If you are pregnant or postpartum, or even trying to get pregnant, your nutrient needs are much higher, and are sometimes hard to meet with food alone. Even if you have a solid, whole foods diet, it can be a good idea to take some vitamins, almost as insurance, that you and the growing or breastfeeding baby will get what you and they need. Especially if you experience nausea in pregnancy and aren’t able to eat all your vegetables, fish or protein, these vitamins can give you much of what your body requires. As I say time and time again with vitamins, health starts with a whole foods diet (real, unprocessed foods as much as you can), so if you are eating mac n’ cheese everyday and skipping out on fruits, veggies, healthy fats and protein, your body will have a harder time absorbing the vitamins you do take, and can be a waste of your money. So as much as you can, try to get some fat, protein and fiber in with your meals and snacks (if you need inspiration, check this post with some quick and healthy snack ideas), and these vitamins below will fill in the gaps quite nicely. A lot of my information came from Lily Nichol’s Real Food for Pregnancy, which has become my perinatal nutrition bible, so if you would like to dive deeper on (well researched and backed up with studies) food and nutrient needs during preconception, pregnancy and postpartum, grab a copy of her book.
I know all about food cravings and aversions, in my first pregnancy, all I wanted was refined carbs and sugar. My go-to’s were apple fitters from Tim Hortons, white pasta with plain pasta sauce, and daily ice cream cones. In my second pregnancy, I was eating a little healthier, but still struggled to get my veggies in. A few work arounds I had were to make hearty soups with lots of cooked veggies and animal protein, as well as daily smoothies, where I would throw in some greens (usually kale or spinach), some cruciferous veggies (always cauliflower), some fat (an avocado and/or nut butter), and protein in the form of protein powder (I used pea), or hemp hearts, add some fruit into the mix and that is a well balanced meal or snack.
Below I will get into the nitty gritty of components to look for in your vitamins, as well as different foods that contain high levels of those vitamins. Stay tuned for a future blog article on the best foods to eat prenatally.
1. Prenatal Multivitamin
When looking for a prenatal vitamin, there are so many out there to choose from. Most of which, only contain the bare minimum of vitamins and minerals needed. Research shows that levels of Vitamin D, Vitamin E, Iron, Zinc, Magnesium, and Folate are lower than recommended amounts in pregnancy.
Like all vitamins and supplements, they are not created equally, so here are a couple things to look out for.
Many of the RDAs (recommended daily allowances) are set to prevent deficiency, not set for optimal health. So in general with prenatal supplements, needs are most likely higher than estimates. A study (1) showed optimal vitamin B12 intake in pregnancy to be triple the current RDA. Other examples of studies show vitamin D needs are significantly higher than recommended as well.
A few things to look for in your prenatal.
1. Make sure B vitamins are activated (which are easier for your body to metabolize). Examples of activated B:
Folate – L-methylfolate, or 5-methyltetrahydrofolate on the ingredients label
Vitamin B6 – pyridoxal-5 – phosphate
Vitamin B12– methylcobalamin, adenosylcobalamin
2. Making sure the ingredient list includes folate and (not folic acid) is especially important, because folic acid is a synthetic form and an estimated 60% of people’s bodies genetically cannot use it in this form. 90% of the Folate in our bodies is in the form of L-methylfolate, and is therefore absorbed more easily by the body. Foods that are rich in folate are: legumes, liver, avocados, eggs, nuts, seeds, and green leafy vegetables.
3. A few other ingredients to look out for in your Prenatal multivitamin:
- Preformed Vitamin A (look for retinyl palmitate instead of beta carotene)
- Vitamin D
- Vitamin K2
Take your prenatal multi with food to help absorbability as well as nausea, and try to find a brand that requires taking more than 1 a day.
“Usually the one-a-day formulas have absolute minimum quantities of vitamins and/or leave out certain nutrients”Lily Nichols, Real Food for Pregnancy
And as Lily states time and time again in her book, a Prenatal vitamin is just an insurance policy and does not give you everything you need. The majority of the vitamins and nutrients you get will be through real food.
Good, Reputable Brands:
This one also comes in the form of a chewable and a protein powder, especially good if you are experiencing nausea and having a hard time taking a capsule. But does not contain any Iron, so if you are anemic, make sure to take an additional Iron supplement.
Although, this one has a very wide spectrum of the vitamins and nutrients required, it doesn’t contain any Iron, so if you are anemic, make sure to add an additional Iron supplement.
Thorne is more cost effective and easy to get in Canada, unlike the 2 above, but is a little low in iodine and selenium, and contains no choline or K2 which are pretty critical. The Iron levels are high, so opt for another multi if your Iron levels are ok. Optimal daily Iron amount is 27mg in pregnancy.
While this formula contains the most important nutrients, there are some that are in low quantities compared to the options above, so I would potentially take 2/ day instead of 1. The only thing to watch here is the Iron, if you don’t need extra Iron, go for another option. I do really like the fact that it has Fish Oil, so that would eliminate your need to take an extra Omega 3 (DHA) supplement, which could be an argument for spending more on this brand. It is also a Canadian company which is a bonus.
2. Vitamin D
This is a hard vitamin to get from diet alone, 90% of vitamin D in the body comes from sunlight (for people who don’t supplement with it). A study from 2011 (2) found that supplementing with higher doses of vitamin D is not only safe, but much more effective at raising the blood levels of vitamin D in mom and baby.
You should get tested for vitamin D levels (an easy blood test you can request from your doctor. Request “25-hydroxy vitamin D“), it will also depend on the time of year (how much direct sunlight you are getting daily) and the colour of your skin (higher amounts of melanin in the skin inhibits vitamin D production from sun exposure).
Most Prenatal multi’s contain only 400-600Iu. Dosage can be more precise once you know your blood levels, but some recommend at least 4,000IU/ day, and even as high as 6,400IU when breastfeeding.
Make sure to get D3 (versus D2) which the body can use more efficiently because it is chemically identical to the form of vitamin D in our bodies.
Vitamin D is fat soluble, so take it with a meal that contains some fat to make sure it is absorbed propertly.
Some other nutrients Vitamin D needs to do its job are; Vitamin A, Vitamin K2, Zinc, Magnesium. So make sure these are in your multivitamin as well.
Food Sources Containing Vitamin D
- Egg yolks (higher vitamin levels found in pasture raised hens)
- Fatty Fish
Notice that all of the Vitamin D rich foods are animal based, so if you are eating a plant-based diet, make sure to take a supplement during pregnancy to compensate.
3. Omega 3
It is recommended to get at least 300 mg of DHA per day (some studies (3) show great benefits with doses as high as 2,200mg/day) . This amount is absolutely possible if you consume 2-3 servings of cold water, fatty fish (ex: salmon, herring, sardines, trout, roe, mussels) per week. When it comes to mercury contamination in fish, the benefits of consuming fish outweigh the drawbacks. The reason being, that fish also contains high amounts of selenium, which is a mineral that binds with the mercury and prevents it from applying toxic effects in the body (4). Some fish to seriously limit or avoid altogether; tuna, making sure to not consume more than 6oz / week, as well as avoiding: swordfish, king mackerel, tilefish and shark (because of their high mercury levels).
Other food sources containing (less concentrated amounts of) DHA:
- Eggs from pasture raised chickens
- Dairy from grass-fed, pasture raised animals
- Meat (especially organs)
Example of DHA levels in fish vs. meat.
3 oz wild sockeye salmon contains 1,409mg DHA while 3oz grass fed beef contains 100mg DHA.
If you have a hard time consuming these foods, take a good quality supplement like; fish oil, cod liver oil, krill oil, or algae oil (a good source if you don’t eat fish).
Good, Reputable Brands:
Our body needs probiotics to improve the healthy bacteria in our bodies and especially our gut. So many things in our bodies respond directly to the health of our microbiome, including our digestion, vaginal health, skin and our immune system. It is estimated that 80% of our immune system is located in our gut. The health of our gut and bacterial balance is especially important during pregnancy for overall health of mom and baby. Consuming probiotic-rich foods and/or taking a probiotic supplement is linked to fewer rates of preterm births and preeclampsia, as well as lowered blood sugar levels and lowered risk of gestational diabetes.
And there was also a study done (5,6) that showed taking a probiotic supplement during late pregnancy and while breastfeeding, may protect against infant allergies, eczema, colic and spitting up.
A lot of probiotics can come from eating naturally fermented foods (see list below), as an example, just 1 tbsp of sauerkraut juice contains 1.5 trillion CFUs (Colony forming units), containing both: lactobacillus and bifidus strains.
If you are opting for a probiotic supplement, aim to get one with at least 30 billion CFU. Probiotic supplements are quite expensive, so personally, I don’t take them every day of the year. If for any reason I have to be on antibiotics, I will take some afterwards for 1-2 months to build up the healthy bacteria in my gut, after they have been wiped out by the antibiotics. I also took them in my 3rd trimester and 1-3 months postpartum.
Food Sources Containing Probiotics – Fermented Foods
- Sauerkraut – So easy to make your own, check out this blog post on how to
- Kombucha (the alcohol content is sometimes a concern for pregnant women, however, most kombucha’s have a lower alcohol content than some overripe fruit)
- Yogurt (plain)- If you have an instant pot, consider making your own with this easy recipe.
Good, Reputable Brands:
A Note on Prebiotics and Added Sugars
Prebiotic fibers feed probiotic bacteria and keep the levels optimal in your gut. Some examples of prebiotic fiber come from; nuts and seeds, vegetables, high fiber fruits, legumes, coconuts. So make sure these are part of your daily diet.
It is always a good idea to limit the consumption of added sugars and refined carbohydrates (white bread/pasta/pastries) to keep the healthy bacteria balanced in your gut. Eating an excess of sugars can feed the unhealthy bacteria and lead to poor digestion, bacterial vaginosis, or yeast infections.
Some Other Minerals to Consider:
Iron needs are almost twice as high during pregnancy due to the increased red blood cell production. The recommended dose is 27mg /day in pregnancy. It is a common practice to get iron levels checked by your doctor during pregnancy, so you can see if your body requires extra iron supplementation or if your prenatal multivitamin has enough. Some common side effects from iron supplementation are; nausea, constipation, and heartburn because the iron is poorly absorbed. That is why it is best to get your iron from food sources. Heme Iron (from animal sources) is the best absorbed (2-4x better than non-heme – plant sources).
Some ways to increase iron absorption are to consume it with foods rich in vitamin C, and avoid eating your iron-rich foods with calcium sources, as these minerals compete for absorbency.
If you are struggling to get more iron into your diet, you might want to consider cooking with a cast iron pan. Cooking in the iron pan fortifies your food’s iron levels, one example is cooking a tomato sauce in a cast iron pan increases the iron content of the sauce by approximately 29 fold (7).
Iron-Rich Food Sources:
- Liver and organ meats
- Red meat
- Dark poultry meat
Magnesium deficiency is very common and can be a great mineral to help ease restless leg syndrome, as well as reduce pregnancy related leg cramps, and can also help the mind and body relax before sleep. Magnesium bizgylycinate is the more easily absorbed form, while magnesium citrate can be taken regularly if you are experiencing constipation.
If you choose to supplement with magnesium, start with 200mg, and work your way up to 300mg/day.
Food Sources Containing Magnesium:
- Brasil nuts
- Pumkin seeds
- Sunflower seeds
- Chia seeds
- Bone broth
- Green herbs (cilantro, parsley, dill, mint, sage, basil)
While most nutrient needs increase during pregnancy, calcium needs do not. So it is rarely recommended to take a calcium supplement. Daily calcium needs are 1000mg/day in pregnancy, but most women are consuming enough calcium through their diet. And interestingly, calcium absorbability doubles in the intestines during pregnancy (8).
The thing you need to watch out for is consuming complementary nutrients, specifically vitamin D, vitamin K2, and magnesium, which help the body absorb and process calcium. And as I stated above, Iron and Calcium compete for absorbency, so if you are taking supplements of both, make sure to take supplements at different times in the day.
Calcium-Rich Food Sources
- While most people think of dairy and milk to get calcium, there are many other sources, many plant-based:
- Green leafy veg (bok choy, spinach)
- Seseme seeds
- Chia seeds
- Sardines or Salmon (canned with bones)
All of the information found in this blog article is for educational purposes only. Use this article as a resource only and PLEASE take any health concerns you are having to your health care practitioner. Be advised that the information I use to write my blog articles are based on the most up-to-date studies I can find at the time of publication. Due to the ever-changing and constantly updating field of research, you may come across information that contradicts the nature of my articles. While I pride myself in keeping up-to-date with research, I can’t be aware of all the relevant studies, so would love it of you send me any updated studies or information. Thank you for allowing me to be part of your health and wellness journey, and thank you in advance for any feedback.
1 Study: Vitamin B-12 status differs among pregnant, lactating, and control women with equivalent nutrient intakes.
2 Study: Vitamin D supplementation during pregnancy: double-blind randomized, clinical trial of safety and effectiveness.
3 Study: Cognitive assessment of children at age 2 1/2 years after maternal fish oil supplementation in pregnancy, a randomized controlled trial
4 Study: Dietary selenium’s protective effects against methylmercury toxicity.
5 Study: Probiotics during pregnancy and breast-feeding might confer immunomodulatory protection against atopic disease in the infant.
6 Study: Administration of a Multi-Strain Probiotic Product to Women in the Perinatal Period Differentially Affects the Breast Milk Cytokine Profile and May Have Beneficial Effects on Neonatal Gastrointestinal Functional Symptoms. A Randomized Clinical Trial.
7 Study: Iron Nutrition and Requirements
8 Study: Maternal Mineral and Bone Metabolism During Pregnancy, Lactation, and Post-Weaning Recovery.
Thanks for reading! And please leave a comment if you have any questions 🙂