Articles

Key takeaways

• Folic acid helps your baby’s spine to develop properly.
• Take folic acid and vitamin D daily.
• Avoid supplements containing vitamin A and most herbal remedies.
• Always speak to your doctor or midwife about your supplement needs.

Essential vitamins for a healthy pregnancy

Some vitamins and minerals are very important during pregnancy. Getting the right nutrients helps your baby grow and develop.

Folic acid

Folic acid is a B vitamin. It helps your baby's spine develop properly. It helps prevent serious problems with your baby's spine (known as neural tube defects), such as spina bifida.

You should take a daily 400 microgram (0.4 milligrams) folic acid tablet. Start taking folic acid as soon as you find out you're pregnant, and don't worry if you weren't taking it before. Continue taking it for the first 12 weeks of your pregnancy. If you have not been taking a supplement, it is not too late to start. It is difficult to get the recommended amount of folate from food alone.

Your midwife or GP may ask you to take a larger amount of folic acid, which is 5 milligrams (mg).

You may need a higher dose if:

• You have had a baby with a neural tube defect before.
• Someone in your close family has a neural tube defect.
• You are taking medicines for epilepsy.
• You have diabetes.
• You have a digestive condition where your body reacts to gluten (coeliac disease).
• Your body mass index (BMI) is 30 or more.
• You have an inherited blood condition, such as sickle-cell anaemia or thalassaemia.
• You take anti-retroviral medicine for HIV.

If any of these apply to you, talk to a GP. They can prescribe a higher dose of folic acid.

Iron

You and your baby need iron to make a substance in your red blood cells that carries oxygen around the body (haemoglobin). Your baby gets the iron they need from you while developing. This can cause your iron levels to fall, which may lead to a condition where you don't have enough healthy red blood cells (anaemia). This can make you feel very tired and weak. It is important to get enough iron throughout pregnancy.

If your blood tests show you are anaemic during pregnancy, your doctor or midwife will give you an iron supplement. Otherwise, you do not need to take an iron supplement, indeed most women do not need to take extra iron during pregnancy.

Vitamin D

You need 10 micrograms (mcg) of vitamin D each day. Vitamin D helps control the amount of calcium and phosphate in the body. These are needed to keep bones, teeth, and muscles healthy.

Your body makes vitamin D when your skin is exposed to summer sunlight. In the UK, this is generally from late March or early April to the end of September. Between September and March, your body cannot make enough vitamin D from sunlight alone.

It is recommended that pregnant and breastfeeding women take a daily supplement containing 10 micrograms of vitamin D. This is especially important between September and March.

You should take vitamin D all year if:

• You have Black or Brown skin.
• You cover your skin a lot when outdoors.
• You spend a significant amount of time inside.

Understanding dosage and prenatal vitamins

Eating a healthy, varied diet during pregnancy will help you get most of the vitamins and minerals you need. However, some supplements are very important.

Choosing a quality prenatal supplement

Some people like to take pregnancy multivitamins. These are generally fine. They tend to be more expensive than buying the recommended supplements separately. They may be helpful if you are vegan or follow a restricted diet. If you have concerns about your diet, talk to your midwife or GP.

Always check the label of any multivitamin. Do not take cod liver oil or any supplements containing vitamin A (retinol) when you are pregnant. Too much vitamin A can be harmful to your baby. Multivitamins not specifically for pregnancy are likely to contain vitamin A.

You can buy folic acid or pregnancy multivitamins from any pharmacy or supermarket. There is no evidence that expensive brands are better than cheaper ones. A GP may also be able to prescribe required supplements for you. You may be able to get free vitamins if you qualify for the Healthy Start scheme.

Supplements to use with caution or avoid

Some supplements can be unnecessary or harmful during pregnancy. Always check with your GP or midwife before taking any new supplement.

Vitamin A

Too much vitamin A can be harmful to your growing baby. Vitamin A is stored in your body, so it is possible to store too much.

During pregnancy, avoid:

• Any supplements that contain more than 700 micrograms (mcg) of vitamin A.
• Cod liver oil.
• Foods such as liver or liver products like pate.
• Fish liver oils. These foods may contain high levels of vitamin A. Always check supplement labels carefully.

Other vitamins and iron

There is no evidence to recommend additional vitamin E during pregnancy. You do not need any other vitamin B supplements besides folic acid.

Most women do not need to take extra iron during pregnancy. Taking routine iron supplements will not necessarily benefit your health. They may also cause unpleasant side effects. These can include heartburn, constipation, or diarrhoea. Your midwife will check your blood at your booking appointment and at 28 weeks of pregnancy. You will only be advised to take iron if you are found to be anaemic.

Herbal and homeopathic remedies

Not all natural remedies or complementary therapies are safe during pregnancy. Some products may not be of high quality. These products are not regulated like medicines. They might contain unlisted ingredients that could be unsafe during pregnancy.

It is best to avoid taking herbal remedies during your pregnancy. Most medicines, including herbal medicines and natural remedies, can cross from your bloodstream to your baby.

For example, St John's Wort is a popular herbal remedy for depression. It is not clear whether it is safe to take during pregnancy. Some herbal remedies, such as blue cohosh, can be harmful to your baby.

Tell your midwife, doctor, or pharmacist if you are using herbal or homeopathic remedies. Also inform them if you are using aromatherapy remedies.

If you decide to use these therapies, always consult a qualified practitioner. You should tell your practitioner that you are pregnant before discussing any treatment. Always check before you take any kind of medicine.