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Do You Need A Prenatal Supplement?

By Elizabeth M. Ward, M.S., R.D.

They can make you queasy and constipated. Are prenatal multivitamin supplements worth the aggravation? Find out who benefits most from prenatal pills, and whether you need to take them or not.

Bridge the Nutrient Gaps

Prenatal vitamins are touted for giving your baby the best start in life, so this may come as a surprise: While it's customary for doctors and other providers to prescribe them, there is no universal recommendation from any health care group for daily prenatal multivitamin pills.

A balanced diet is the best way for most healthy women to get the nutrients they, and their baby, need during pregnancy. Trouble is many women in their childbearing years come up short for several nutrients that affect their health and their pregnancy, including folic acid and iron.

Focus on Folic Acid

Folic acid, a B vitamin, is necessary soon after conception occurs. Experts recommend 400 micrograms (mcg) a day for women capable of becoming pregnant. Folic acid helps to prevent neural tube defects, such as spina bifida, during the first 30 days of pregnancy, when a woman may not know she's expecting a child.

The suggested daily intake for folic acid throughout pregnancy is 600 mcg. Fortified grains, including bread, cereal, and pasta, provide the same form of folic acid found in supplements, and fortified foods are considered as reliable a source of the vitamin. Prescription prenatal vitamins often contain 1,000 mcg of folic acid; over-the-counter prenatal pills may have upwards of 800 mcg.

Iron It Out

It's possible to get the folic acid you need every day from fortified grains, but it's unlikely that diet will supply the iron you require during pregnancy. Iron helps the body transport oxygen, prevent anemia in mom, and reduce the risk of preterm and low birth-weight babies.

Suggested iron intakes nearly triple during pregnancy to 27 milligrams (mg) daily. Prenatal vitamins usually supply all the iron you need during pregnancy, and sometimes more. Regular multivitamin pills' iron content varies.

Build Strong Bones

Although calcium and vitamin D requirements are no greater when you're expecting, women may not get enough of the two nutrients before they conceive and after, according to the 2010 Dietary Guidelines for Americans.

Calcium is necessary to build baby's bones and teeth, and to maintain the strength of mom's skeleton, too. Vitamin D is essential for calcium absorption by the body. Prenatal pills usually have more calcium than regular multivitamins, but they don't provide all the calcium you need every day, and many lack adequate vitamin D.

Prenatal Supplements: Do's and Don'ts

Women who eat a balanced diet and don't have an iron deficiency may satisfy their pregnancy nutrient needs with a regular multivitamin. Women who ate a poor-quality diet before conception and those who consistently miss out on certain nutrients are the best candidates for over the counter and prescription prenatal supplements.

There's no research to support the idea that prescription prenatal pills, which often have more iron and folic acid, as well as other nutrients, are any better than the over the counter variety. No matter what type of pill you take, consider this. Dietary supplements are like seat belts: they offer some insurance, but don't give you a license to drive recklessly. Relying too heavily on supplements can give you a false sense of security about the quality of your diet.

Always ask your doctor what's right for you.

About the Author

Elizabeth M. Ward, M.S., R.D., is a registered dietitian, a writer, and mother of three. She has worked at the Joslin Diabetes Center and the American Heart Association, and for seven years counseled children and adults about healthy eating and disease prevention at Harvard Vanguard Medical Associates in Boston.

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