What to Look for in a Prenatal Multivitamin

Are you expecting, or even just hoping? Congratulations: it’s time to take extra good care of yourself.  Growing another human is no small feat; your body will be maxing out its resources to support the development of your baby and prepare you for labor. Even if you normally live a pretty healthy lifestyle, most of us are short on key nutrients to begin with, even before pregnancy ups the nutritional demands. That’s why it’s so important to take a prenatal multivitamin to make sure that your body and your baby are getting what they need.

Not just any multivitamin will do. Pregnancy has unique nutritional needs, and prenatal multivitamins are specifically designed to meet those needs. Your body will make 50% more blood during pregnancy, for instance, increasing your need for iron. Nutrients such as folate become extra important to support your baby’s neurological development and prevent birth defects. Prenatal vitamins will typically contain crucial nutrients like these in higher amounts.

But not all prenatal multivitamins are alike, either. Prenatal multivitamins can vary a lot in the details, from how many nutrients they include to the amounts of those nutrients and the forms that they take. Some prenatal vitamins skimp on important ingredients in order to fit their formula into a gummy or a one-a-day dose. Others include nutrients in cheaper, synthetic forms that may be harder for your body to absorb. Some even include unnecessary additives like artificial preservatives, colors or flavors. In other words: check that label.

So what should you look for in a prenatal multivitamin? Here’s a good list for reference:

Folate

Every prenatal multivitamin should include some form of folate, or vitamin B9, to support healthy fetal development and help prevent neural tube defects and other pregnancy complications.1 Experts such as the NIH and the American College of Obstetricians and Gynecologists recommend at least 600 mcg a day. While you can get some of this from food, such as leafy greens, food-based folate is absorbed at a much lower rate than supplemental folate, and is easily destroyed through the cooking process. It’s better to overshoot than undershoot with this one, so look for a prenatal multi that has close to 600 mcg or more.

It’s also important to check the form of the folate in your prenatal multivitamin. The most common form is folic acid, a synthetic form that your body must convert into active folate. The problem is that up to 60% of women have a genetic variation that doesn’t allow them to make this conversion.2 It’s better to look for a multi that contains the natural, active form of folate, called methylfolate or L-5-MTHF. Our NATURELO Prenatal Multivitamin includes 800 mcg of active methyl folate.

Iron

Your body draws on iron during pregnancy to make extra blood, supply oxygen to the fetus, and support the development of muscle and blood cells. Lack of iron can result in pregnancy anemia, which not only makes you feel more tired and weak, but can increase the risk of preterm delivery and low birth weight.3 Since iron deficiency is common even before pregnancy,4 it’s especially important to get enough now. Mayo Clinic recommends 27 mg of supplemental iron per day, and that’s what our Prenatal Multivitamin includes.

The form of iron in your supplement is also important. Some forms of iron can be tough on the digestive system, which is the last thing you need during pregnancy, when you may already experiencing gastric upset and constipation. That's why our prenatal multivitamin uses a clinically tested, chelated form of iron called Ferrochel, which is much easier on the stomach and is clinically shown to be better absorbed and more effective than other standard forms of iron.5

Calcium

It takes a lot of calcium to build your baby’s bones and muscles, circulatory system and nervous system -- and if there isn’t enough available, your baby will draw it out of your bones.6 Women are already at risk of low bone density if they lack calcium, so you have to keep an eye on this one. Experts recommend getting at least 1000 mg of calcium per day, which is more than any multivitamin will include. There’s good reason for this: too much calcium at once interferes with the absorption of iron. Luckily, it’s fairly easy to get much of your daily calcium from food. 

The Mayo Clinic recommends at least 250 mg of calcium in your prenatal multivitamin to be on the safe side. Our NATURELO Prenatal Multivitamin includes 295 mg of calcium in a plant-based form derived from marine algae, as research shows that this form is easier for the body to absorb.7 We also include plant-based vitamin D3, vitamin K2, and magnesium to support healthy calcium metabolism. If you’re vegan or don’t eat dairy, it can be harder to get calcium from food, so you may want to take an extra calcium supplement in addition to your prenatal multivitamin. 

Vitamin D

In order to absorb all the calcium you need, you have to have enough vitamin D. However, vitamin D deficiency is surprisingly common, affecting nearly half of the U.S. population. Traditionally, most prenatal vitamins would include 400-600IU of vitamin D, but many doctors now recommend 800-1000IU, or more if you are deficient. Our NATURELO Prenatal Multivitamin includes 800IU of plant-based vitamin D3, but if your vitamin D levels are low, you may also want to take an additional vitamin D supplement. Some recent research even suggests that taking high doses of vitamin D during the first two terms of pregnancy, up to 4000IU per day, is not only safe but may reduce the risk of pregnancy complications. 

Iodine

Iodine is crucial for healthy thyroid function, which regulates your metabolism, body temperature, heart rate, and more. It also supports your baby’s growth, brain development, and thyroid development. Your body will need 50% more iodine than usual during pregnancy, as your metabolism shifts into overdrive to support all the rapid growth. Iodine used to be easy to get through iodized salt, but since many of us switched to using sea salt or Himalayan salt, iodine deficiency has become more common. The American Academy of Pediatrics recommends 290 mcg per day for pregnant women, yet many prenatal multivitamins contain less or none at all. Our NATURELO Prenatal Multivitamin includes 290 mcg of iodine in a plant-based form sourced from wild-harvested kelp.

B Vitamins

Not just folate (B9), but all the B vitamins are important for supporting your baby’s brain and nervous system development. While most prenatal vitamins include at least a few, our NATURELO Prenatal Multivitamin includes all eight, at levels that meet or exceed standard recommendations. The next most important B vitamin after folate is probably B12, which works in partnership with folate to support healthy brain, spine, and neural tube development and prevent birth defects. B12 deficiency is fairly common, especially for vegans, since it’s mostly found in animal products. The NIH recommends at least 2.8 mcg per day; our prenatal vitamin includes 4.8 mcg as methylcobalamin, the most biologically active form.

Vitamin B6 can help with nausea; it’s even an ingredient in many morning sickness drugs. WebMD recommends at least 1.9 mg per day; our prenatal includes 3.4 mg in the biologically active P-5-P form. Biotin (B7) is important for fetal growth and development, and is a common deficiency during pregnancy. At least 30 daily mcg is recommended; our prenatal multi includes 55 mcg. B1 (Thiamin), B2 (Riboflavin), B3 (Niacin), and B5 (Pantothenic Acid) are also important for keeping you and your baby healthy. We made sure to include them all in our prenatal multivitamin, at levels that meet or exceed recommendations by the American Pregnancy Association

DHA

A growing abundance of research is pointing to the importance of omega-3 fatty acids during pregnancy, particularly DHA. DHA is highly concentrated in the human brain and eye, and plays a crucial role in fetal cognitive and visual development.8 It’s also associated with healthier labor and delivery outcomes.9 Many U.S. women are already deficient in omega-3s, which are found mostly in fish, and pregnancy will increase your need for them even more. Unless you’re comfortable eating fish 3 times a week, it’s a good idea to take a supplement to help boost your DHA levels. 

Recommendations for DHA during pregnancy start at 200-300 mg per day, with some research suggesting up to 600-1000 mg per day.10 Yet many prenatal multivitamins don't include DHA at all. Our NATURELO Prenatal Multivitamin includes 100 mg of plant-based DHA to supplement your diet. But it doesn’t hurt to take more, especially if you’re avoiding fish because of potential neurotoxins like mercury, which can harm your baby. Our NATURELO Vegan DHA supplement provides an additional 800 mg DHA per day in a plant-based form sourced from marine algae.

Choline

Research has only recently uncovered the importance of choline for a healthy pregnancy. Choline works in partnership with the B vitamins to support healthy brain and nervous system function, and it plays a crucial role in your baby’s healthy cognitive development.11 According to the American Medical Association, over 90% of Americans don't get enough choline in their diet. But since awareness about choline and its role in pregnancy is still under the radar, many prenatal multivitamins don't include it. Our NATURELO Prenatal Multivitamin includes 55 mg of choline to complement your diet. But you need 450 mg a day, so be sure to eat foods with choline as well, such as eggs, broccoli, and soy.

Other vitamins and minerals

Other nutrients typically recommended for a healthy pregnancy include antioxidant vitamins like A, C, and E, and minerals like zinc and copper. The form of these nutrients is also important. Vitamin A is essential for your baby’s visual development, but preformed vitamin A, or retinol, can be risky, and is associated with birth defects and liver toxicity in high doses.12 For that reason, it’s safer to get your vitamin A in the form of plant-based provitamin A from carotenoids. 770 mcg a day is recommended; our NATURELO Prenatal Multivitamin includes 1040 mcg in the form of beta carotene.

Vitamins C and E help protect cells from oxidative stress, which has been linked with pre-eclampsia and other pregnancy risks, according to the World Health Organization. Vitamin C also synthesizes collagen, helping to build cartilage, bones, and skin for your baby. Our prenatal multivitamin includes both vitamins in their daily recommended amounts, in plant-based forms sourced from acerola cherries and sunflower. 

Zinc is an essential mineral that supports healthy cell division and a healthy immune system. Over 80% of pregnant women are estimated to be low in zinc, with deficiency linked to low birth weight and other health risks.13 Copper helps form red blood cells and your baby’s heart, blood vessels, skeletal and nervous systems.14 Our prenatal multivitamin includes both minerals in their recommended amounts and in a chelated form that’s easy for your body to absorb.

TLDR

For best results, look for the following ingredients in your prenatal multivitamin:

  • Vitamin A (beta carotene)
  • Vitamin C
  • Vitamin D3
  • Vitamin E
  • Vitamin K2
  • Thiamin (B1)
  • Riboflavin (B2)
  • Niacin (B3)
  • Vitamin B6
  • Folate
  • Vitamin B12
  • Pantothenic Acid (B5)
  • Choline
  • Calcium
  • Iron
  • Iodine
  • Magnesium
  • Zinc 
  • Copper
  • DHA

References:

1. Greenberg, James A et al. “Folic Acid supplementation and pregnancy: more than just neural tube defect prevention.” Reviews in obstetrics & gynecology vol. 4,2 (2011): 52-9.

2. “Folate and Folic Acid in Pregnancy.” American Pregnancy Association, Sep 2019.

3. Nils Milman, "Oral Iron Prophylaxis in Pregnancy: Not Too Little and Not Too Much!", Journal of Pregnancy, vol. 2012, Article ID 514345, 8 pages, 2012. https://doi.org/10.1155/2012/514345

4. Johnson-Wimbley, Terri D, and David Y Graham. “Diagnosis and management of iron deficiency anemia in the 21st century.” Therapeutic advances in gastroenterology vol. 4,3 (2011): 177-84. doi:10.1177/1756283X11398736

5. Szarfarc SC, de Cassana LM, Fujimori E, Guerra-Shinohara EM, de Oliveira IM. "Relative effectiveness of iron bis-glycinate chelate (Ferrochel) and ferrous sulfate in the control of iron deficiency in pregnant women." Arch Latinoam Nutr. 2001 Mar;51(1 Suppl 1):42-7. PMID: 11688081.

6. Barney, A., Charkalis, D.M., Pari-Keener, M. “Here’s What a Good Prenatal Vitamin Should Have.Parents, May 2015.

7. Adluri RS, Zhan L, Bagchi M, Maulik N, Maulik G. Comparative effects of a novel plant-based calcium supplement with two common calcium salts on proliferation and mineralization in human osteoblast cells. Mol Cell Biochem. 2010;340(1-2):73-80. doi:10.1007/s11010-010-0402-0

8. Greenberg, James A et al. “Omega-3 Fatty Acid supplementation during pregnancy.” Reviews in obstetrics & gynecology vol. 1,4 (2008): 162-9.

9. Carlson, S.E., Gajewski, B.J., Valentine, C.J. et al. Assessment of DHA on reducing early preterm birth: the ADORE randomized controlled trial protocol. BMC Pregnancy Childbirth 17, 62 (2017). https://doi.org/10.1186/s12884-017-1244-5

10. Whitney E. RD. “DHA Supplementation During Pregnancy: How Much Is Enough?” Mar 2018.

11. Korsmo, H.W.; Jiang, X.; Caudill, M.A. Choline: Exploring the Growing Science on Its Benefits for Moms and Babies. Nutrients 2019, 11, 1823.

12. Stewart, D.H. “Vitamin A in your pregnancy diet.” Baby Center.

13. Darnton-Hill, Ian. “Zinc supplementation during pregnancy.” World Health Organization, July 2013.

14. Stewart, D.H. “Copper in your pregnancy diet.” Baby Center.