Paging Dr. Grunebaum: Prenatal Vitamins, Part 1: Where and When to Start Prenatal Vitamins

In a two-part series, Dr. Grunebaum  of BabyMed.com, Director of Obstetrics and Chief of Labor & Delivery at NewYork-Presbyterian Hospital/Weill Cornell Medical Center, gives us his advice on prenatal vitamins.  Today, we’ll hear the general scoop on prenatals.  Tomorrow, he’s going to dive into the specific supplements DHA and EPA and tell us why they are so vital for prenatal health.

The very first recommendation you hear when you are pregnant is that you should take your prenatal vitamins during pregnancy.

Taking prenatal vitamins is important to ensure that you and your baby receive adequate and balanced nutrition.

It’s hard to get all the nutrients you and your baby need, even if your diet is close to perfect and you eat a broad range of foods, including meat, dairy products, fruits, vegetables, grains, and legumes.

Prenatal vitamins are specially formulated multivitamins that supplement a diet and often make up for any nutritional deficiencies in the mother’s diet. The most important ingredient in prenatal vitamins is folid acid, a B vitamin. Folic acid can reduce your risk of having a baby with a serious birth defect of the brain and spinal cord, called the “neural tube” and taking it before pregnancy can also reduce the risk of a miscarriage or other fetal malformations.

Most women however do not realize that to achieve optimal outcomes folic acid and prenatal vitamins must be taken several months prior to conception, at least 1-2 months prior to conception. Preconception vitamins, especially folic acid, are more effective and have a more beneficial effect when taken before than during pregnancy. That is not to say you should not take your vitamins during pregnancy, but taking folic acid and vitamins before pregnancy ensures that you optimally decrease certain complications.

Because about half of all pregnancies are unplanned, the U.S. Public Health Service recommends that all women of childbearing age get 400-600 micrograms of folic acid each day. In fact, the FDA now requires that all flour products — such as breads, buns, and bagels — be fortified with extra folic acid. A woman who has had a prior child with a neural tube defect should discuss the appropriate dose of folic acid with her doctor before her next pregnancy. Studies have shown that taking a larger dose (up to 4,000 micrograms) at least one month before and during the first trimester may be beneficial.

While a daily vitamin supplement is no substitute for a healthy diet, most women need supplements to make sure they get adequate levels of nutrition and minerals. In addition to folic acid there are other ingredients which are crucial during pregnancy including Calcium to prevent a new mother from losing her own bone density as the fetus uses the mineral for bone growth. Most typical prenatal supplements do not contain enough Calcium to support nutrition during pregnancy, so you may want to add additional calcium supplementation during pregnancy. In addition, adding iron to your daily supplements helps both the mother and baby’s blood carry oxygen.

Finally, not all prenatal vitamins are the same. You should carefully read the ingredients in your prenatal supplement to ensure you get enough vitamins and supplements and don’t take too much of certain Vitamins like Vitamin A that could be harmful.

Read carefully the list of ingredients. Optimally, you should take a prenatal vitamin that has about 100% of the recommended daily allowance (RDA). Too much of certain vitamins may be harmful, so staying around 100% of RDA recommended daily allowance assurance that you take the correct amount.