What to Look For in a Prenatal Vitamin By Alicia Barney, Diana McKeon Charkalis, and Maria Pari-Keener, MS, RD
Prenatal vitamins often have a mile-long ingredient list that seems to include the whole alphabet of vitamins, but you should look for the right amounts of a few key nutrients, including:
Perhaps the most important ingredient in a prenatal vitamin is folic acid, a vitamin that can help prevent birth defects of the brain and spine (called neural tube defects). The March of Dimes recommends that all women of childbearing age get 400 micrograms of folic acid daily; increase that amount to 600 micrograms of folic acid daily once you become pregnant. Many prenatal vitamins include more, which is fine, says Julie Levitt, M.D., an ob-gyn at Women's Group of Northwestern in Chicago, because the folic acid found in supplements is more easily absorbed by our bodies than folate, the naturally occurring version.
Prenatal vitamins with iron should be a top priority. You'll need twice as much of this mineral, now that you're pregnant, to make extra blood to take care of your baby. Pregnant women should get 27 milligrams of iron each day.
This mineral is vital for the development of your baby's bones, teeth, heart, muscles, and nerves, and mamas-to-be should get 1,000 milligrams daily. Getting enough calcium should be a priority: Skimping now could increase your risk of osteoporosis later in life. "What the fetus doesn't get through the diet, the fetus will take out of mom's bones," says Scott Sullivan, M.D., the director of maternal-fetal medicine at Medical University of South Carolina. "A supplement protects mom from being the calcium reservoir."
This vitamin helps you absorb calcium and is important for your baby's bones, teeth, eyes, and skin. March of Dimes suggests getting 600 IU (international units) of vitamin D a day during pregnancy, and many doctors recommend even more—800 or 1,000 IU—because many people are deficient.
During pregnancy you need 220 micrograms of iodine every day to help your baby's brain and nervous system, according to March of Dimes. Dr. Sullivan recommends your prenatal pill have at least 150 micrograms (foods like fish and dairy can make up the rest) and says the source should be potassium iodide, as iodine from kelp can break down before you get a chance to take it.
How Many Supplements Do I Actually Need?
A prenatal vitamin will often contain 100 percent of the recommended daily allowance (RDA) for folic acid, and 100 percent or more of the RDA for iron, but it may have only around 250 mg of calcium, so if you don't get much in your diet (if you're vegan, for instance, or lactose intolerant) consider taking an additional supplement. You'll want to down it at a different time of day than your prenatal vitamin, as large amounts of calcium can't be absorbed along with the iron in your prenatal vitamin, says Dr. Levitt. You could take your iron supplement in the morning and your calcium supplement at night.
What About Side Effects?
It's ironic that the time when many women can't keep anything down (early pregnancy morning sickness, anyone?) is crucial to getting key nutrients via sometimes bulky and smelly pills. Downing vitamins on an empty stomach can make nausea worse, so try taking them with smooth-textured food you do like (applesauce, smoothies, or ice cream).
While there's not much risk of over-supplementing, overdosing on vitamin A, however, can cause birth defects. Skip anything that lists more than 100 percent of the recommended dietary allowance of vitamin A on the back of the bottle, says Dr. Levitt.
When in doubt, ask your doctor about your prenatal vitamin and any other supplements you're taking. You'll want a vitamin you're comfortable with since you shouldn't necessarily drop the pill after delivery. Most doctors recommend taking a prenatal vitamin as long as you're breastfeeding, or even longer if you plan to have another baby soon—a choice that makes picking a vitamin seem like a breeze!