pantry.
Healthy ways to include more fish or seafood:
FSANZ Advice on fish consumption:
NSW Food Authority, Pregnancy foods to eat or avoid when pregnant.http://www.foodauthority.nsw.gov.au/foodsafetyandyou/life-events-and-food/pregnancy/foods-to-eat-or-avoid-when-pregnant
Sinikovic et. al. Women’s awareness of the importance of long chain omega-3 polyunsaturated fatty acid consumption during pregnancy: knowledge of risks, benefits and information accessibility. Public health nutrition, 2009, Volume 12(4):562-569.
Emmett et. al. Expanding awareness of Docosahaxaenoic acid during pregnancy. Nutrients, 2013 Volume 5 (4):1098-1109.
Starling et. al. Fish intake during pregnancy and foetal neurodevelopment – A systematic review of the evidence. Nutrients, 2015 Volume 7 (3): 2001-2014
Oken et. al. Fish consumption and Docosahaxaenoic acid (DHA) supplementation in pregnancy. Up to Date, 2018