Prenatal vitamins

For your reading enjoyment, a bit about prenatal vitamins.  Why they are important, the types of prenatals out there, and what to do when you just can’t stomach it.

The super multivitamin.

For a mother’s health, and the health of her baby, she is advised to take so-called ‘prenatal vitamins’ during pregnancy. Prenatal vitamins are specially formulated multivitamins that make up for any nutritional deficiencies in the mother’s diet.  The super multivitamin.  If you suspect you might be pregnant or are trying to get pregnant, it’s in the best interest of your health and your unborn baby’s health to start taking your prenatal vitamins and to continue taking them throughout your pregnancy.

What makes them different from regular multivitamins?

Prenatal vitamins have extra folic acid, iron, and calcium, which are all important minerals and supplements during your pregnancy.

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.’ A baby with spina bifida, the most common neural tube defect, is born with a spine that is not closed. The exposed nerves are damaged, leaving the child with varying degrees of paralysis, incontinence, and sometimes mental retardation.

Neural tube defects develop in the first 28 days after conception, before many women realise they are pregnant. Because about half of all pregnancies are unplanned, the Department of Health recommends that you take 400 micrograms of folic acid each day while you are trying to conceive, and should continue taking this dose for the first 12 weeks of pregnancy. . 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.

There are natural sources of folic acid: green leafy vegetables, nuts, beans, and citrus fruits. It is also found in many fortified breakfast cereals and some vitamin supplements.

Calcium during pregnancy can prevent a new mother from losing her own bone density, as the fetus uses the mineral for bone growth.

Iron helps both the mother and baby’s blood carry oxygen.

While a daily vitamin supplement is no substitute for a healthy diet, most women need supplements to make sure they get adequate levels of these minerals.

Not all vitamins are created equal.

No, you don’t necessarily need to take the prenatal your OB prescribes you.  You can take over the counter ones, but be careful in selecting them.  Look for vitamins containing the ingredients listed below.

• 400 mcg of folic acid
• 400 IU of vitamin D
• 200 to 300 mg of calcium
• 70 mg of vitamin C
• 3 mg of thiamine
• 2 mg of riboflavin
• 20 mg of niacine
• 6 mcg of vitamin B12
• 10 mg of vitamin E
• 15 mg of zinc
• 17 mg of iron

My prenatal makes me nauseated.  What do I do?

Unfortunately, your prenatal vitamin can make you feel a little queasy.  It’s believed to be related to the level of iron.  Some prenatal vitamins contain up to 30 mg of iron, which can be difficult to stomach.  If you have trouble stomaching your prenatal, try the following:

• Take your prenatal vitamin with food or before bed.
• Consider taking a food-based prenatal vitamin, which are typically easier on the stomach and easier to digest than mineral based vitamins.
• Chewable or liquid vitamins are also an option.
• If it’s the size of the vitamin that’s causing the problem, again, chewable or liquid vitamins are available.  You can also get prenatal vitamins without calcium that are much smaller and easier to swallow.  However, you would have to take a separate pill to get your extra necessary calcium.
• If all else fails, consider talking to your HCP about taking a prenatal that doesn’t have iron in it, at least during your first trimester when you’re typically your sickest.  You can try to eat foods high in iron (such as dark leafy greens) to make up for the lack of iron in your prenatal.  If this doesn’t work, continue to talk with your HCP until you find something that works for you.

Beware of constipation.

That extra iron in your prenatal, on top of making you nauseated, unfortunately can cause constipation.  Constipation is already common enough during pregnancy, and the extra iron is only going to add on to it.  Constipation in pregnant women is thought to occur in part due to hormones that relax the intestinal muscle and by the pressure of the expanding uterus on the intestines. Relaxation of the intestinal muscle causes food and waste to move slower through your system.

Let me tell you something.  Everything’s worse when you’re pregnant.  Even constipation.  Many moms complain of a heavy achey pressure in their pelvis and become concerned about their pregnancy.  Constipation is quite the culprit.

Preventing and treating constipation.

Prevention and treatment of constipation involve much of the same thing. Here are a few things that you can do to help prevent constipation from occurring or treat it if you are already experiencing it:

• Eat a high fiber diet: Ideally, you will consume 25 to 30 grams per day of dietary fiber from fruits, vegetables, breakfast cereals, whole grain breads, prunes and bran.
• Drink a lot of fluids: Drinking plenty of fluids is important, particularly with your increase of fiber. Drink 10 to 12 cups of fluids each day.  I can’t tell you how important staying hydrated is. It is the combination of a high fiber diet and lots of liquid that best help you eliminate your waste. Sweat, hot/humid climates, and exercise may increase your need for additional fluids.
• Exercise routinely: If you are inactive, you have a greater chance of constipation. Walking, swimming and other moderate exercises help the intestines work by stimulating your bowels. Schedule exercise three times a week for 20-30 minutes each.
• Over-the-counter remedies: There are over-the-counter products such as Metamucil which may help soften your bowel movements and reduce constipation. Always speak to your health care provider before using over-the-counter medications.  Your HCP may even prescribe a stool softener, such as Colace or Docusate, if the constipation becomes enough of a discomfort.
• Reduce or eliminate iron supplements: Iron supplements may contribute to constipation. Good nutrition can often meet your iron needs during pregnancy. Taking smaller doses of iron throught the day rather than taking it all at once can reduce constipation. Talk to your health care provider about checking your iron levels and recommendations to manage iron intake during pregnancy.

Do not!

Do not take laxatives.  Laxative pills are NOT recommended for the treatment of constipation during pregnancy because they might stimulate uterine contractions and cause dehydration.

Mineral oils, such as castor oil, should NOT be used during pregnancy because there is an increased reduction in nutrient absorption.  And if you drink enough castor oil, you might trigger the same problem laxatives can cause.

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