Vitamins and Minerals during Pregnancy

Supplements have become a fixed feature of prenatal care in most countries. With the exception of folic acid, all nutritional needs during pregnancy can be met through a properly planned, nutritious diet. However women in nutritional risk groups including those with poor diets or suffering from substance abuse or pregnant teenagers are advised to take supplements. Many doctors are in favor of the idea that pregnant women in general take prenatal supplement during the course of their pregnancy. Moreover the fact remains that pregnant women need more of almost every vitamin and mineral than women who are not pregnant.

Recommended daily allowances (RDA) of vitamins and minerals

Don't fall into the trap of thinking that since some is good, more must be better! In the case of vitamins an excessive intake can be harmful. Very high doses of Vitamin A, D and C are teratogenic i.e. substances or drugs that cause fetal abnormalities. Seek your doctor's approval on which vitamin formula is best during the pregnancy period.

Calcium	1000-1200 mg
Phosphorous	1200 mg
Magnesium	320 mg
Iron	30 mg
Iodine	140 mcg
Selenium	60 mcg
Zinc	15 mg
Vitamin A	800 mcg
Vitamin D	10 mcg
Vitamin E	10 mg
Vitamin C	50-70 mg
Vitamin B1 Thiamin	1.5 mg
Vitamin B2 Riboflavin	1.6 mg
Vitamin B3 Niacin	17 mg
Vitamin B6	2.2 mg
Folic acid	400-600 mcg
Vitamin B12	2.2 mcg

Folate Essentials

• Folic acid before and in the very early pregnancy months help in the prevention of neural tube defects such as spina bifida. 0.4 - 0.6 mg of folic acid on daily basis is a prerequisite for all women trying to conceive.

• A folic acid supplement is necessary since foods alone do not provide adequate amounts.

• Folic acid should also be taken in the final trimester

• Folate should be taken in the pre-planning stage of pregnancy, ideally 3-6 months before conception.

• Overcooking destroys the heat sensitive folic acid.

• Prenatal vitamins usually contain between 0.4 mg to 1 mg of this vitamin.

Food sources: green leafy vegetables, asparagus, broccoli bananas, dried peas and beans, fortified breakfast cereals and bread, orange juice

Iron essentials

• Iron is the only nutrient for which the fetus acts like a parasite, taking what it needs from the mother. If the mother has insufficient stores, she can suffer from iron deficiency anemia.

• Since you no longer menstruate during pregnancy, your body becomes more equipped at extracting iron from food. Logically you will not need iron supplements. But the truth is generally women are deficient in this mineral.

• The average woman's diet does not provide an adequate supply of iron.

• Iron combines with protein to form hemoglobin in the red blood cells.

• Your body can store iron therefore a healthy diet means a healthy store of iron.

• Elemental iron is the available or absorbable part of the tablet. To allow for the necessary 30 mg of iron to be absorbed by the mother, the tablet strength of ferrous sulphate should be 150 mg, 300 mg of ferrous gluconate and 100 mg of ferrous fumarate.

• Since iron can suppress zinc levels do not exceed the recommended dose.

• Iron intake must be high because it takes about 6 weeks to build up supplies.

• The iron in meat (heme iron) is easily absorbed in comparison to plant sources (nonheme iron).

• Iron in excess causes constipation.

• Tea and coffee inhibit iron absorption; wait an hour after meals or supplements before drinking the beverage.

Food sources: lean red meat, egg yolks, fish, spinach, dried legumes, prunes, wholegrain cereals

Calcium Essentials

• This is the most abundant mineral in the body with 99% found in the bones and teeth.

• Sufficient calcium can be achieved through diet alone, except for the lactose intolerant.

• Calcium is necessary for blood clotting, muscle contraction and nerve signaling.

• It helps prevent high BP.

• It is important to boost calcium levels throughout pregnancy but more so in the last trimester.

• Calcium becomes especially important if you are below 25 as peak bone health isn't reached until after you turn 25.

Food sources: milk, cheese, yoghurt, canned fish with bones (salmon and sardines) tofu, tempeh, leafy vegetables

Zinc Essentials

• Zinc is necessary in cell replication.

• Low intake leads to low birth weights.

• Iron supplement may interfere with zinc absorption.

• Zinc is found in protein rich foods such as meat and fish.

• If you are getting enough of this mineral before conceiving, you probably won't need to take more in the form of supplements during pregnancy.

• Ordinarily zinc supplements are not required but in cases where high doses of iron are prescribed zinc supplementation may be necessary.

Food sources: seafood, meats, eggs, corn, peas

Vitamin D Essentials

• This vitamin is needed for the absorption of calcium and for baby's bone and teeth development.

• Your body manufactures vitamin D from sun exposure.

• In some countries where sunshine isn't always guaranteed pregnant women need to take vitamin D supplement of 10 mcg a day.

• This vitamin is fat soluble and can be stored in the body.

Food sources: oily fish, eggs, polyunsaturated margarine and butter

Vitamin B family Essentials

• B vitamins are necessary for cell formation, especially in the first trimester when cell division is at its peak.

• B vitamins are water soluble and excreted in the urine

• B1 and B3 are necessary for good birth weight.

• B2 and B6 to balance hormones.

• B2 and B5 for energy.

• B6 is a must for proper development of fetal immune system and improving metabolism and in providing relief of severe nausea and vomiting.

• B12 aids in the manufacture of red blood cells and for fetal nervous system

Food sources: fortified breakfast cereals, vegetables, whole grains, meat, fish, eggs and milk

Vitamin A Essentials

• Its natural forms include retinol (mature version found in animal products) and beta carotene derived from plant sources and converted in the body to vitamin A.

• Vitamin A is fat soluble hence can be stored in the body.

• Vitamin A is involved in the production of baby's cell membranes, heart, nervous system and vision

• Very large doses of retinol has been linked to an increased risk of birth defects

• Liver is the only food that provides high amounts of retinol so liver and liver products such as pate should be avoided

• Supplements should contain vitamin A in the form of beta carotene rather than retinol as beta carotene is safer.

• Vitamin A dose in supplements or multivitamin should not exceed 8,000 IUs.

• Anti-acne medication Accutane is a vitamin A product and is teratogenic in pregnancy.

• Vitamin A excess or deficiency can be dangerous to the fetus

Food sources: fish oils, dairy produce, egg yolk, yellow and red fruits, red and dark green vegetables

Vitamin C Essentials

• Vitamin C is useful in the manufacture of tissues, collagen, healthy skin.

• Just like B vitamins, vitamin C is water soluble and has to be supplied on regular basis.

• Vitamin C helps in the absorption of iron and boosts the maternal immunity system.

• Excessive dose of ascorbic acid in the fetus may lead to symptoms of vitamin C deficiency in the newborn

Food sources: cranberries, kiwi, citrus fruits & juices, peppers, potatoes, green vegetables

Magnesium Essentials

• Along with manganese, it is essential for hormone balance and energy production

• Aids in the absorption of calcium and combined with calcium it helps in the formation of muscles, cells and nerves as well as in the creation of bones and teeth.

Food sources: legumes, nuts, whole grain, peanut butter, spinach

Phosphorous Essentials

• This mineral helps in bone and teeth development

• Phosphorous and calcium should be in balance for the prevention of leg cramps.

• Excess phosphorous can disturb the calcium balance so there should be a control on snack foods, sodas since these are high in phosphorous.