Studies have shown nutrient deficiency during pregnancy have been linked to the increase risk of “anaemia, pregnancy-induced hypertension and pre-eclampsia, foetal growth restriction and increased labour complications”.
A healthy and varied diet is the best way to get the nutrients you need before, during and after pregnancy. However the very obvious physiological changes when pregnant mean your nutrient requirements increase significantly, sometimes making it difficult to meet these needs through foods alone.
Supplements recommended by doctors, midwives and other health professionals are often used to help top up nutrient levels, particularly for important pregnancy micronutrients such as Folate and Iodine.
Macronutrients Vs Micronutrients?
Nutrients used by the body to function each and every day, they are broadly classified into two groups Micronutrients and Macronutrients. During pregnancy the need for both types of nutrients increases.
- What Are Macronutrients? Macronutrients refer to those needed in larger amounts. The human body requires 3 main macronutrients; carbohydrates, fats, and proteins.
- What Are Micronutrients? Micronutrients refer to those needed in smaller amounts. These include vitamins, minerals and trace elements such as Vitamin C, iron, magnesium, Vitamin D, B12 and many more.
Why Take Supplements When Pregnant?
The right amount of vitamins and minerals are vital for the energy, growth and development for you and your baby during pregnancy. And while meeting the continually growing demand throughout pregnancy with nutrient-dense diet is always the best plan – sometimes this is not possible or there are underlying reasons why supplementation is needed.
Here are just some of the reasons why women (under the advice of their doctor) may choose to supplement their prenatal, pregnancy and post-natal diets.
- Undiagnosed Pre-Existing Deficiencies. Some women don’t find out they are lacking in a vitamin or mineral until they have their first pregnancy blood test. Supplements are often recommended in order to bring this back into balance more swiftly.
- Hyperemesis Gravidarum. Essentially an extreme form of continual morning sickness, characterised by severe nausea and vomiting, Hyperemesis Gravidarum can lead to nutrient deficiencies due to the inability to keep food and water down.
- Poor Diet. Although we all make an effort to eat well sometimes there are reasons why this is not possible, under-eating or making poor dietary choices may increase the need to supplement with vitamins and minerals.
- Birth Defects. In New Zealand it is recommended that women supplement Folic Acid as studies have shown this results in a reduction in the risk of neural tube defects (source Ministry of Health).
- Dietary Restrictions. Those who have certain dietary requirements due to allergies or intolerances may need to keep a closer eye on nutrient intake and deficiencies using supplementation strategically to fill the gaps.
- Multiple Pregnancies. Obviously if you are carrying twins or triplets your nutrient needs are going to be much greater than carrying just one baby. In these instances your health professional may recommend supplements to ensure optimal nutrition for both mother and babies.
- Medical Conditions. Some pre-existing medical conditions such as Diabetes may mean there is an increased need for dietary monitoring and supplementation.
Please note; If you are pregnant, or planning a pregnancy, it is important to be very careful of any supplements you are taking as some have the potential to do more harm than good.
Prenatal Vitamin And Mineral Supplements
A healthy diet is the best way to get the nutrients you need before pregnancy, however sometimes on the advice of your health professional it can be beneficial to take supplements to top up the body to provide the very best start for mother and foetus. In New Zealand supplementing your diet with folate before becoming pregnant is recommended by the Ministry of Health,
1. Folate (Folic Acid)
The Ministry of Health recommends Folate supplementation for four weeks before becoming pregnant. Folate is important for the formation of blood cells and new tissue. Taking folate prior to conceiving has been clinically proven to reduce the risk of neural tube birth defects such as Spina Bifida.
2. Prenatal Multivitamins
For many women preparing their body for pregnancy is an extended process and taking a specially formulated for pregnancy multivitamin supplement such as Elevit is a great way to top up the vitamins and minerals in a general manner. Look for a good multivitamin with iodine and folate included and preparations can begin preferably 3 months prior to conception.
Vitamin And Mineral Supplements During Pregnancy
Being pregnant is the most nutritionally demanding phases of a woman’s life, taking a pregnancy vitamin can help cover any gaps in the daily diet. In New Zealand supplementing your diet with folate and iodine while pregnant is recommended by the Ministry of Health, read on for some of the more common micronutrients to be aware of when looking for supplements during pregnancy.
1. Folate (Folic Acid)
Folate is also important during the early stage of pregnancy as it supports the baby’s brain and spinal cord development. As it is sometimes difficult to source the increased amounts of folate needed for mother and baby through diet alone, supplementation during the first 12 weeks of pregnancy is recommended by health professionals in New Zealand – see you doctor or midwife for the correct product and dosage for you.
Iodine supports normal growth and development, and is essential for healthy brain development. The need for iodine increases during pregnancy and breastfeeding and it can be difficult to get enough from food alone. The Ministry of Health recommends women take an iodine supplement throughout their pregnancy. See your doctor for more information on the correct dose for you.
A woman’s iron requirement increases significantly during pregnancy which is not surprising as iron is essential for transporting oxygen around the body using the blood. Good iron levels are particularly important during the third trimester of pregnancy, as this is when iron deposition in the foetus is increased. Iron supplements are good for preventing iron deficiency anaemia and low birth weights for baby.
Mother and baby require adequate amounts of calcium for strong bones and teeth as well as for the circulatory, muscular and nervous systems. Calcium levels are particularly important for women during the third trimester where significant amounts are stored for lactation and also transferred to the baby.
5. Vitamin D
Vitamin D is important in aiding the absorption of calcium, it is used for the transfer of calcium to the growing baby and contributes to bone strength. For women who do not get a lot of sun exposure, have dark skin or are obese Vitamin D deficiency can be an issue. The Ministry of Health provides guidelines on how to get more Vitamin D.
While present is a variety of foods, magnesium needs during pregnancy are increased. Studies have indicated magnesium plays an important role in regulating muscle relaxation, increased birth weights and blood pressure.
Zinc is needed by the body for protein synthesis, cell division and DNA synthesis; unfortunately varying degrees of zinc deficiency are quite common among the general population. Most often linked to low birth weights, low levels of zinc have also been implicated in foetal loss and prolonged labour (source WHO).
Postnatal Vitamin And Mineral Supplements
After your baby is born your body requires time and energy to heal and recover not only from the birth but from the considerable nutrient drain and also continuing lactation needs. The focus now is on replenishing the vitamin and mineral levels in the mother to aid in recovery and also assist with the increased nutrient needs for lactation.
Due to the production of breast milk it is important to keep on top of a new mothers protein levels. Protein is best obtained from food sources such as red meats, chicken, fish (avoid those traditionally high in mercury), eggs and dairy products.
Iron levels in postpartem women are usually under pressure during the six weeks following childbirth (source NCBI) particularly if there has been significant blood loss as a result of the delivery and more iron is not consumed in sufficient quantities. Iron is needed for energy levels, and low levels may result in fatigue, impaired cognitive abilities and symptoms symptomatic of depression.
A form of vitamin B, choline is most commonly known to help with focus and memory, and can sometimes be helpful with the issue commonly referred to as “pregnancy brain.” Choline is found in foods such as egg yolks, broccoli and almonds.
4. Omega-3 Fatty Acids
While there are many factors and situations that contribute to post-natal depression, a deficiency in omega-3 fatty acids has been linked to this condition experienced post-birth by many women. If you do not regularly eat foods such as oily fish, especially salmon and sardines – supplementation may be an option for you.
The obvious demands of breast feeding mean a women’s calcium levels may come under strain. Eating calcium rich foods such as dark leafy greens, almonds and dairy foods is best, however if dietary restrictions are an issue speak to your doctor about calcium supplementation.
Always check with your doctor before taking any vitamin or mineral supplements before, during or after pregnancy. If you think you might be pregnant or for help with pregnancy related matters or more information on dietary requirements when pregnant, seek the professional advice of your GP, LMC or Midwife.
Please Note: All information contained in this article is given as general information; this is not intended to provide educated health or medical advice. Always consult your healthcare professional for specific medical reasons and advice on dietary requirements or nutritional supplements.