Healthy pregnancy: Best supplements and vitamins

I have patients who are trying to conceive, pregnant, and breastfeeding, and they all have similar concerns: Do I need to take supplements? Which supplements should I take? Below I've outlined the supplements I recommend for a happy, healthy pregnancy and newborn baby, and advice on picking quality products that will best support your health during this important time.

1. Pick a prenatal vitamin

A good prenatal vitamin is the backbone of a healthy pregnancy plan, before and after conception. A study by researchers at the UC Davis MIND Institute found that women who reported not taking a daily prenatal vitamin immediately before and during the first month of pregnancy were nearly twice as likely to have a child with an autism-spectrum disorder as women who did take the supplements.

The supplement you choose should include natural vitamin E (l-alpha tocopherol) instead of synthetic vitamin E (dl-alpha tocopherol). Ensure your prenatal contains iron, to avoid anemia. An optimal amount of iron citrate, which is non-constipating and easier on the stomach, per day is 30 to 45 mg. Your prenatal vitamin should include folic acid, good levels of B vitamins, and the minerals in their most easily absorbed, citrate form (as compared to carbonate). Select a multivitamin that is free of additives, binders, fillers, and artificial colors (not a big pink pill, for example) and that does not provide more than 10,000 IU of vitamin A per day.

I think it is also useful to take a prenatal three times per day, one pill with each meal. The Thorne Basic Prenatal is one of my favorites. I recommend starting it as soon as you are trying to conceive and continuing through to the end of breastfeeding.

2. Get enough folic acid and B12

Blood levels of folic acid and B12 decline while you're pregnant, making supplementation extremely important. Research has shown that a deficiency of folic acid greatly increases the risk of neural tube defects and low birth weight. Similarly, low vitamin B12 has been linked to birth defects.

Requirements for both nutrients double during pregnancy and are best met with 600 mcg to 1 mg of folic acid each day in supplement form. One study suggested that to reduce the risk of having pregnancies affected by neural tube defects, women should boost their vitamin B12 levels to above 300 ng/L (or 221 pmol/L) prior to conceiving. Having sufficient amounts of folic acid and vitamin B12 before getting pregnant is important, because these nutrients seem to be most vital in an embryo's first few days and weeks.

3. Take fish oils for brain food
Healthy types of oils are necessary for the formation of every cell in the body. Omega-3 fats, especially DHA, are necessary for the complete development of the human brain during pregnancy and the first two years of life. Studies have shown that women who supplement their diets with fish oils have children with higher IQs. DHA is essential for a healthy nervous system and immune system, and the part of the brain affected by omega-3 fats is related to learning ability, anxiety/depression, and auditory and visual perception.

Omega-3 fats also help balance the immune system, which may assist in the prevention of allergies, colic, and skin problems later in life. Omega-3 and omega-6 fats also help to improve milk production and to reduce the risk of breast engorgement. I recommend 2-4 capsules twice daily, both during and after pregnancy. 4. Watch calcium, magnesium, and vitamin D3

A combination of calcium and magnesium with vitamin D3 is recommended for bone health, and for the treatment and prevention of the muscle cramps that typically occur in the legs during pregnancy. Excessive hair loss and dental problems that sometimes accompany pregnancy may also be avoided or lessened with calcium and magnesium supplements. During pregnancy these nutrients help with the development of your baby’s bones and teeth, breast milk production, and regulation of blood pressure, heartbeat, water balance in the cells, and muscle contractions. Getting the right amount of calcium will ensure strong bones for you, and studies show that postpartum women who are getting enough calcium get back to their pre-pregnancy weight more easily.

Ensure you reach the optimal amount of 1,200 mg each day between your prenatal multivitamin and a separate calcium-magnesium supplement. Ensure that you are getting 2,000IU of vitamin D daily throughout your pregnancy.

5. Take a mixed vitamin-E supplement

Getting the right amount of vitamin E helps babies fight off oxidative stress to the heart and lungs. It also prevents the destruction of red blood cells, an absence of which can cause anemia. This is especially important to premature babies who, upon being born, are usually low in vitamin E.

There are eight antioxidants called tocopherols that make up the vitamin-E family. A good vitamin-E supplement contains all eight types, whereas many vitamin E supplements only contain alpha tocopherol. That's why I recommend an additional mixed vitamin-E capsule daily, in addition to what's in your multivitamin. Ultimate E from Thorne Research or Ultimate E from AOR are excellent choices.

Natasha Turner, N.D. is a naturopathic doctor, Chatelaine magazine columnist, and author of the bestselling books The Hormone Diet and her newest release, The Supercharged Hormone Diet, now available across Canada. She is also the founder of the Toronto-based Clear Medicine Wellness Boutique.