From the Guidelines
Prenatal supplements, such as Ritual prenatal multivitamins, should be taken daily throughout pregnancy and ideally started at least one month before conception. The standard recommendation is to take one prenatal vitamin daily with food to minimize nausea, and continue throughout pregnancy and during breastfeeding. Most prenatal vitamins contain essential nutrients like folic acid (400-800 mcg daily), iron (27 mg), calcium (1,000 mg), vitamin D (600 IU), DHA (200-300 mg), and iodine (150 mcg) 1. Ritual specifically contains 1,000 mcg of folate, 18 mg of iron, 350 mg of DHA, and other essential nutrients in a delayed-release capsule designed to reduce nausea. These supplements help prevent neural tube defects in the developing baby, support maternal blood volume expansion, promote proper bone development, and ensure adequate nutrition when dietary intake may be insufficient.
Some key points to consider when taking prenatal supplements include:
- Starting supplementation at least one month before conception to ensure adequate folate levels 1
- Taking a daily prenatal vitamin with food to minimize nausea
- Continuing supplementation throughout pregnancy and during breastfeeding
- Informing your healthcare provider about all supplements you're taking to ensure they're appropriate for your specific needs during pregnancy
- Monitoring for potential side effects like constipation from iron and taking steps to mitigate them, such as taking the supplement with food, staying hydrated, and maintaining physical activity 1
It's also important to note that women with certain medical conditions, such as obesity or diabetes, may require higher doses of folic acid (4-5 mg daily) 1. Additionally, women who have undergone bariatric surgery may require closer monitoring of their nutrient levels and supplementation to prevent deficiencies 1. Always consult with your healthcare provider to determine the best course of supplementation for your individual needs.
From the Research
Recommendations for Prenatal Supplements
The American College of Obstetricians and Gynecologists (ACOG) recommends that all pregnant women take a prenatal vitamin supplement to ensure they get all the necessary nutrients for a healthy pregnancy 2.
Key Nutrients for Pregnancy
Some of the key nutrients that are essential for pregnancy include:
- Vitamin A
- Vitamin D
- Folic acid
- Calcium
- Iron
- Omega-3 fatty acids
Target Doses for Supplementation
The target doses for supplementation are:
- ≥198 mcg retinol activity equivalents of total vitamin A (with ≤2063 mcg preformed retinol)
- 7-91 mcg vitamin D
- 169-720 mcg dietary folate equivalents of folic acid
- 383-943 mg calcium
- 13-22 mg iron
- ≥59 mg ω-3 FAs 2
Foods That Optimize Intake of Key Micronutrients
While it is difficult to meet nutritional requirements from diet alone, some foods that can help optimize intake of key micronutrients include:
- Seaweed (raw or cooked without fat) for vitamin A, folate, calcium, iron, and omega-3s
- Fish, vegetables, and beverages for target amounts of 4 of the 6 nutrients 3
Omega-3 Fatty Acid Supplementation
Omega-3 fatty acids are essential for fetal neurodevelopment and may be important for the timing of gestation and birth weight 4. Pregnant women can obtain adequate omega-3 fatty acids by consuming a variety of sources, including:
- Vegetable oils
- 2 low-mercury fish servings a week
- Supplements (fish oil or algae-based docosahexaenoic acid)
Calcium-Iron-Folic Acid Prenatal Supplement
A combined calcium-iron-folic acid prenatal supplement can help support implementation of the new World Health Organization recommendations for calcium supplementation during pregnancy 5. The supplement should contain:
- 1.5 to 2.0 g of elemental calcium per day
- 60 mg of iron
- 400 microg of folic acid
Evidence-Based Recommendations for Mineral Supplementation
Evidence-based recommendations for mineral supplementation during pregnancy include:
- Calcium: 1.5 to 2.0 g per day
- Iron: 60 mg per day
- Magnesium: 350-400 mg per day
- Selenium: 60-70 mcg per day
- Zinc: 15-20 mg per day
- Iodine: 220-250 mcg per day 6