Can i take multivitamins while pregnant

Vitamins and other nutrients during pregnancy

During pregnancy your baby gets all necessary nutrients from you. So you may need more during pregnancy than you did before pregnancy.

Taking prenatal vitamins and eating healthy foods can help give you all the nutrients you and your baby need during pregnancy.

Make sure your prenatal vitamin has folic acid, iron and calcium in it. Most have the right amount of each of these.

Talk to your provider to make sure you get enough vitamin D, DHA and iodine each day.

Don’t take any supplements without your provider’s OK.

What are prenatal vitamins?

Prenatal vitamins are multivitamins for pregnant women or women who are trying to get pregnant. Compared to a regular multivitamin, they have more of some nutrients that you need during pregnancy. Your health care provider may prescribe a prenatal vitamin for you, or you can buy them over the counter without a prescription. Take a prenatal vitamin every day during pregnancy. If you’re planning to get pregnant, start taking prenatal vitamins before you get pregnant.

Your body uses vitamins, minerals and other nutrients in food to strong and healthy. During pregnancy, your growing baby gets all necessary nutrients from you. So you may need more during pregnancy than you did before. If you’re pregnant with multiples (twins, triplets or more), you may need more nutrients than if you’re pregnant with one baby. Your prenatal vitamin contains the right amount of nutrients you need during pregnancy.

If you’re a vegetarian, have food allergies or can’t eat certain foods, your provider may want you to take a supplement to help you get more of certain nutrients. A supplement is a product you take to make up for certain nutrients that you don’t get enough of in foods you eat. For example, your provider may recommend that you take a vitamin supplement to help you get more vitamin D, iron or calcium.

Which nutrients are most important during pregnancy?

All nutrients are important, but these six play a key role in your baby’s growth and development during pregnancy:

1. Folic acid
2. Iron
3. Calcium
4. Vitamin D
5. DHA
6. Iodine

What is folic acid?

Folic acid is a B vitamin that every cell in your body needs for healthy growth and development. Taking folic acid before and during early pregnancy can help prevent birth defects of the brain and spine called neural tube defects (also called NTDs). Some studies show that taking folic acid may help prevent heart defects and birth defects in your baby’s mouth (called cleft lip and palate).

• Before pregnancy take a vitamin supplement with 400 mcg of folic acid every day.  
• Take a vitamin supplement with 400 mcg of folic acid each day, even if you’re not trying to get pregnant.
• During pregnancy, take a prenatal vitamin each day that has 600 mcg of folic acid in it.

Check the product label to see how much folic acid is in it.

If you’re at high risk for having a baby with an NTD, talk to your provider about how you can safely take 4,000 mcg of folic acid each day to help prevent an NTD. Start taking 4,000 mcg at least 3 months before you get pregnant and through the first 12 weeks of pregnancy. You’re at high risk if:

• You’ve had a pregnancy with an NTD in the past.
• You or your partner has an NTD.
• Your partner has a child with an NTD.

Don’t take several multivitamins or prenatal vitamins. You can get too much of other nutrients, which may be harmful to your health. Your provider can help you figure out the best and safest way for you to get the right amount of folic acid.

You can also get folic acid from food. Citrus fruits, green leafy vegetables and beans are all excellent sources of folic acid. Some foods are also enriched with folic acid, such as cereals, bread, rice and pasta.

What is iron?

Iron is a mineral. Your body uses iron to make hemoglobin, a protein that helps carry oxygen from your lungs to the rest of your body. You need twice as much iron during pregnancy than you did before pregnancy. Your body needs this iron to make more blood so it can carry oxygen to your baby. Your baby needs iron to make his own blood.

During pregnancy you need 27 milligrams of iron each day. Most prenatal vitamins have this amount. You also can get iron from food. Good sources of iron include:

• Lean meat, poultry and seafood
• Cereal, bread and pasta that has iron added to it (check the package label)
• Leafy green vegetables
• Beans, nuts, raisins and dried fruit

Foods containing vitamin C can increase the amount of iron your body absorbs. It's a good idea to eat foods like orange juice, tomatoes, strawberries and grapefruit every day.

Calcium (in dairy products like milk) and coffee, tea, egg yolks, fiber and soybeans can block your body from absorbing iron. Try to avoid these when eating iron-rich foods.

If you don’t get enough iron during pregnancy, you may be more likely to experience:

• Infections.
• Anemia. This means you have too little iron in your blood.
• Fatigue. This means you feel really tired or exhausted.
• Premature birth. This means your baby is born too soon, before 37 weeks of pregnancy.
• Low birthweight. This means your baby is born weighing less than 5 pounds, 8 ounces.

What is calcium?

Calcium is a mineral that helps your baby’s bones, teeth, heart, muscles and nerves develop. During pregnancy, you need 1,000 milligrams of calcium each day. You can get this amount by taking your prenatal vitamin and eating food that has a lot of calcium in it. Good sources of calcium include:

• Milk, cheese and yogurt
• Broccoli and kale
• Orange juice that has calcium added to it (check the package label)

If you don’t get enough calcium during pregnancy, your body takes it from your bones and gives it to your baby. This can cause health conditions, such as osteoporosis, later in life. Osteoporosis causes your bones become thin and break easily.

What is vitamin D?

Vitamin D helps your body absorb calcium. It also helps your body’s nerves, muscles and immune system work. Your immune system protects your body from infection. Vitamin D helps your baby’s bones and teeth grow.

During pregnancy, you need 600 IU (international units) of vitamin D each day. You can get this amount from food or your prenatal vitamin. Good sources of vitamin D include:

• Fatty fish, like salmon
• Milk and cereal that has vitamin D added to it (check the package label)

What is DHA?

Docosahexaenoic acid (DHA) is a kind of fat (called omega-3 fatty acid) that helps with growth and development. During pregnancy, you need DHA to help your baby’s brain and eyes develop. Not all prenatal vitamins contain DHA, so ask your provider if you need to take a DHA supplement.

During pregnancy, it is recommended that women eat 8 to 12 ounces of seafood low in mercury each week. Good sources of DHA include:

• Herring, salmon, trout, anchovies, halibut, catfish, shrimp and tilapia
• Orange juice, milk and eggs that have DHA added to them (check the package label) 

What is iodine?

Iodine is a mineral your body needs to make thyroid hormones, which help your body use and store energy from food. You need iodine during pregnancy to help your baby’s nervous system develop. The nervous system (brain, spinal cord and nerves) helps your baby move, think and feel.

During pregnancy, you need 220 micrograms of iodine every day. Not all prenatal vitamins contain iodine, so make sure you eat foods that have iodine in them. Ask your provider if you need to take an iodine supplement.

Good sources of iodine include:

• Fish
• Milk, cheese and yogurt
• Enriched or fortified cereal and bread (check the package label)
• Iodized salt (salt with iodine added to it; check the package label)

Last reviewed September, 2020

Can I take vitamin and mineral supplements in pregnancy?

In a nutshell

Yes, it's safe to take most multivitamin supplements during pregnancy – as long as you avoid brands that contain vitamin A (too much vitamin A – retinol – can damage your unborn baby). But, many experts say, you don’t actually need to take multivitamins while you're pregnant.

In fact, in a new study published in the Drug And Therapeutics Bulletin researchers suggest that, while there’s no harm in taking multivitamins while you're pregnant, you might be wasting your money – pregnancy multivitamins can cost around £15 for a month's supply – because there's no evidence that the tablets improve your or your baby's health.

What is important, though, is that you stick with NHS advice to take 2 specific supplements in pregnancy: folic acid and vitamin D.

What does the latest study say exactly?

The researchers, whose conducted a thorough review of all available studies on this subject, found that there’s "no evidence to recommend that all pregnant women should take prenatal mutli-nutrient supplements beyond the nationally advised folic acid and vitamin D supplements" – both of which can be bought separately and inexpensively.

In other words, according to the researchers, special pregnancy multivitamins – often containing a combo of B1, B2, B3, B6, B12, C, D, E and K, iodine, magnesium, copper, iron, zinc, selenium and folic acid – offered no discernible extra health benefit to a pregnant woman or her baby.

So, what is recommended, then?

You should be able to get the vitamins and minerals you need during pregnancy from eating a varied, healthy diet.

But the NHS currently advises all pregnant women also to take 400 micrograms (400 mcg) of folic acid a day during the first 12 weeks of their pregnancy.

This is because studies show it may lower the risk of certain neural tube (brain and spine) defects your baby could develop, such as spina bifida. (Pregnant Women who’ve been told by their midwife or GP that they’re at high risk of such deficiencies are sometimes advised to take a higher dose – 5 milligrams (5mg) – of folic acid.)

It’s also advised that pregnant women take a daily 10 microgram dose of Vitamin D. (You should also keep taking this after the birth, if you decide to breastfeed).

Both folic acid and vitamin D tablets, suitable for pregnant women, are available in good pharmacies and supermarkets at a considerably lower cost than multivitamin supplements. You may also be able to get them on prescription from your GP or through the Healthy Start scheme.

More like this

What do the supplement manufacturers say?

Dr Carrie Ruxton, a dietician at the Health Supplements Information Service, has pretty much rejected the new study’s findings. She told The Guardian that just because multivitamins don't produce clinical effects, it doesn't mean they aren't useful in combatting "dietary gaps" for pregnant women who aren't eating the right foods in pregnancy.

In other words, if your diet's a bit unvaried or not as healthy as it should be, Dr Ruxton thinks pregnancy vitamins might be a way to making sure you're getting all the vitamins and minerals you need.

So what should I do?

It’s totally up to YOU whether or not you want to take multivitamin supplements during your pregnancy. They're safe, as long as you avoid ones containing vitamin A.

But all the current evidence suggests that they’re not essential, so as long as you make sure you're getting folic acid and vitamin D, you can save yourself a pretty penny by not taking anything else.

If you’re ever in doubt about what's right for you, get in touch with your midwife or GP.

Read more

• Is it safe to give peanut products to babies?
• Why you shouldn't stop taking folic acid despite the headlines
• Dental treatment while pregnant - is it safe?

Do pregnant women need to drink vitamin preparations?

Almost every woman during pregnancy, doctors recommend taking various vitamin preparations. But do pregnant women need to take vitamins? Is a balanced diet not enough?

Almost every woman during pregnancy, doctors recommend taking various vitamin preparations. But do pregnant women need to take vitamins? Is a balanced diet not enough? We asked these and other questions to Ekaterina Aleksandrovna Minchenkova, an obstetrician-gynecologist at Expert Clinic Smolensk. nine0003

— Ekaterina Alexandrovna, what is the role of vitamins in the body in general and in the body of a pregnant woman in particular?

— Vitamins are special substances that everyone (not only women) need in small amounts for the normal functioning of the body. They are involved in metabolism, they are biological accelerators of chemical reactions occurring in the cells of the body, etc. In a pregnant woman, the need for vitamins and microelements is higher, because the fetus also needs them. nine0003

— What vitamins can you get from food?

- Most vitamins are not formed in our body, but come from food. If a pregnant woman eats a full, rational, varied diet, then she does not need an additional intake of vitamins and minerals (with some exceptions). They will be easily obtained with food in sufficient quantities. No vitamin supplement can match the benefits of proper nutrition.

- Speaking of nutrition, you said "with a few exceptions." That is, despite the correct diet, pregnant women should still take some vitamins? And if so, which ones?

Yes. During pregnancy, doctors prescribe some vitamins and minerals, even if the woman eats normally. I will dwell on those that I consider the most important. Vitamin number 1 for pregnant women is vitamin B9, or folic acid. Probably, one could do without additional intake of other vitamins, but without folic acid - in any way. This is because the strongest evidence for the need for vitamin supplementation during pre-pregnancy and the first 12 weeks of pregnancy is only for folic acid. With a lack of this vitamin, the likelihood of neural tube defects in the fetus, as well as some other defects (cleft lip, palate, congenital heart defects, malformations of the urinary tract and extremities, congenital hydrocephalus) may increase. nine0003

The recommended dose of folic acid is 400-500 mcg (micrograms) per day, in rare cases it may be more. To cover the daily dose of this vitamin, you need to eat 500 g of liver (chicken, goose, pork, beef, cod, etc.) or 1 kg of salad. It is difficult to provide the required daily amount of folic acid through food, so the doctor prescribes it in the form of a drug.

Next is vitamin D. It is formed in the body under the influence of ultraviolet rays (the main way to obtain it), and in some quantities comes with certain foods. All pregnant women may be recommended an additional dose of 600 - 1200 IU / day. But it is better to visit a doctor to decide whether it is necessary or not. nine0003

Vitamin B12 supplementation may be indicated for vegans and vegetarians.

I would like to say about trace elements - they are also important for the body of a pregnant woman. All women in the CIS countries are advised to take additional iodine in the form of potassium iodide. Before pregnancy, the dose of iodine is 100–150 mcg per day. With the onset of pregnancy, throughout its entire duration and during breastfeeding, the dose increases to 250 mcg per day. But usually the coverage of the need for iodine is distributed as follows: we get 50 micrograms from food, and take 200 micrograms in the form of a drug. In case of thyroid diseases, consultation with an endocrinologist is mandatory. nine0003

Calcium 1000 mg per day should be taken daily from food or mineral supplements if the woman does not consume calcium-containing foods.

Omega-3 polyunsaturated fatty acids (PUFAs). WHO still does not recommend the additional intake of this component during pregnancy and insists on a healthy diet. A sufficient intake of omega-3 is necessary for the proper formation of the organs of vision and the brain of the unborn child. In 2018, a study was conducted in which several thousand pregnant women participated. A diet high in omega-3s has been shown to reduce the risk of preterm birth from 7% to 2%, as well as the risk of having small babies. nine0003

An excellent source of omega-3-PUFAs are salmon fish, tuna and seafood. If you use them 2 times a week, then you do not need supplements and dietary supplements with this component. Everyone else should think about changing the diet or taking them additionally (of course, after consulting a doctor).

- You talked about the possible consequences of a lack of folic acid. And what can a deficiency of trace elements lead to in a pregnant woman and an unborn child?

- Children born to mothers with mild to moderate iodine deficiency are more likely to have behavioral disorders in the form of attention deficit hyperactivity disorder. Severe iodine deficiency in pregnant women is fraught with an increase in the frequency of stillbirth and infant mortality, miscarriage, the birth of underweight children, children with mental retardation.

Lack of calcium also leads to negative consequences: bone density decreases, which leads to the development of osteoporosis in menopausal women and an increased risk of fractures in old age. Possible heart rhythm disturbance, muscle spasms, convulsions. In pregnant women, especially those at risk, the likelihood of developing gestational hypertension (high blood pressure) and preeclampsia (a pathology in which blood pressure rises during pregnancy, edema is formed, and protein appears in the urine) increases. nine0003

Calcium is best absorbed from dairy products, 2-3 servings of which will provide the daily intake. 1 serving is equal to 200 ml of milk, kefir, curdled milk, fermented baked milk, or 200 g of yogurt, or 100 g of cottage cheese or 40 g of cheese.

Iron deficiency in the mother's body before pregnancy and in its early stages can "cross out" all subsequent efforts of parents and teachers in teaching children. The developing brain of a future baby is especially sensitive to a lack of iron in the body, including in the case of its hidden deficiency, when hemoglobin is normal, and there are few iron reserves. nine0003

Many people know that iron is necessary for the formation of hemoglobin, which is able to bind oxygen. Hemoglobin is found in red blood cells, which carry oxygen to the cells. And if there is little oxygen, then the cells suffer. Imagine feeling out of breath. So it is here: the brain cells of a still little man (3-12 weeks of pregnancy), lacking oxygen, divide more slowly, because of which neural connections are simplified, the gray matter suffers, and your baby will no longer become a genius, even if you responsibly began to take iron supplements after 12 weeks of pregnancy. nine0003

— Can I take prenatal vitamins without a doctor's prescription?

— No. I recommend taking vitamins only after consulting a doctor if they are deficient. Among persons who may be at increased risk of vitamin deficiency:

• obese people;
• vegans;
• having some bowel disease;
• people with low socioeconomic status;
• real hungry

and some others. For these women, an additional intake of vitamins will be justified.

- Can vitamin supplements taken during pregnancy be harmful or useless?

- At the moment there is no evidence that multivitamins prevent the development of any diseases, that they are necessary and useful. That is, they turned out to be ineffective. Vitamins usually contain more than 5 components. And even a very qualified clinical pharmacologist will not calculate all the options for the interaction of active components in a living organism. According to many studies, most multivitamin complexes are not absorbed by the body. They contain components (vitamins and trace elements) that are incompatible with each other: calcium and iron, fat- and water-soluble groups of vitamins, zinc and folate. B1, B6 and B12, although from the same group, are at war with each other or reinforce each other's negative effects. Therefore, if you take vitamins, it is better to take them separately, and only those that are really necessary. nine0003

Often the dosages of the components do not correspond to the recommended ones (for example, folic acid is recommended at a dose of 400 mcg per day, and in multivitamins it is often contained in an amount of 200 mcg, etc.).

All supplements and vitamin complexes containing vitamin A should be avoided due to its possible teratogenic effect (that is, the ability to cause malformations in a child during pregnancy).

There are no natural vitamins on the modern pharmaceutical market. Without exception, all preparations contain vitamins or their analogues, which are obtained synthetically. The natural ones are found only in foodstuffs. nine0003

— Do prenatal vitamins have side effects?

- Of course. Firstly, as with any other drugs, they can cause an allergic reaction. Side effects from the gastrointestinal tract are also common: nausea, vomiting, constipation, diarrhea, etc. The load on the liver is high. Excess intake of certain vitamins can lead to cancer.

— Is it possible for a pregnant woman to take vitamins with uterine fibroids? And if so, which ones? nine0010