Supplements

So you’ve just found out your pregnant! A myriad of emotions will be running through you and you may start to wonder what do I need to do to support my myself and my unborn baby? Good nutrition is paramount!

Aside from good nutrition supplements are equally as important, I wished we lived in a world where supplementation wasn’t necessary that we could get all our essential vitamins and minerals only through food. Unfortunately, with modern agricultural practices, pesticides, antibiotics and poor soil quality our fruits and vegetables is not what it used to be. In fact, I learnt recently that all the fruits and vegetables you buy from the supermarket (organic doesn’t go through the same process) are essentially bathed in a bath of sanitising solution. Spinach with a side of sanitiser doesn’t quite tickle my fancy.

Unfortunately, doctors have limited knowledge in the area of supplements, it reaches about as far as knowing to take folic acid to reduce the risk of neural tube defects. This is certainly true but I’m here to tell you folic acid isn’t the best form of this vitamin to take and that most people won’t be able to convert the majority of that folic acid into “active folate” (methyltetrahydrofolate) which the body can actually utilise.

Here are the definite must have vitamins & minerals for pregnancy:

  1. FOLATE (NOT FOLIC ACID)

Folate is a B group vitamin that is essential for carrying all of our genetic information within DNA & RNA. When the body has ample supply of folate our DNA & RNA can then facilitate the formation of our cells, without proper cell division, a developing foetus’s growth is jeopardised.

During pregnancy our need for folate doubles and deficiencies are linked with neural tube defects namely spina bifida, in addition to abnormalities of the skeleton, heart and lungs, miscarriages, premature labours and anaemia 1, 2.

Taking a folate supplement prior to conception is ideal to prevent spina bifida (a neural tube defect in which the spinal cord does not close properly). Closure of spinal cord occurs around 28-29 days of conception, which of course is well before many women know they are in fact pregnant.

The recommended daily intake (RDI) for folate is 400-1000mcg. Note – women who suffer from epilepsy should be mindful of supplement dosages as large doses of folic acid have been known to induce seizures3.

  1. IRON

Iron is essential for the production of haemoglobin, which transports oxygen in the blood. Our blood volume increases by a whopping 40% during pregnancy so having an ample supply of iron on board is paramount to help prevent miscarriages and anaemia, and ensure appropriate brain, eye and bone development 4. RDI for iron is 30-60mgs.

  1. VITAMIN C

Vitamin C improves iron absorption and assists bone and teeth formation. It is also essential for the production and breakdown of collagen and is an important factor in maintaining chorioamniotic membranes, these are the membranes that make up amniotic sac that surrounds and protects your developing baby. A small but well-designed double-blind randomised controlled trail conducted in the American Journal of Clinical Nutrition found a decreased incidence of PROM (premature rupture of membranes) in pregnant women who supplemented with vitamin C after 20 week of gestation compared to a placebo5.

  1. VITAMIN B12

Vitamin B12 is another key player in red blood cell formation and is important for healthy nerve tissue development and works closely with folic acid. Often a very high intake of folic acid can mask a vitamin B12 deficiency. A study published in Pediatrics found pregnant women with a vitamin B12 level of <250ug/L tripled their risk of having a baby with a neural tube defect6. Therefore, it is imperative women planning to become pregnant or are currently pregnant have their vitamin B12 levels tested. Aim for levels higher than 300ug/L. More research is needed to assess whether levels higher than this further decease the risk.

Another new interesting body of research is beginning to link maternal vitamin B12 deficiency with increased obesity, which in turn has been associated with an increased risk of insulin resistance and gestational diabetes mellitus (GDM). Women with high folate concentrations with a vitamin B12 deficiency were at the highest risk for GDM7.

My Pregnancy Supplements

  1. CALCIUM

Our need for calcium during pregnancy and lactation is significantly increased to meet the demands of your growing baby and breastfeeding infant to support skeletal mineralisation and growth8. We all know calcium is important for the formation of bones and teeth but calcium also assists in heart function, blood clotting and nerve transmission. In fact, calcium also helps to prevent muscle cramps and pre-eclampsia. The World Health Organisation recommends where calcium intake is low a calcium supplementation is recommended to help prevent pre-eclampsia, in women who have a higher risk of developing the condition, mainly due to the increased risk of maternal deaths and pre term births9.

Calcium supplementation 1200mg/d has been shown to reduce bone resorption which basically means it reduces calcium and other key minerals being released from bones into the blood8. In turn reducing skeletal loss which commonly occurs during pregnancy.

Please bear in mind calcium supplementation should be accompanied with magnesium and vitamin D to aid absorption.

  1. MAGNESIUM

Magnesium is a wonder mineral which I’ve dedicated an entire article to. Magnesium helps with the:

  • Correct function of our nerves and muscles
  • Muscle cramps
  • Sleep
  • Anxiety
  • Liver stress due to excess hormones
  • Varicose veins
  • Haemorrhoids

I recommend at least 400mg/d and 450mg/d whilst lactating, more may be needed depending on your individual circumstances.

  1. VITAMIN K

Vitamin K is essential for blood clotting and a deficiency in this vitamin predisposes pregnant women to haemorrhages and miscarriage.

  1. PROBIOTICS

Probiotics are paramount during pregnancy, it’s estimated that up to 75% of women will experience a yeast infection in their lifetime and pregnant women have an increased susceptibility due to hormonal changes which can alter the delicate balance of gut bacteria. Remember if you’ve had to take antibiotics during pregnancy a probiotic is essential to re-establish a healthy gut flora prior and prevent a potential yeast infection from rearing it’s ugly head.

Probiotics are of particular important for women with a history or eczema and lactose intolerance. Lactobacillus rhamnosus during the last trimester and 6 months’ post-partum has been shown to reduce the risk of eczema in children10.

  1. ESSENTIAL FATTY ACIDS

I’ve dedicated an entire article on DHA omega and its importance during pregnancy but in short it’s essential for healthy brain, eye and nervous system development. Children whose mothers supplemented with DHA Omega during pregnancy had higher mental processing scores, psychomotor development and eye-hand coordination11.

  1. VITAMIN D

Vitamin D is involved in foetal brain and immune development and unfortunately a deficiency is very common amongst pregnant women. Deficiencies have been linked to an increased incidence of low birth weight babies and bacterial vaginosis in pregnant women. Another important consideration is its role in peanut allergy.

A study conducted by HealthNuts in >5000 1yr old aus infants found those with vitamin D deficiency were 3 times more likely to develop a food allergy

  1. 11 times more likely to develop a peanut allergy
  2. Relationship only true in Australian children
  3. It’s not just vitamin D but a whole myriad of things

Another study by National Health & Nutrition Examination Survey

  1. 3100 children/adolescents and 3400 adults
  2. Vit D serum levels <15ng/mol correlated with IgE sensitisation to 11 of 17 allergens tested (aeroallergens and food allergens)

This association does not prove causation; thus further research is needed.

  1. IODINE

Iodine is essential for early brain function and development in children and is detected in every organ and tissue in your body12. Particularly during the first 12 weeks of pregnancy, before your baby’s thyroid is developed and becomes active, the mother is the sole source of thyroid hormones.

A study published in 2013 demonstrated a mild iodine deficiency during pregnancy produced offspring with a decreased intellect. Mothers with low iodine in early pregnancy had children with lower IQs at age 8 compared to controls and also have significantly poorer reading ability at age 913.

How Much?

  • 200mcg/d for pregnant women
  • 290mcg/d for lactating women

 

  1. ZINC

Zinc is needed for early on embryonic development and cell division, meaning it ensures unborn babies bits and pieces develop and grow in the right places. Deficiencies have been linked to miscarriage early on due to immune dysfunction, hormonal or poor embryo development. Unfortunately, it’s the most common deficiency throughout preconception and pregnancy, in particular for women who been on the oral contraceptive pill (OCP), which is known to deplete our bodies of this essential mineral.

Zinc also helps to keep the immune system of pregnant women strong, which is often depleted due to the increased demand. If this wasn’t enough to convince you to take zinc straight away, then maybe this will. Zinc REDUCES stretch marks and cracked nipples, as it improves the elasticity of the skin14.

Phew you must be exhausted after reading all of the information, but it’s important to understand what vitamins and minerals you and your unborn need to ensure a safe, happy and healthy pregnancy and baby once earth side.

Here is my wrap on my top 12 vitamins and minerals during pregnancy with dosages. And for those who are dying to know I’ve also included the current supplements I take and recommend.

  1. Folate

Dose: 400mcg-1000mcg/d

Best Form: Methlytetrahydrofolate – (Obtain from Thorne Basic Prenatal – Best pregnancy multivitamin going around)

  1. Iron

Dose: 30-60mgs/d

Best Form: Iron Bisglycinate

  1. Vitamin C

Dose: 100mg-500mg/d

  1. Vitamin B12

Dose: If deficient 1000-5000mcg/d

If not deficient 3mcg during pregnancy and 3.5mcg during lactation

Best Form: Methylcobalamin

  1. Calcium

Dose: 1100mg during pregnancy / 1200mg during lactation

  1. Magnesium

Dose 400mg/d during pregnancy / 500mg/d during lactation

Best Forms: Magnesium citrate, magnesium orotate or magnesium bisglycinate

  1. Vitamin K
  2. Probiotics
    1. Best to see a healthcare practitioner who can decide which one is best for you and your circumstances
  3. Essential Fatty Acids
    1. 1st Trimester
      1. 430-860mg daily
    2. 2nd Trimester
      1. 860-1720mg daily
    3. 3rd Trimester
      1. 1700- 2500mg daily
    4. 0-4months
      1. 1700-2500mg daily
    5. 4 months +
      1. 900-1700mg daily
    6. Vitamin D

Dose: If deficient 1000IU-3000IU/d / If adequate 300-600IU/d

  1. Iodine

Dose: 200mcg/d for pregnant women / 290mcg/d for lactating women

  1. Zinc

Dose: 30-50mg/d a night away from iron supplement

Best Form: Zinc Picolinate next best is zinc citrate

My Current Supplement Regime

  • Thorne Basic Prenatal
    • This is by far the best pregnancy multivitamin you can purchase unfortunately it’s not sold in Australia but can be purchased online at iherb.com
  • Bioceuticals DHA Omega
  • Sandra Cabot Magnesium Complete
  • Bioceuticals Muscleze P5P
  • Metagenics Ultraflora SB Dysbiosis
    • I’m prone to recurrent thrush and UTIs
  • Nutri Doc Zinc Picolinate
  • Nordic Naturals Pro EFA
    • This is based on my individual needs
  • Flordis Ellura
    • This is the only cranberry supplement I’ve found you can take during pregnancy for UTIs. I take this sporadically if I feel a UTI coming on.

In health and happiness,

Megan Jane

Naturopath | Medical Scientist | Nutritionist

BBioMedSci

BClinSci

 

References

  1. Henderson I MD. American Medical Association records released in 1987 during trial in U.S District Court Northern Illinois Eastern Division, No. 76C 3777. May, 1987
  2. Hultman C. Austim May Result From Intra-uterine Growth Restrictions, Foetal Distress. Epidem. 2002;13:417-423.
  3. Roberts J. Fabulous Folic. Informed Choice; Spring: 2004.
  4. Brewer S Dr. Super Baby. Boost your Baby’s Potential from Conception to Year 1. London: Harper Collins; 1988.
  5. Casanueva E, Ripoll C, Tolentino M, Morales RM, Pfeffer F, Vilchis P, Vadillo-Ortega F. 2005. Vitamin C supplementation to prevent premature rupture of the chorioamniotic membranes: a randomized trial. Am J Clin Nutr. Apr;81(4):859-63.
  6. Author manuscript; available in PMC 2014 Sep 12. Published in final edited form as: Pediatrics. 2009 Mar; 123(3): 917–923. doi: 10.1542/peds.2008-1173
  7. Anne M. Molloy, N. Kirke, James F. Troendle, Helen Burke, Marie Sutton, Lawrence C. Brody, John M. Scott, and James L. Mills. 2014. Maternal Vitamin B12 Status and Risk of Neural Tube Defects in a Population with High Neural Tube Defect Prevalence and No Folic Acid Fortification. Nutr J. 2014; 13: 116.
  8. Adrienne S Ettinger,corresponding author Héctor Lamadrid-Figueroa, Adriana Mercado-García, Katarzyna Kordas, Richard J Wood, Karen E Peterson, Howard Hu, Mauricio Hernández-Avila, and Martha M Téllez-Rojo. Effect of calcium supplementation on bone resorption in pregnancy and the earlypostpartum: a randomized controlled trial in Mexican Women. Nutr J. 2014 Dec 16;13(1):116.
  9. World Health Organisation. 2011. WHO recommendations for prevention and treatment of pre-eclampsia and eclampsia.
  10. Rautava S, Kainonen E, Salminen S, & Isolauri E. 2012. Maternal probiotic supplementation during pregnancy and breast-feeding reduces the risk of eczema in the infant. J Allergy Clin Immunol. 2012 Dec;130(6):1355-60.
  11. Singh, M. (2005). Essential fatty acids, DHA and human brain. Indian J Pediatr. Mar;72(3):239-42.!
  12. Leung, A.M. et al. (2011). Iodine nutrition in pregnancy and lactation. Endocrinol Metab Clin North Am. Dec; 40(4):765-77.
  13. Bath S, Steer C, Golding J, Emmett P, Rayman M & Phil D. 2013. Effect of inadequate iodine status in UK pregnant women on cognitive outcomes in their children: results from the Avon Longitudinal Study of Parents and Children. The Lancet. Volume 382, No. 9889, p331–337.
  14. Naish F. Roberts J. The Natural Way to Better Babies. Australia: Random House; 2000.

 

 

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