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Prenatal Supplements

Updated on February 23, 2013

Prenatal Vitamin and Mineral Supplements: An Overview

A pregnant woman’s nutritional requirements differ from those of others. If you are pregnant, you especially need more folate (folic acid), iron and calcium. This will ensure healthy fetal growth as well as a healthy pregnancy. A major part of this critical requirement is fulfilled by prenatal vitamin supplements.

A typical prenatal vitamin supplement would contain vitamins A, C, D and E, as well as B vitamins including thiamine (B1), riboflavin (B2), pantothenic acid (B5), B6, and niacin (B12) and of course folic acid. It may also contain iron, calcium and other minerals such as magnesium, selenium, copper and zinc.

Most of these supplements come in the form of pills. Some, especially calcium supplements, are available as chewable tablets. Some others are also available in the liquid form, although they are slightly on the steeper side.

Prenatal supplements do not follow any specific formula. Some may have more iron, whereas others may be richer in folate. While some of these are available only on prescription, many can be bought over the counter. However, always consult your healthcare provider before selecting a specific supplement.

Why do Women Need Prenatal Supplements?

Prenatal supplements are beneficial not only for the fetus but also for the pregnant mother. While vitamins and minerals are essential for general well-being, their role gets more critical during pregnancy. Some; such as folic acid, calcium and iron; need to be taken in much larger quantities during pregnancy.

Folic Acid

Every woman of childbearing age is recommended to have 400 mcg of folic acid per day. For a pregnant woman, the requirement increase by almost double. Folate is a type of vitamin B that significantly reduces risks of neural tube defects, such as spina bifida and cleft palate, for the fetus.

In Spina Bifida, the spine of the fetus fails to close properly, causing damage to nerves. This often results in children having paralysis of the lower limbs. Spina Bifida can develop in the embryo in the very first week of pregnancy, and so it is advisable to start taking folate supplement months before conceiving.

Calcium and Iron

A pregnant mother’s body makes much more blood to support the growing fetus and placenta. Therefore, it requires higher amounts of iron. Pregnant women are recommended to take 27 mg of iron each day, which is almost 50 percent more than the normal requirement.

The Center for Disease Control recommends all pregnant women to take an iron supplement of 30 mg from the very first prenatal visit. The iron requirement grows in the last two trimesters as the growing baby needs more blood.

The daily calcium requirement of women above 18 years of age is around 1,000 mg. But a growing fetus takes its share of calcium from mother’s bones, and hence an addition supply of calcium is required for pregnant mothers to prevent bone density loss.

Though the skeletal development of the fetus happens mainly in the last trimester, it is best to start taking extra calcium from the very beginning of the pregnancy to keep an extra store of calcium in the bones.

How to Choose the Right Prenatal Supplement?

Prenatal supplements are available in such a vast variety that it is difficult to choose the right one. The best way always is to talk to the health-care provider. Taking a blood test could help in determining the amount of iron required during pregnancy, especially during the third trimester.

It is best to choose a supplement that has enough extra amounts of folic acid and iron. It is also necessary to ensure that it does not contain excessive amounts of other nutrients. Overdosing on these, especially on vitamin A, can be extremely dangerous to the baby.

Women who find it difficult to swallow large pills can take opt for separate pills for vitamins and calcium. A good number of calcium supplements are available in chewable tablet form. Taking liquid vitamin supplements can also be a good option.

Some supplements contain added herbs, amino acids or enzymes. The body does not really need these extras. It is best to check with a health-care provider before taking any such supplement.

What Are the Possible Side Effects?

Prenatal supplements have their fair share of side effects. A majority of women who take these supplements complain of nausea and an upset stomach. Many experience a nasty, metallic aftertaste. The best way to avoid these side effects is to take the supplements after dinner. Most women are able to sleep through the night without any trouble. Changing your supplements might also help, but it is not advisable to stop taking them altogether.

Iron supplements are known to cause constipation. Drinking a lot of water and adding more fiber to the diet usually help overcome this problem. Some medical practitioners suggest taking pills that contain iron in the form of ferrous fumarate or ferrous gluconate instead of ferrous sulfate which is used in most of the supplements. A slow release pill is another option, though it is more expensive.

Iron supplements also cause the stool color to change to black. This, however, is not an indication of any problem.

Women experiencing any other signs of side effects--difficulty in breathing; swelling of face, tongue, lips or throat; or hives--should seek emergency medical help.

What Are the Associated Risks?

The main risk associated with prenatal supplements is the risk of overdosing. Consuming vitamin A in quantities higher than 8,000 IU can be fatal for fetus. Most supplements contain 3,000 to 5,000 IU of vitamin A, which can be easily supplemented by eating food with higher vitamin A content. It is best to take a single dose of your supplement and fill in the remaining requirement with nutritious food rather than taking two vitamin pills and getting overdosed.

Avoiding them altogether is also not a very good idea though, as it puts the growing fetus at higher risk of developing neural tube defects. The pregnant mother, too, is more susceptible to iron and calcium deficiencies, which increase the risk of anemia and bone loss.

Some Myths Associated with Prenatal Supplements

Several myths are associated with the consumption of prenatal supplements. Since women are suggested to start taking the supplements even when they are trying to conceive, many women believe that these help in conceiving. The truth, however, is that certain nutrients, such as folic acid, are required from the very onset of pregnancy and since you cannot be sure when you would conceive, it is best to keep a good bank of nutrients in your body when trying to conceive.

Even though prenatal supplements provide a good amount of vitamins and minerals, remember that they are just "supplements": they do not contain 100 percent of the daily required amount of the nutrients needed for a healthy pregnancy. So make sure that you eat a well-balanced diet, even while taking the vitamin and iron pills. A pregnant woman should strive to eat five servings of different fruits and vegetables every day in addition to whole grains.

Calcium content of prenatal vitamin supplements is especially low, with most of them having only 15–25 percent of the daily requirement. Some of them might not contain any calcium. It is essential to eat calcium rich food. Taking an additional calcium supplement is also a good idea.

Also Keep a Note of These Basics

You are advised to start the prenatal vitamins as soon as you are pregnant or even before conceiving if you are trying for it. Since there are various types of prenatal supplements available over the counter, many women tend to pick them up without consulting the experts. However, certain things must be learned before popping that pill.

What is the Right Time to Take Them?

The most important thing to learn is when and how to take prenatal supplements. Though taking them after a meal is a good idea, certain foods, such as dairy products, hinder the absorption of iron and calcium.

Calcium, in turn, blocks certain vitamins and iron from getting absorbed, and so it is a good idea to eat a meal lean in calcium before taking the vitamin supplement. Calcium supplement should also be taken at a separate time. Vitamin D helps in calcium absorption and should be taken along with the calcium supplement if your supplement is not fortified with it.

How to Store Them?

Prenatal supplements can be easily stored in any cupboard or kitchen top. They should be kept away from heat, sunlight and moisture and always stored in their original bottles. Like any other medicine, supplements too need to be kept out of reach of children. The excessive iron in them can fatally harm children, and so can an overdose of several pills.

According to many medical experts, including the American Pregnancy Association, non-pregnant women and men can also take prenatal supplements. On the other hand, high iron levels of these supplements can cause some side effects. It is best to avoid them and take a regular multivitamin supplement.

What is the Right Dosage?

It is very important to take correct dosage of prenatal supplements. While a little extra store of iron or folate won’t harm much, an overdose of these and other vitamins can seriously harm both the fetus and pregnant mother. One pill a day is enough to provide those extra nutrients required by pregnant women. There is no need to take any other multivitamin while taking prenatal vitamins.

What to Do When Overdosed?

Vitamin overdose symptoms include headache; nausea; vomiting; stomach problems; flaking skin; hair fall; muscle, joint or back pain; tingling inside and around the mouth; weight loss; change in urine color and blood in urine.

An overdose of vitamin A can cause deformities in fetus, while vitamin D overdose can even result in mental retardation of the baby.

Immediate emergency medical help should be sought in case of the slightest overdose detection.

To avoid getting overdosed, it is essential to take only one pill in 24 hours. In case of missing a dose, take it as soon as possible, but if it’s getting nearer to the time of the next dose, it is best to skip.

Consulting Healthcare Provider

As with any medication, prenatal supplements should be taken after consulting the healthcare provider. The doctor should be informed of any current or past allergy or disease, especially stomach ulcers, liver problems, bone, kidney or liver diseases, increased bodily iron or red blood cell destruction. The healthcare provider should also be told if you have any history of blood transfusions or alcoholism. This is the time to stay healthy and keep your baby healthy too, so don’t hide anything from your doc.

Certain medicines such as antacids, diuretics, thyroid medicines, antibiotics, heart or blood pressure medicines, on-steroidal anti-inflammatory drugs and some anti-seizure medicines can interact adversely with prenatal multivitamins. If you are on any kind of medication, make sure to talk to your doctor.

Pregnant women who are breastfeeding should also consult their doctor before taking any prenatal vitamins, even though in most cases it is safe to take them.

The healthcare provider might ask for some simple blood tests to determine the individual requirements of a pregnant woman before prescribing any prenatal vitamin.

Check Your PSQ (Prenatal Supplement Quotient)

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