Do I need to take a prenatal supplement for pregnancy?
A recent research study identified 90% of pregnant women do not meet nutrient requirements during pregnancy from food alone and must rely on supplementation to help meet their increased needs.
Yet, 99% of the 20,000 supplements available (US) did not meet requirements for 6 essential nutrients during this life phase (vitamin A, vitamin D, folate, calcium, iron and omega-3 fatty acid).
These nutrients are crucial for proper fetal growth and development, and deficiencies can increase the risk of miscarriage and increase the risk of serious health conditions such as neural tube defects.
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What does this mean?
Firstly, it highlights how difficult it can be to meet the increased requirements needed for fertility and pregnancy. Even someone with the best intention may suffer from morning sickness, food cravings and food aversions which may interrupt their ‘ideal eating plans’.
I also want to point out this is why preconception planning to help build up stores BEFORE pregnancy is important. Suboptimal nutrient intake is also associated with reduced fertility, and poor egg quality and taking a good quality prenatal should be part of your preconception plan.
It also highlights you can’t just grab any old prenatal, forget your diet and expect it to do everything you need it to. Finding the ‘perfect supplement’ or supplement regime takes a bit of craftsmanship- it’s finding a beautiful balance between your need and requirements and your current dietary intake.
To book a prenatal supplement plan and have a fertility nutritionist design the perfect prenatal regime specifically for you- click here & apply the $10 off discount code 'PRENATALSUPP10'
So, how do you pick a prenatal supplement?
General Tips:
Pick from a reputable company
Check the ingredients are in the dosage you are looking for and in their most bioavailable form.
Check there are no unnecessary or ‘filler’ ingredients.
Ideally start taking your prenatal 3-4 months before conception, right through pregnancy and even into postpartum to support recovery and breastfeeding.
Consider the following nutrients:
Folate/ folic acid
Folate is the naturally occurring B vitamin and folic acid is the synthetic form, folate is necessary for DNA synthesis, gene expression and helps to prevent early pregnancy defects that can lead to miscarriage including preventing neural tube defects. Folate intake is extremely important in the 1st trimester (and even before pregnancy for egg development) and remains to be important throughout pregnancy.
Many prenatal contain folic acid (the synthetic form) however given the increased awareness of MTHFR gene mutation, between 15-30% of the population may not be able to activate folic acid, so consider opting for a prenatal containing the activated form L-methyl folate or follinic acid.
Some people with a history of epilepsy, neural tube defects, diabetes or inflammatory bowel disease, or those with a high BMI, may require additional folic acid.
Vitamin D
Vitamin D is one of the most important nutrients for fertility, its essential in hormone production, boosting egg quality and supporting implantation by facilitating the fertilisation of the egg. Suboptimal and low vitamin D status is associated with decreased fertility and lower rates of IVF success. It also directly impacts AMH production which is highly associated with maintaining ovarian reserve.
Vitamin D deficiency is much more common than you would imagine, in fact, 1 in 4 Australians are deficient, unsurprisingly geographical location and season impact the prevalence.
Of course, the sun is the ultimate source of D3 (activated vitamin D) through short and sensible sun exposure. In supplements, two forms are available cholecalciferol (D3) (animal-based form) or ergocalciferol (D2) (plant-based form). Our bodies prefer the D3 form and cholecalciferol is shown to raise vitamin D stores more effectively than D2.
Many prenatal vitamins contain some vitamin D, usually around 400IU, however, for many people this amount will not meet their needs. Your unique requirements should be based on your recent blood work, please discuss your ideal dosage with a professional before starting any supplements.
B12
Vitamin B12 and folate (b9) work synergistically for many physiological processes including the synthesis of DNA, and B12 is also critical for hormone production. A B12 deficiency is associated with impaired egg development, abnormal ovulation and can impact implantation.
B12 is usually found in animal-based products including eggs and dairy, while we don’t need much of it anyone following a vegan or vegetarian diet may struggle to meet the demands. When looking at a prenatal 2.6mg to 5mg a day is sufficient as either cobalamin or in its’s activated form, methylcobalamin.
Choline
Choline also plays a role in reducing the risk of neural tube defects, reduces the risk of miscarriages, supports healthy growth of the placenta, supports baby's brain development and may also play a role in ovarian function.
It’s naturally found in eggs, meat, beans and legumes. Despite its importance, it’s not commonly found in many prenatals, however, a daily dose of 450mg is recommended.
Iron
Iron is another essential mineral for fertility and pregnancy, iron deficiency is one of the main causes of amenorrhea (missing period) and of course, if you don’t have a period and are not ovulating you can’t fall pregnant. Iron requirements really step up during pregnancy, and by the second half, requirements are almost double that of a none pregnant person.
Iron deficiency is extremely common and should be tested for prior to trying to conceive when you do conceive and around 20 weeks gestation if you are prone to low iron.
The difficult thing is, iron can cause constipation, so look for an iron amino acid chelate such as iron bis-glycinate. Iron also competes for absorption with other nutrients usually found in a prenatal (zinc, calcium etc) so if you have low iron it may be best to address that in a separate supplement. This should be taken at least 2 hours before or after your prenatal. Please seek advice on what dosage is suitable for you.
Iodine
Iodine supports thyroid health, which helps to regulate many of our bodily systems, including menstruation. Iodine deficiency is associated with infertility. Iodine continues to be important through pregnancy as the thyroid hormone is involved in baby's brain development.
Iodine deficiencies are becoming more common due to a reduction in soil quality and as people move away from foods that have been fortified with iodine.
Iodine is found in fish, seafood, seaweed and iodised salt. Look for a prenatal which contains ideally 220 mg, or at least 150 mg of iodine.
Omega 3- EPA/DHA
Omega-3’s, specifically EPA & DHA (found in fatty fish) are crucial for fertility and pregnancy, aid in egg quality, support implantation, reduce the risk of preterm births, essential for fetal brain development and protective against postpartum depression. Wow, there’s really not a lot they don’t do when it comes to fertility and pregnancy! Read more about Omega-3's here.
Supplementing may be important if consuming fatty fish isn’t part of your diet 2-3 times a week. The current Australian recommendation is only 115 mg of omega-3 fatty acids in total, however, the American Pregnancy Association recommends at least 300 mg daily intake of DHA, and various studies report a greater dose may be more appropriate depending on the mother's diet. However, a prenatal is unlikely to contain a high dose of DHA, so an additional supplement may be required, again this should be discussed with your fertility nutritionist.
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Other important nutrients to consider in your prenatal are; vitamins B3, B6, selenium, magnesium, zinc and calcium- but maybe I’ll save those for another day!
Please note: This blog is for general information purposes only, it does not replace individualized advice provided by your healthcare provider or fertility nutritionist.
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