The information included in Dear Stephanie posts is for educational purposes only. It is not intended nor implied to be a substitute for professional medical advice. Always consult your healthcare provider to determine the appropriateness of the information for your own situation, or if you have any questions regarding conception, pregnancy, or your prenatal treatment plan. For more Dear Stephanie posts, click here. Have a question for Steph? Click here to e-mail her.

Dear Stephanie,

Help! There are so many prenatal vitamins to choose from! I’m overwhelmed with all the choices. What do you recommend? – Chelsea S. on Instagram (and many other mamas who DM us this question regularly!)

Even with a well-designed, whole foods-based diet, you can still be deficient in certain nutrients, such as magnesium, iron, vitamin D, and choline, so I’m glad you’re being thoughtful about this decision. Since you’re “eating for two”* we want to make sure your food plus supplements work together to encourage nutrient sufficiency for you and your baby’s growing demands. We want to keep you and baby well nourished, healthy, and happy.

Since we don’t know how your first trimester will go, we want to make sure you’ve got plenty of nutrients on-board to see you through some of the potentially challenging days (or weeks). That way, if your diet starts resembling what you ate during your freshman year of college, you can feel confident that your needs are being met. This is why I recommend to start taking a prenatal vitamin while you’re trying to conceive.

I’ll discuss three factors to consider when choosing a quality prenatal multivitamin:

  1. Whether it’s food-based or synthetic
  2. The forms and amount of vitamins it contains
  3. What you can tolerate

*The phrase “eating for two” is sometimes misunderstood to mean that mamas need to double their intake. Calorie needs only increase by about 340 calories in the second trimester and 450 calories in the third trimester. We’re using it here to refer to the fact that your baby’s growth requires sufficient nutrient intake and stores to keep you and baby healthy and happy.

Looking for more nutrition support during pregnancy? Join Healthy Mama, Happy Baby to access resources and community support.

What’s the difference between food-based and synthetic prenatal vitamins?

The majority of prenatal multivitamins you’ll find on store shelves are synthetic, meaning they’re composed of highly-processed, isolated nutrients. This is different than a food-based supplement that’s made from concentrated whole foods. Food-based supplements include phytonutrients and other components that are naturally part of the whole food version of that nutrient. These components work synergistically, which can improve their safety and bioavailability.

This isn’t to say that synthetic prenatal multivitamins are bad, they’re just different. They both have their place depending on your budget, needs, and preferences. For example, synthetic prenatal vitamins tend to have higher levels of nutrients and may require you to take fewer capsules.  I’ve used both synthetic (Thorne Research Basic Prenatal) and food-based (Innate Response Baby & Me) prenatal multivitamins during my pregnancies.

How can I be sure I’m getting the most available form and the right amount of a nutrient?

If you choose a food-based prenatal multivitamin, your best bet is an organic option, but don’t sweat it if your budget doesn’t allow. The source of the vitamin should be listed so you can avoid anything you may be intolerant of or allergic to. Many of the popular brands are gluten/dairy-free, but check your labels.

For synthetic multivitamins, you’ll want to look for nutrients in their most active or absorbable forms. This includes the methylated type of folate (listed as L-5-MTHF, L-methylfolate, or L-5-methyltetrahydrofolate), B6 (in the form of pyridoxal 5’-phosphate) and B12 (in the form of methylcobalamin).

If needed, choose an iron in a chelated form (such as ferrous bisglycinate chelate), which is more easily absorbed and less likely to cause constipation and other complaints.  You may also consider herbal and dietary approaches to increasing your iron levels, such as nettle tea and red meat. Of course, work with your provider to choose a solution that best meets your needs.

Some prenatal vitamins include herbs such as red raspberry, ginger, probiotics, and enzymes, so you’ll want to consider whether those would be a valuable addition to your regimen.

What if prenatal vitamins upset my stomach or cause other discomfort?

Food-based prenatal vitamins tend to be easier on the stomach than synthetic. If you’re someone who has a hard time tolerating supplements, food-based may be the way to go to avoid indigestion, stomach cramps, nausea, and heartburn.

To reduce the potential discomfort, make sure you’re taking your prenatal with food. This is less important for food-based supplements, but it can still help. You may also choose to break up the dosage, so you’re not taking all of the capsules/tablets at once. For example, if the recommended dose is two capsules a day, you could consider taking one with lunch and one with dinner. Also, try to have a source of dietary fat with your meals when taking your vitamins to ensure optimal absorption (for nutrients such as beta-carotene and vitamin D).

If capsules or tablets just aren’t working for you, you could consider prenatal gummies or a prenatal powder (SmartyPants Prenatal Complete> is a good choice). Yes, these two options will have sugar, flavorings, and other additives, but I’d argue that they’re better than not taking anything to support this time of increased nutrient demands.

I know these types of considerations will increase the cost, so again, don’t beat yourself up if you can’t afford everything I’m mentioning. I know you’re doing the best you can! For more information on supplements to take during your pregnancy, you can check out my podcast, Real Food Mamas, episode #61, where I interviewed a leading expert on women’s health and supplements, Dr. Low Dog, MD.

Looking for more specific brand recommendations? Stay tuned as I’ll share and discuss some of my favorite prenatals in a future Dear Stephanie post.


Steph(hi)-6Stephanie Greunke is a registered dietitian with a master’s degree in nutrition who specializes in women’s health. She is a certified personal trainer and prenatal and postnatal corrective exercise specialist. Stephanie guides and supports women locally and globally through her web-based private practice, RockYourHormones.com.

 

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