Prenatal supplements. So many options. So much confusing information! Wouldn't it be awesome if you could just go to Walgreens or the drugstore and snag a prenatal vitamin off the shelf and know it has all the nutrients you need?
Unfortunately, this isn't the case. Not all prenatal supplements are created equal and many don't have all the nutrients you need to support your growing body and create a tiny human!
Prenatal supplements are like an insurance policy. They are not a replacement for eating real, whole nutrient dense food, but it is an opportunity to increase your chance of getting all the nutrients you need throughout pregnancy and postpartum, especially as pregnancy aversions, cravings, or lack of resources may keep you from eating a varied diet.
Quick side note: I know these are called "prenatal" supplements, but it is incredibly important to CONTINUE your supplements postpartum. Remember! You are still growing another human, they are just on the outside! So to be sure you can maintain your own nutrient stores, promote health and postpartum recovery, while growing a cute and strong kiddo, keep taking these through your breastfeeding journey or at least 3 months postpartum if breastfeeding is not an option.
5 Supplements You Need in Your Prenatal Routine
Ideally your prenatal vitamins should contain at a minimum Folate, B-Complex, an activated form of Vitamin A, Vitamin C, Vitamin D3, Vitamin K2, Calcium, Iodine, and and Zinc. When you're choosing a prenatal multi, know that not all are created equal, meaning some ingredients cannot be absorbed or used by the body (basically making expensive urine).
When choosing a prenatal multi vitamin look for the following ingredients:
Methylated Folate, not folic acid.
Approximately 60% of the population has a genetic mutation in the MTHFR gene which impacts their ability to convert (or methylate) folic acid into its active and usuable form: folate. (1)
Folate is an essential nutrient (meaning we have to get it from food or supplement sources) that is vital for fetal development, including protein synthesis and vitamin metabolism. Folate deficiency is often linked with neural tube defects,
Even if you do not have the MTHFR defect, it may be a good idea to choose the activated form of folic acid. Stress inhibits our ability to properly methylate nutrients. (2)
You may see this listed on the ingredients list as:
Calcium with Vitamin D3 + K2
Vitamin D3 + K2 work synergistically, along with calcium to build strong bones, enable proper hormone function, protect immune function, and protect our arteries.
Because these nutrients need to work together, supplementing with just calcium, without D3 and K2, can be detrimental to overall health (4) Vitamin D3 and K2 are needed for the absorption of and metabolism of calcium (5)
According to the American Pregnancy Association, we need approximately 4000 IU of vitamin D. (5) But that will vary on your own serum levels. I highly recommend working with your provider to get your Vitamin D levels tested!
Choline is an essential nutrient that plays a role fat metabolism, DNA creation, neurotransmitter creation and provides structure to our cells!
We need a minimum of 450mg per day during pregnancy and at least 550mg per day while breastfeeding. (3)
Many prenatal vitamins won't have this nutrient included, so If liver and eggs aren't on your daily meal plan, you can supplement with phosphatidylcholine.
Prenatal Multivitamin Supplement Recommendations
Garden of Life Prenatal
Pure Synergy Purenatal
Fish contains the omega 3 fatty acids EPA and DHA. These are essential to brain development, hormone regulation, and maintaining balanced inflammatory responses.
The best real food sources include wild-caught sardines and salmon. Ideally we'd be eating at least one serving of cold water fish per day, but that's not realistic (or palatable) for many. Try your best to eat at least one serving of fish per week and supplement with a high-quality fish oil. Fish oil is not the place to skimp. Look for a supplement with strict processing standards!
Grass-Fed Organ Complex
We have several posts all about liver, how to sneak it into your diet, why you should eat it and all that jazz. But some still can't get over the taste or texture or idea. I get it! Others may have difficulty sourcing high-quality organ meats. So another option is to supplement with desiccated (freeze dried and powdered) organ meats. It's another pill to pop, but you don't have to taste it and you can still get the benefits. WIN WIN WIN WIN.
Liver, and other organ meats, are a fantastic source of B vitamins, Vitamin A, Vitamin C and choline.
Magnesium is the wonder macro mineral that we don't talk about enough, and it is especially helpful during pregnancy. Magnesium plays a role in sugar processing, stress handling, calcium metabolism and muscle relaxing.
If you're experiencing muscle cramping, especially in your legs or abdomen (make sure they aren't contractions!), nausea, difficulty sleeping, trouble with bowel movements, or high blood pressure, you may be magnesium deficient (6).
Food sources of magnesium include leafy greens, dark chocolate (true story), sesame seeds, chia seeds, and pumpkin seeds (7). Unfortunately due to modern farming practices, our soil has been depleted of important minerals. Even if you consume lots of leafy greens, you may not be getting the nutrients you hoped for.
That's where supplements come in handy. There are lots of different magnesium supplements on the market. The main three are Magnesium Citrate (commonly found in products like Natural Calm), Magnesium Glycinate and Magnesium Chloride.
I recommend magnesium glycinate or chloride for most, as they are the most bioavailable forms. Magnesium citrate has a laxative effect on the body, and isn't as readily absorbable. for other uses.
Trace Minerals Mega Mag : I add these drops to sparkling water or small glass of juice to mask the taste.
Pure Encapsulation Magnesium Glycinate. These are capsules you can take throughout the day. Before bed is especially nice as magnesium has a calming effect and can help you sleep better.
Collagen and Gelatin
Collagen is the most abundant protein in the body and is used to build healthy connective tissue, bones, hair, skin and nails. Struggling with protein aversions? Collagen to the rescue! Collagen and gelatin are also a major dietary source of glycine, an amino acid that becomes conditionally essential during pregnancy (6). Glycine helps with methylation -- converting nutrients within the body to active and usable forms!
Eating plenty of collagen rich foods will not only help build baby's strong bones, but also will help support your growing body and stretching skin. Collagen rich foods also typically contain hyaluronic acid which helps improve skin health and ease joint pain (8) all excellent things during pregnancy!
If your diet contains lots of bone broth, slow cooked meats and meat with the skin on, you are most likely getting enough collagen in your diet (6).
However, supplementing with collagen or gelatin powders can be very helpful when you can't stomach protein or want to make a quick smoothie in the morning. I add collagen peptides to my coffee every morning!
As always, choose grass-fed, well sourced collagen peptides!
Side note: Collagen can be added to cold or hot beverages and stirred in. Gelatin will gel (hence the name) when added to cold/cool liquid. We love making our own fruit gummies, but if you aren't going iced coffee gummies, then stick with collagen!
Collagen Supplement Recommendations:
My Prenatal Supplement Routine.
Please note this is specific to my body's unique needs! For example, I live in the grey (yet still beautiful) PNW, so my ability to make and convert vitamin D is limited. I choose to supplement with additional Vitamin D3+K2. I also need some love in the digestion department, so I take digestive enzymes at each meal.
If you want a more tailored approach with prenatal nutrition, let's work together! I help clients hone in on their specific nutrition, fitness and lifestyle needs to prepare for the best possible pregnancy, birth and postpartum experience.
1. James A Greenberg, Y. (2011). Folic Acid Supplementation and Pregnancy: More Than Just Neural Tube Defect Prevention. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3218540/
2. Doni, D. (2014). Folic Acid and MTHFR – Could You Have a Genetic Mutation?. Retrieved from https://doctordoni.com/2014/04/folic-acid-and-mthfr-could-you-have-a-genetic-mutation/
3. Cheatham, C. L., Goldman, B. D., Fischer, L. M., da Costa, K.-A., Reznick, J. S., & Zeisel, S. H. (2012). Phosphatidylcholine supplementation in pregnant women consuming moderate-choline diets does not enhance infant cognitive function: a randomized, double-blind, placebo-controlled trial. The American Journal of Clinical Nutrition, 96(6), 1465–1472. http://doi.org/10.3945/ajcn.112.037184
4. Bolland Mark J, Avenell Alison, Baron John A, GreyAndrew, MacLennan Graeme S, Gamble Greg D et al. Effect of calcium supplements on risk of myocardial infarction and cardiovascular events: meta-analysis BMJ 2010; 341 :c3691 Retrieved from https://www.bmj.com/content/341/bmj.c3691
5. Vitamin D and Pregnancy. (2017). Retrieved from http://americanpregnancy.org/pregnancy-health/vitamin-d-and-pregnancy/
6. Nichols, L. (2018). Real food for pregnancy. Lily Nichols.
7. Good Sources of Magnesium | Ancient Minerals. (2018). Retrieved from https://www.ancient-minerals.com/magnesium-chloride/magnesium-sources/
8. Hyaluronic Acid: Your Very Own Anti-Aging Acid. (2018). Retrieved from https://draxe.com/hyaluronic-acid/