What you've heard or may have experienced for yourself is true: vitamin pills can exacerbate the nausea of early pregnancy. But aren't they necessary for a healthy pregnancy? Your body does need extra vitamins and minerals during pregnancy. If you are already in good health, a well-balanced diet including whole grains, fruits and vegetables, dairy products and lean meats will cover the increased nutritional demands of pregnancy. While supplements contain only some of the nutrients needed for optimal fetal development and growth—and are not a substitute for a healthy diet—many women take a prenatal vitamin for added assurance that their nutritional needs are being met.
Some women have increased needs for supplements. If you are vegetarian, have other dietary restrictions, or have a medical condition that interferes with adequate vitamin and mineral absorption, speak to your provider about taking a supplement. Similarly, women carrying twins and women unable to discontinue using cigarettes or other drugs will have higher nutritional needs.
The increased requirement for certain vitamins and minerals in pregnancy includes folic acid, iron, vitamin B6, vitamin C, vitamin D, zinc, copper and calcium. Check to see that your prenatal vitamin contains these. Some vitamins are water-soluble such as folic acid, vitamin B, C and D. Excess amounts of these vitamins will be excreted into your urine. Fat-soluble vitamins, including A, E and K can accumulate in body tissues and fat; take care to avoid excesses of these. No more than 10,000 IU of vitamin A should be taken daily, for higher levels have been linked to birth defects.
Folate (or folic acid) is an especially important nutrient, shown to decrease the rate of neural tube defects. Take at least 400 micrograms before conceiving and continue this in the first months of pregnancy. Iron needs increase after the 12th week of pregnancy. Iron is better absorbed when taken with citrus juices (orange, grapefruit), but can be hard on your stomach and cause constipation. Ask your provider for gentler forms to take if you have any difficulties.
Many women may not get adequate amounts of an omega-3 fat called docosahexaemoic acid (DHA), which is helpful for brain and neurologic development. Coldwater fishes such as salmon contain DHA; flaxseed oil also contains omega-3's, or you can take it as a supplement.
The best way to give your developing baby a good start is through eating a well-balanced diet and taking any supplements at the proper dosages (consult with your health provider). If you find that prenatal vitamins upset your stomach, take them after meals or talk to your doctor about waiting to use them until later in your pregnancy. If swallowing a pill is difficult for you, you can use a children's formula or crush your vitamins and mix them with food or juice. And remember, supplements do not replace good eating habits.
Our parenting advice is given as suggestions only. We recommend you also consult your healthcare provider, and urge you to contact them immediately if your question is urgent or about a medical condition.