Writing this entry was more beneficial than I would have assumed. I’ve often been asked what prenatal vitamins I am taking and finally compiled a list. I’m expecting baby number two in a few months and I definitely have a go-to vitamin routine. In the back of my mind, I know the basic benefits of each supplement but not necessarily all of the minute advantages each nutrient yields for my baby and me and the science behind those nutrients. Compiling these notes encouraged me to delve into each vitamin and it’s potential for the health and development of my growing baby and for the sustaining nourishment for my own body.
As a general guideline, I try to draw nourishment from food sources before supplementation, but sometimes an additional boost is necessary. In my opinion, if there is ever a time to increase supplement intake it is during the demands of pregnancy when your body is supporting two heartbeats, two bodies. I’ve also known women who choose not to take any additional vitamins during pregnancy and instead pursue an incredibly nutrient dense regime. I choose to balance between these two views.
I share this as my personal journey of discovering what works for me having worked closely with my midwife and Naturopath. I’ve had labs drawn at various points pre-pregnancy and during pregnancy and had some genetic testing done so I know what nutrient boosts and supplements my body needs and which I need to avoid. I give myself flexibility in this process, tuning in to my body regularly to see if I need more or less of a certain nutrient.
Please work with your midwife, OBGYN and/or doctor regarding the supplementation that is right for you. Bear in mind that what is healthy for one individual, can be dangerous for another–This is not medical advice.
Prenatal (Seeking Health, Thorne, or Pure Encapsulations Nutrient950)
One of the main things I look for in a prenatal vitamin is that it has Folate (the natural form of B9 found in food) or more specifically L-5-Methyltetrahydrofolate instead of Folic Acid (the synthetic, lab derived form of folate). B9 is the essential vitamin that supports neural tube development. Here’s the deal; in order for our body to utilize folic acid, it has to go through a conversion process called methyltetrahydrofolate (MTHF).1,2 It is estimated that 40-60% of women have a genetic variant called MTHFR which makes it nearly impossible for folic acid to be converted as it needs to be (many men have it too!).2 This unmetabolized folic acid can cause a myriad of problems. If you pay attention to food labels, you’ll notice that folic acid is used to reinforce most bread, cereal and many other packaged food items, and anytime you see “enriched flour” as an ingredient, you can almost guarantee the presence of folic acid. Opt to avoid these foods and look for organic options, being careful to read labels even then! Seek wholesome folate through organic leafy greens, beans, nuts, citrus, melons and berries. I also love it when a prenatal lists the exact version and/or source of a particular vitamin (i.e. Niacin (as Niacinamide from Organic Holy Basil). If the nutrients are not listed clearly, you can always call the manufacturer and ask for more details.
Vitamin D3 and Vitamin K2 (MK-7)
I take 10,000 IU of Vitamin D and 200mcg of Vitamin K2. K2 is necessary for proper absorption of D3 into the body. Vitamin D is linked to just about every health condition you can imagine. It is a staple in my supplements year-round. Here is a great article I found regarding Vitamin D in pregnancy (with quality references) if you are eager for more details on this subject. A mother’s intake of Vitamin D during lactation also impacts how much Vitamin D baby gets. It is incredibly important in the development of a newborn’s immune system.3
Fish Oil (EPA/DHA)
It’s all about those Omega-3 fatty acids—Docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA). These fatty acids have vital influence on fetal and newborn neurodevelopment and vision. The omega-3 fatty acid EPA and the omega-6 fatty acid AA are essential structural components of every cell in the body.4 All of the omega-3 and omega-6 fatty acids absorbed by the fetus must ultimately be obtained from the mother by placental transfer.4 Only about 4% to 11% of DHA is retroconverted to EPA. Pregnant women who only supplement DHA without any dietary EPA may be unable to create the right balance of eicosanoids (signaling molecules) and may limit the transport and uptake of DHA into fetal cells.4 Quality is vital when looking for a fish oil supplement. Fish oil is susceptible to oxidation, pollutants and heavy metals. Omega-3 plant sources include flaxseed, chia seed, hemp hearts, pumpkin seeds, walnuts and seaweed (including chlorella and spirulina).
“Ferritin makes iron available for critical cellular processes while protecting lipids, DNA, and proteins from the potentially toxic effects of iron.”5 Ferritin is required to help transport thyroid throughout the body, and an iron deficiency can produce hypothyroidism and vice versa.6 I take ferritin as an extra iron source year round. This is not necessary for everyone, but when I last had my blood tested, I had incredibly low ferritin levels. Side note, this was also when my doctor recommended I start eating high quality red meat 2-3x a week. Up until this point, I had been a vegetarian or vegan my whole life. I’ll have to write more on this later. Everyone has a personal dietary journey, but this turned out to be an important healing link for mine (especially healing from a miscarriage, staying healthy through pregnancy and recovering postpartum). I take 10mg daily as discussed with my doctor. See my notes on iron supplements and iodine below for more information about the role of iron and thyroid in pregnancy for baby and mama.
Methylcobalamin is the active form of B12. I enjoy taking B12 because I get a noticeable energy boost from it, but there are many other benefits for mama and baby too. B12 helps maintain the health of the nervous system and blood cells, helps make DNA, boosts offspring’s cognitive function and insulin resistance, and as with B9 (folate), it can help prevent spinal and central nervous system birth defects.7 B12 is also beneficial during the lactation period as baby will receive it’s benefits through breastmilk. Taking it sublingually helps it absorb best into the body as the nutrients enter the bloodstream directly without having to be processed through the gastrointestinal track.
Foods high in B12 include such things as sardines, animal liver and kidneys (especially lamb), salmon, beef, milk and dairy products. In general, Vitamins A, B12, and D3 are found mainly in animal-derived foods.8 I always look for grass-fed, pasture raised meat options when we do eat meat, wild-caught fish, and organic or raw dairy products. It’s about quality over quantity especially with these items!
Vegetarians and vegans in particular often need to supplement B12 into their diets. There are many B12 fortified foods like breakfast cereals, however, this is not in it’s ideal form. Tempeh, broccoli, spinach, various types of tea leaves, seaweed, algae, asparagus, mung bean sprouts and some wild edible mushrooms have small amounts of B12, but seldom do we eat enough of these to even come close to getting enough of this vital nutrient in our diets. 8
Digestive Bitters (Wildflower Clinic)
My digestion is usually full steam ahead, but during pregnancy it tends to get sluggish which is a common symptom. These herbal digestive bitters help awaken my natural stomach juices and keep things functioning optimally. Digestive bitters can help to ease indigestion, nausea, cramping, gas, bloating, and heartburn and are best taken before a meal. My friend Dana is a certified herbalist at the clinic and she took into account my specific health needs as well as my specific pregnancy timeline in formulating this blend for me.
Red Raspberry Leaf Tea or Tincture
Raspberry leaf is often discussed for it’s benefits during pregnancy, but it’s dense nutrients make it a profitable choice for women of all stages of life. It has a sort of black tea flavor and mixes well with other herbal teas or blends. Raspberry leaf has high vitamin and mineral content including vitamins A, B, C and E, magnesium, potassium, iron and calcium.9 In addition to the high nutrient profile other pregnancy specific benefits include improving sleep, soothing leg cramps, relieving nausea, toning the uterine and pelvic muscles and support for hormone health.10
It is generally recommended to avoid ingesting red raspberry leaf during the first trimester because of it’s strong influence on the uterus and the potential for miscarriage early on. I’ll often have a cup or two a week during the first trimester if desired, but I’m aware of my intake and avoid daily consumption and tincture form during these early weeks. During the second trimester, I love using the tincture form and I’ll usually add the recommended dose to my quart water bottle first thing in the morning to sip on for the first part of the day.
A FEW TIMES A WEEK OR AS NEEDED:
Magnesium and Apple Cider Vinegar
I like to mix these two together and take it anytime I feel like my digestion or energy needs help. It’s actually my first “go-to” tonic of sorts. I prefer to take it at night and the magnesium helps eliminate pregnancy leg cramps and helps me sleep better (because of it’s influence on neurotransmitter GABA that promotes sleep, and how it interacts with melatonin levels to regulate sleep-wake cycles), and the ACV helps me stay regular first thing in the morning (it’s my staple for all things gut health). A little ACV goes a long way. I only take a teaspoons or two at a time. Make sure you get the good ACV with “The Mother.”
Magnesium also helps baby build strong bones and teeth in utero, improves growth and circulation of the fetus, and additional supplementation during pregnancy likely decreases probability occurrence of many complications of pregnancy.11 Magnesium may help decrease nausea and ease headache pains. For aches, pains and digestion during pregnancy or the first few months postpartum, magnesium is my first choice.
Probiotic (ProBiota Women by Seeking Health)
Our friendly bacteria! I recently switched to this probiotic from one I was taking by Pure Encapsulations, because this probiotic specifically targets gut and vaginal flora for women. My midwife and ND both recommended taking a regular probiotic through pregnancy and especially early postpartum to combat slowed digestion and build my own microbiome which in turn benefits the baby at birth and throughout breastfeeding. Probiotics need to be refrigerated and thus despite my best efforts to remember to take it before breakfast everyday, I usually only remember a few times a week.
Baby receives a few non-pathogenic strains of bacteria through the placenta and amniotic fluid and a few maternal microorganisms make it through to baby as evidenced by measurements found in meconium (baby’s first poops) and cord blood.12 As baby passes through the birth canal, they pick up the mother’s vaginal bacteria and it immediately reaches the newborn gastrointestinal track.12 This is where baby gets their beginning stash of healthy microbiome and immune support at the beginning of their life on the outside. Some mamas who deliver via cesarean incorporate what is called vaginal seeding wherein the doctor places gauze swabs in the vagina during the c-section and then as soon as the baby is born these swabs are rubbed over the newborn’s face, body, eyes and mouth for them to receive this beneficial bacteria.13,14
Breastmilk is another benefit to baby’s gut health and requires mama to continue to build her gut flora. “The rich composition of human milk provides passive immunoprotection against infections and inflammation”12 This article from the US National Library of Medicine was fascinating and covered the basics of probiotics and gut microbiota especially as it pertains to pregnancy, the first 12 months of an infant’s life, and breastfeeding. By one year, gut microbiota is similar to that of an adult.12 Probiotic food sources include fermented foods like sauerkraut, kimchi, pickled vegetables, yogurt, kombucha, kefir (water and dairy), miso, and sourdough.
Choline is an essential nutrient found in foods such as milk, meat (especially liver), eggs (especially yolks), fish, most nuts and vegetables like broccoli, cauliflower and Brussels sprouts. It has important functions during the fetal and neonatal periods when the brain is rapidly developing. “A mother delivers large amounts of choline across the placenta to the fetus, and after birth she delivers large amounts of choline in milk to the infant; this greatly increases the demand on the choline stores of the mother.”15 Choline is usually best obtained through diet, though during pregnancy and exclusive breastfeeding I choose to supplement additional choline via a capsule a few times a week just to ensure I’m getting enough. I take around 420mg daily, but have heard up to 600mg daily can be beneficial.
Molybdenum is an essential mineral found in grains, legumes and organ meats. It stimulates enzymes that help break down harmful sulfites and stops toxins from building up in the body. I’ve had some genetic testing done and have a partial CBS gene mutation, which essentially means my body can’t process sulfites very well. As the body metabolizes sulfur, ammonia is created as a byproduct and is easily excreted through urine. Individuals with CBS cannot effectively metabolize and eliminate ammonia.16,17 I take molybdenum periodically when I’ve eaten high sulfur foods to help my body process these sulfites. I cannot say this enough, DO YOUR OWN RESEARCH and consult your physicians. Many people actually need more sulfur versus less sulfur in their diets. Sulfur based amino acids are building blocks to many enzymes including the antioxidant enzyme glutathione.
Iron (Ferrasorb by Thorne)
This was recommended by my midwife after my first trimester labs. My iron levels were OK, but on the low levels of the spectrum (people with plant based diets often have lower iron levels). During the course of pregnancy, a women’s blood volume will increase by 50% in her body to support the uterus and growing baby. Our bodies need iron to make the extra blood (hemoglobin). Iron stimulates the movement of oxygen from the lungs to the rest of your body and to the baby. Low red blood cell counts can often lead to low energy and fatigue. My midwife recommended I take a supplement as well as focus on eating high iron foods like lentils, quinoa, organic leafy greens, broccoli, high quality red meat, pumpkin seeds, cashews and whole grains.
Adrenal Cortex (Seeking Health)
Our adrenal glands are located on top of each kidney and produce hormones that help regulate metabolism, immune system, response to stress, and blood pressure as well as creating cortisol and sex hormones.18 Adrenals and thyroid are closely related. I’m taking this supplement on the recommendation of my ND and my mother. Breastfeeding on top of pregnancy (especially first trimester) and no return of my regular cycle left me feeling depleted on a nutritional and energy level. My mom noticed this and encouraged me to supplement a little, and just a week later I saw my ND and she told me the exact same thing! My endocrine system was bogged down and needed some help! I usually take this after lunch as my afternoon pick-me-up. Taking it too late in the day can keep me up at night.
Adrenal/Mood Support Tincture (Wildflower Clinic)
I’ve learned a lot about the power of food and herbs since my first pregnancy. This second time around I wanted to be more intentional about using plants to balance and strengthen my body. I reached out to my friend Dana from Wildflower Clinic and shared my specific needs, challenges and hopes for health as I continued through my second and third trimester in pregnancy. She asked me several detailed questions and I shared information I had received and discussed with my midwife and ND. She made a few recommendations and created this custom adrenal and mood support tincture for me. I started by taking it every morning, and now that I’m feeling more balanced, I take it as needed (meaning when I feel a particular dip in energy or mood, I’ll take it for a few days in a row until I’m feeling balanced again.)
I have a liquid form and I’ll put one or two drops in my 32oz. stainless steel water bottle first thing in the morning (usually with a lemon slice, a little quality salt for hydration and minerals, and a few drops of my raspberry leaf tincture). The dosage I use is roughly 3mg in one drop versus many liquid iodines run about 150-200mcg per drop. Iodine helps maintain the normal function of the thyroid. Our bodies need iodine to make thyroid hormones, and these hormones control the body’s metabolism and aid in proper bone and brain development especially during pregnancy and infancy. 19,20,21 The increased demand for iodine continues for nursing mothers, as babies receive iodine through breast milk. I personally feel a subtle energy boost on the mornings I take iodine as well.
Iodine is especially important in the first 12 weeks of pregnancy because the unborn child’s thyroid isn’t active on it’s own yet, so the baby relies solely on the mother’s thyroid hormones.22 Yet another reason to begin taking some of these supplements during the conception process or before if possible. Too much iodine may be harmful, so once again, consult the needs of your own body and discuss it with your doctor.
A Final Note
I realize this list can be overwhelming, it’s also not an exhaustive list. As I stated earlier, I don’t take all of these things all of the time. These are specific to my current needs during this current pregnancy and season of life. I was also breastfeeding my 17-month-old during the first 20+ weeks of pregnancy which significantly contributed to my need for increased nutrition via food sources and supplementation. Follow the advice of your body, your baby, and your healthcare support as you consider the prenatal vitamins that are right for you.
1. Scaglione F, Panzavolta G. Folate, Folic Acid and 5-Methyltetrahydrofolate are not the same thing. PubMed. 2014 May;44(5):480-8. https://www.ncbi.nlm.nih.gov/pubmed?term=24494987. Accessed April 2020.
2. Meletis, CD. Folate vs Folic Acid – Facts about Vitamin B. American Pregnancy Association. https://americanpregnancy.org/infertility/folate-vs-folic-acid-what-you-need-to-know/. Accessed April 2020.
3. Hollis BW, PhD. Vitamin D and Breastfeeding: An interview with Bruce Hollis, PhD. Charleston, SC; 2018. https://kellymom.com/nutrition/vitamins/vitamin-d-and-breastfeeding/. Accessed April 2020.
EPA & DHA:
4. Greenberg JA, MD., Bell SJ, DSc, RD, and Van Ausdal W. Omega-3 Fatty Acid Supplementation During Pregnancy. Reviews in Obstetrics & Gynegology. 2008 Fall; 1(4): 162–169. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2621042/. Accessed April 2020.
5. Knovich MA, Storey JA, Coffman LG, and Torti SV. Ferritin for the Clinician. Elsevier Blood Reviews. 2009 May; 23(3): 95–104. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2717717/. Accessed April 2020.
6. Dahiya K,, Verma M, Dhankhar R, Ghalaut VS, Ghalaut PS, Sachdeva A, Malik I, and Kumar R. Thyroid profile and iron metabolism: mutual relationship in hypothyroidism. Biomedical Research. (2016) Volume 27, Issue 4. Published online 2008 Oct 2. https://www.alliedacademies.org/articles/thyroid-profile-and-iron-metabolism-mutual-relationship-in-hypothyroidism.html. Accessed April 2020.
7. Deshmukh U, Katre P, and Yajnik CS. Influence of maternal vitamin B12 and folate on growth and insulin resistance in the offspring. PubMed. 2013 Jul 19. https://www.ncbi.nlm.nih.gov/pubmed/23887113. Accessed April 2020.
8. Watanabe F, Yabuta Y, Bito T, and Teng F. Vitamin B12 Containing Plant Food Sources for Vegetarians. Nutrients. 2014 May; 6(5): 1861–1873. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4042564/. Accessed April 2020.
RED RASPBERRY LEAF:
9. Wells K. Raspberry Leaf. 2019. Medically reviewed by Dr. Betsy Greenleaf, D.O. https://wellnessmama.com/5107/raspberry-leaf/. Accessed April 2020.
10. Parsons M, Simpson M, and Ponton T. Raspberry leaf and its effect on labour: safety and efficacy. PubMed. 1999 Sep;12(3):20-5. https://www.ncbi.nlm.nih.gov/pubmed/10754818. Accessed April 2020.
11. Zarean E, and Tarjan A. Effect of Magnesium Supplement on Pregnancy Outcomes: A Randomized Control Trial. PubMed. 2017. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5590399/. Accessed April 2020.
12. Maria Elisabetta Baldassarre, Valentina Palladino, Anna Amoruso, Serena Pindinelli, Paola Mastromarino, Margherita Fanelli, Antonio Di Mauro, and Nicola Laforgia. Rationale of Probiotic Supplementation during Pregnancy and Neonatal Period. PubMed. 2018 Nov; 10(11): 1693. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6267579/. Accessed April 2020.
13. Neu J, and Rushing J. Cesarean versus Vaginal Delivery: Long term infant outcomes and the Hygiene Hypothesis. Clinics in Perinatology. 2011 Jun; 38(2): 321–331. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3110651/. Accessed April 2020.
14. Stein R. Researchers Test Microbe Wipe To Promote Babies’ Health After C-Sections. February 2016. https://www.npr.org/sections/health-shots/2016/02/01/464905786/researchers-test-microbe-wipe-to-promote-babies-health-after-c-sections. Accessed 2020.
15. Zeisel SH. Nutrition in pregnancy: The argument for including a source of choline. PubMed. 2013 April. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3639110/. Accessed April 2020.
16. Kruger WD and Gupta S. The effect of dietary modulation of sulfur amino acids on cystathionine β synthase–deficient mice. PubMed. 2017. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4801721/. Accessed April 2020.
17. Jockers. CBS Mutation and low sulfur diet. https://drjockers.com/cbs-mutation-low-sulfur-diet/. Accessed April 2020.
18. The Johns Hopkins University. Adrenal Glands. 2020. https://www.hopkinsmedicine.org/health/conditions-and-diseases/adrenal-glands. Accessed April 2020.
19. Mercola. Iodine Supplements in Pregnancy May Boost Babies’ Brains. Alternate Health Therapy. August 2015. https://alternativehealththerapy.wordpress.com/2015/08/24/iodine-supplements-in-pregnancy-may-boost-babies-brains/. Accessed April 2020.
20. World Health Organization (WHO). Iodine supplementation in pregnant and lactating women. https://www.who.int/elena/titles/iodine_pregnancy/en/. Accessed April 2020.
21. Paolo Ghirri, Sara Lunardi and Antonio Boldrini. Iodine Supplementation in the Newborn. PubMed. 2014 Jan; 6(1): 382–390. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3916868/. Accessed April 2020.
22. Lee SY and Pearce EN. Iodine intake in pregnancy. Nature Reviews Endocrinology. 2015 May; 11(5): 260–261. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4590285/.
Disclaimer: This post contains affiliate links. If you make a purchase, I may receive a small commission at no cost to you. This post is not meant to be medical advice. Please consult your healthcare provider for professional guidance.
Lachelle has a love for writing and holistic health. MBA, 500RYT Yoga Instructor, founder of Ello Lifestyle and Ello Candle Co., Lachelle spends most of her time as a wife and mother to two daughters, looking for ways to optimize health, create an efficiently running home, embrace the chaos, and pursue those things that make life feel enchanted.