A healthy, balanced diet is important before, during and after pregnancy. Supplements and multivitamins are popular, but not all vitamins and minerals in these products are needed, and you may be getting most of these as part of a healthy diet. Currently, folic acid and iodine supplements are recommended for nearly all women planning a pregnancy or who are pregnant because it is difficult to get the required amount from foods alone. Iron, calcium and vitamin D are important for a healthy pregnancy but supplements should only be taken if recommended by a doctor, obstetrician or midwife.
1. Folic acid (Folate)
What is folic acid/folate? ‘Folate’ is the natural form, found in food. When it has been added to food (e.g. in bread) or in a supplement, it is called ‘folic acid’. They are a type of B vitamin (vitamin B9).
Why is folic acid/folate important during pregnancy? Folic acid/folate is important for a healthy nervous system. It promotes normal development of the spine and spinal cord during the early stages of pregnancy and therefore helps prevent birth defects such as spina bifida, where the baby’s spine doesn’t develop properly.
What foods contain folic acid/folate? Folate is found naturally in green leafy vegetables, citrus fruit, legumes, nuts and eggs. Since 2009, wheat flour used for making bread in Australia has been enriched with folic acid. However, even though folic acid is found in many foods, it is easily lost from the body (e.g. through cooking or boiling processes) and folic acid deficiency is common.
Should I take a supplement? Yes – this is widely recommended for all women, because it is difficult to get enough folic acid from diet alone. Most women need a supplement with a minimum of 400 micrograms (or 0.4 mg) daily.
Some women may be at increased risk of neural tube defects, such as those with certain medical conditions (e.g. diabetes, obesity) or taking certain medications, and may need a higher dose of folic acid.
Which stage in pregnancy is folic acid/folate important? Spina bifida can occur when the brain and spinal cord are forming, which is the time even before you realise you’re pregnant and in the early stages of pregnancy. Start taking folic acid at least 1 month before you start trying to fall pregnant and it should be continued for the first 3 months of pregnancy.
What is iodine? Iodine is important for our thyroid (a gland in the throat) which regulates our metabolism, growth and development.
Why is iodine important during pregnancy? In a developing baby, iodine is important for brain and physical growth and development. Iodine deficiency is the world’s leading cause of preventable intellectual disability in children.
What foods contain iodine? Seafood and seaweed are a good source and some brands of bread and dairy products which have been enriched with iodine. However, pregnant women can find it difficult to eat the required amounts of iodine from food alone, particularly since there are precautions with seafood that contain mercury.
Should I take a supplement? Yes, unless you have a thyroid condition (e.g. hyperthyroidism). It’s recommended that women who are planning pregnancy, pregnant or breastfeeding should take a 150 micrograms iodine supplement daily. Avoid taking kelp (seaweed) supplements or products because they have varying levels of iodine and may also contain mercury.
Which stage in pregnancy is iodine important? Iodine is important from the moment you start planning on becoming pregnant, and throughout your entire pregnancy. It’s also important in breastfeeding and should be continued.
What is iron? Iron is a mineral that is a vital part of red blood cells, moving oxygen around the body and making extra blood as required.
Why is iron important during pregnancy? Your iron requirements are increased because your body needs to make extra blood to supply oxygen to your growing baby. If your iron levels are low, you may feel tired and find it difficult to concentrate. For your baby, low iron levels can affect their growth and increase the risk of a premature birth and a low birth weight.
What foods contain iron? Red meat is the best source but iron is also found in chicken, seafood, leafy green vegetables, eggs and legumes. Vitamin C helps the body absorb iron so increasing vitamin C-rich foods can be helpful. Foods rich in vitamin C include oranges, tomatoes, strawberries and kiwi.
Should I take a supplement? No, unless you’ve been told to by your doctor, midwife or obstetrician. Although low iron is a concern, too much iron can cause problems, so iron supplements aren’t widely recommended for all pregnant women. Iron supplements can also cause constipation and other side effects.
Your iron levels are usually checked (with a blood test) at your first antenatal check-up and then again at around 28 weeks. Based on your iron levels and risk factors for iron deficiency, you may be recommended a specific iron supplement and dose.
Which stage in pregnancy is iron important? Generally in the third trimester to support your baby who will start building their own supply of iron, and support your growing placenta.
What is calcium? Calcium is a mineral important for strong bones, teeth, nerves and muscles, and a healthy heart.
Why is calcium important during pregnancy? During pregnancy, you transfer calcium to your growing baby if you don’t have enough, calcium is drawn from your bones.
What foods contain calcium? Dairy products such as milk, yoghurt and cheese are the best sources of calcium, and in smaller amounts, calcium is found in sardines, tofu, salmon and green leafy vegetables. Many products are ‘calcium-fortified’ which means that calcium has been added during the manufacturing process. It is recommended that all pregnant women eat at least 1,000mg calcium daily, which is about 3 serves of calcium-rich foods.
Should I take a supplement? Calcium supplements aren’t widely recommended in pregnancy – you should aim to get your calcium from foods. If you don’t think you’re getting enough calcium-rich foods, don’t start taking a calcium supplement without first speaking with your doctor of obstetrician. There are different types of calcium supplements and too much calcium can be problematic.
Which stage in pregnancy is calcium important? Throughout pregnancy and breastfeeding.
5. Vitamin D
What is vitamin D? Vitamin D helps the body absorb and use calcium, which is important for strong bones and teeth.
Why is vitamin D important during pregnancy? Low levels of vitamin D can lead to issues with bone growth or rickets.
What foods contain vitamin D? The main source of vitamin D is sunlight, but small amounts of vitamin D are found in foods such as egg yolk and oily fish (e.g. salmon).
Should I take a supplement? Vitamin D supplements aren’t widely recommended in pregnancy. Your vitamin D levels may be tested or you may be recommended a supplement if you’re at risk of vitamin D deficiency, e.g. you spend little time outdoors, you have dark skin, you cover your skin for religious reasons.
Which stage in pregnancy is vitamin D important? Throughout pregnancy and breastfeeding.