It’s not about you. If there’s one rule to master when it comes to nutrients for pregnancy, that’s it.
When you’re pregnant, you are building an entire new human being, not just nourishing one. That brand-new human is in miniature, for sure, but all the parts need to be formed properly in order to assure your child’s future health. All those parts also need to function properly. Fortunately, you don’t have to know how to do all this. Everything comes together naturally inside you. But you do need to provide the proper building blocks—all the necessary nutrients for that magnificent creation taking place in your womb.
Think what would happen if you tried to build a concrete apartment building without steel reinforcement bars (rebars). The building would look good for a while, but would soon crumble. Think what would happen if you baked a cake from scratch, put in all the wholesome ingredients, and then forgot the baking powder. It wouldn’t even look good. It would come out flat.
Your responsibility as a mother begins even before conception, says Mary Bove, ND, a naturopathic physician and midwife in private practice in Brattleboro, Vermont, and author of An Encyclopedia of Natural Healing for Children and Infants. Once you decide that you want to conceive, you should start preparing your body to give birth to a healthy child, says Dr. Bove. And that means eating right.
Don’t think vitamins. Think food. Both before and throughout pregnancy, a woman should be getting the “high end” of the Recommended Dietary Allowances (RDAs) for all vitamins and minerals, and ideally she should be getting all of these nutrients in the food she eats on a daily basis, says Dr. Bove. In practice, this translates into five to nine servings a day of fruits and vegetables. And if possible, she adds, choose produce that is “local, organic, top quality.”
You also need to get enough protein, says Dr. Bove. You should have some protein with each meal. Top sources of protein are lean meats and fish. If you’re eating fish, stay away from varieties that are likely contaminated with mercury. These include swordfish, king mackerel, shark, halibut, and tuna. Good choices include sardines, anchovies, salmon, tilapia, clams, crabs, scallops, and pollock. You’ll need to continue to avoid potentially contaminated fish throughout your pregnancy as well.
If you’re a vegetarian, says Dr. Bove, you can get more protein by adding more nuts and seeds to your diet. Getting plenty of fiber is also important, and you’ll get quite a bit from all those fruits and vegetables. But beans, legumes, and whole grains, all of which are high in fiber, should also be part of your regular fare.
Both before and during pregnancy, you need to pay attention to the kinds of fats that you consume, says Dr. Bove. You’ll be getting some saturated fats in meats and dairy products, and that’s okay, she says. But you should strictly limit your consumption of hydrogenated fats and trans fats. That means reading labels and avoiding any products that are made with either kind of fat. This includes anything made with partially hydrogenated oils.
What about taking a multivitamin? Shouldn’t that be a part of every woman’s pre-pregnancy plan? And shouldn’t she also be taking a multivitamin just for insurance throughout the duration of her pregnancy?
“There’s a lot to be gained by setting the foundation with foods,” says Dr. Bove. “The female body is equipped to give birth. All you need to do is give it the right kinds of food.”
But we don’t all eat as well as we should, even when we think we might become pregnant. What then?
“Ask yourself three questions,” says Dr. Bove. “Do I eat right? Do I eat balanced meals? Do I eat two or three times a day? If you can’t answer yes to all of those questions, then maybe you do need supplements.”
Before you choose any supplements, whether it’s a multi or individual nutrients, here’s one very important rule: Discuss every supplement you want to take with your doctor before taking it. The same goes for herbal products and over-the-counter medications.
Any multivitamin you take should be a prenatal formula or one created specifically for pregnant women, says Dr. Bove. You can take a prenatal formula right through pregnancy and through nursing, up until the baby is weaned, she says. And it should be a food-based multi, she says. A number of companies make food-based multivitamins for women who are pregnant or who are trying to conceive.
The first 3 months of pregnancy can be the most difficult for many women. That first trimester can be marked with nausea, vomiting, fatigue, and sensitivity to even the look and smell of foods, says Dr. Bove. At this point, a multivitamin can contribute to a woman’s nausea. If this happens, skip the multi for the first trimester and concentrate on eating several small, light meals a day. You can resume taking the multivitamin after the first trimester, when nausea typically settles down, she says.
When you’re pregnant, you need more protein than you would normally take in—a good 70 to 90 grams a day, says Dr. Bove. Just to put this in perspective, a 3-ounce chicken breast provides 20 grams of protein, and two eggs provide 12 grams. What this means is that you’ll likely need to eat some protein with every meal.
Along with paying careful attention to eating a balanced diet, there are a number of individual nutrients that require special attention.
Vitamins B6 and B12 are especially helpful in early pregnancy, as they can ease nausea and vomiting, says Dr. Bove. It helps to get 100 to 150 milligrams of B6, she says. The Dietary Reference Intake for B12 is 2.4 micrograms.
You need folic acid, another B vitamin, both before and during the early stages of pregnancy to help the baby’s spine form.
The role of folate (the natural form found in food) in preventing neural tube defects—a type of birth defect that deforms the spine—is fairly well known. What is not as well known is that getting adequate folate levels may also help prevent Down syndrome. In a 2005 study, Dutch researchers concluded that in certain women, adequate folate intake around the time of conception may help prevent expression of a gene that causes this form of mental retardation in their babies. Good food sources of folate include fortified breakfast cereals, spinach, rice, peas, and broccoli.
Doctors generally recommend getting 800 micrograms of folic acid. You can meet all of your vitamin B needs by taking a B-complex supplement.
The mineral calcium is necessary for bone formation. It is so important to the growing fetus that if a woman does not consume enough calcium, her own bones and teeth will give up their stones of the mineral in order to nourish the fetus. Of course, you want your baby to be healthy. But you also don’t want to increase your risk for osteoporosis and a mouth full of bad teeth, so make doubly sure that you’re getting enough calcium for both yourself and your baby.
Dr. Bove suggests getting 1,000 milligrams a day, making sure that at least some of that total comes from diet. If you try to meet your calcium needs exclusively through supplementation, she says, you’ll run the risk of getting kidney stones. Good sources of calcium include low-fat dairy products, sardines with bones, and leafy, green vegetables such as spinach, kale, and turnip greens.
Your doctor can tell by a simple blood test whether or not you are anemic. “If you’re anemic and you need a supplement of iron, by all means do it,” says Dr. Bove. All pregnant women experience a drop in iron levels sometime between the 28th and 30th weeks of pregnancy, she says. For many women, this takes them too low, and they do need a supplement at that time.
Generally, supplementation is in the range of 25 to 50 milligrams, depending upon how severe the anemia is, says Dr. Bove. She prefers a liquid supplement of iron picolinate or gluconate, rather than iron sulfate or fumarate.
“Calcium can’t get into the bones if you don’t have enough magnesium to unlock the door,” says Dr. Bove. The general rule is that you should get half the amount of magnesium as calcium. So if you’re consuming 1,000 milligrams of calcium, you should get 500 milligrams of magnesium.
However, says Dr. Bove, getting more magnesium can be helpful if a woman is constipated, a frequent issue during pregnancy. In that case, taking 800 milligrams of magnesium might be helpful. If constipation is an issue for you, ask your doctor about taking this much magnesium whenever you have a problem.
Along with calcium, vitamin D is needed to build a baby’s bones.
Just how necessary an adequate level of vitamin D is was clearly revealed in a study done in the United Kingdom and published in 2006 in the medical journal Lancet. Researchers studied a group of 198 children born in 1991 and 1992 in a hospital in Southampton. At that time, they tested the mothers’ vitamin D levels and found that 49 percent had less than adequate levels. Then 9 years later, researchers examined the children for bone mass. They found weaker bones in the children of the mothers who had low vitamin D levels at the time they gave birth.
“Maternal vitamin D insufficiency is common during pregnancy and is associated with reduced bone-mineral accrual in the offspring during childhood,” the researchers concluded in their published paper. “Vitamin D supplementation of pregnant women, especially during the winter months, could lead to long-lasting reductions in the risk of osteoporotic fracture in their offspring.”
Osteoporosis is a disease of weakened bones that are more easily broken. This study makes it clear that a child’s health can be affected for years to come, on into adulthood, by whether or not the mother gets an adequate intake of vitamin D while she’s pregnant.
A woman needs to get at least 400 to 800 IU, says Dr. Bove, adding that a doctor may want her to take more if she’s deficient in this vitamin.
Most pregnant women and women looking to conceive should be taking a multivitamin specifically formulated for pregnancy. Do not take any supplements, including multivitamins, a B-complex supplement, or herbs for pregnant women, without first discussing it with your doctor. The same goes for over-the-counter medications. Don’t take even a cold remedy without first running it by your doctor.
B vitamins |
Take a B-complex supplement. Follow the package directions. |
Calcium |
1,000 milligrams 25 to 50 milligrams, preferably as a |
Iron* |
liquid supplement of iron picolinate or gluconate |
Magnesium† |
500 milligrams |
Vitamin D |
400 to 800 IU |
*Do not take an iron supplement unless your doctor determines that you are anemic.
†You can take more magnesium if you’re constipated.