What Should be in my Prenatal Vitamin, and which one should I Take?

I get asked this question as an OB all the time!  There are so many prenatal vitamins on the market and it can be confusing and overwhelming as a first-time mom.  Am I taking the right one?  Does it have everything that I need to keep my baby healthy? Below I explore why prenatal vitamins are important and what are the most important nutrients that should be in your prenatal vitamins.  I also review a couple brands that have all these nutrients, so you don’t have to take multiple supplements while pregnant. 

1. Why are Prenatal Vitamins important?
   1. Pregnancy increases the need for certain nutrients and prenatal vitamins help fill gaps in the mother’s diet to promote healthy fetal development, reduce risks of complications, and support overall maternal health.
      
      
2. What are the most important nutrients that should be in your prenatal vitamin?
   • Methyl folate: Folate (Vitamin B9) is crucial for preventing neural tube defects such as spina bifida and anencephaly.  The neural tube forms in the first 28 days after conception.  A lot of women don’t even know they are pregnant at this point, so we always recommend starting prenatal vitamins 1 month before you try to conceive.  Traditional prenatal vitamins use folic acid which the body must convert through several steps (involving the MTHFR enzyme) into the active form 5-methylfolate.  I strongly recommend that my patients use methylated B vitamins because they are already converted into the active form.  This is especially important for women who have abnormalities of the MTHFR enzyme.  Women who have an abnormality in the MTHFR enzyme can take additional folic acid but they cannot convert it to the active form and will not have adequate levels of folate necessary for a healthy pregnancy.  The advantages of methylated B vitamins include higher bioavailability, more effective reduction in homocysteine levels, and no accumulation of unmetabolized folic acid.
   • DHA (Omega-3 Fatty Acid) is essential for baby brain and eye development especially in the third trimester.  It may reduce preterm birth, preeclampsia, improve infant cognitive/visual outcomes, bolster immune development, and aid maternal mood (decreasing postpartum depression risk).  It is found in fatty fish like salmon sardines and mackerel (wild caught fish are better than farmed fish).  300mg DHA are recommended daily in pregnancy. 
   • Vitamin D helps with calcium absorption, promotes fetal bone and tooth mineralization, and immune function.  It may lower risks of preeclampsia, gestational diabetes, preterm birth and infections.  The recommended daily unit in pregnancy is 600 IU. 
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3. Which brand of prenatal vitamins include methylated B Vitamins, DHA, adequate vitamin D, iron, and iodine without having to take multiple supplements to ensure you are getting enough nutrients that your growing baby needs?  Disclosure: I am not receiving compensation or invested in any of the companies that produce these products.  You can purchase these products on Amazon.
   • Pink Stork Total Prenatal +DHA: includes methylated folate and methylated B12, vegan DHA, iron, and vitamin D.
   • Ritual Essential Prenatal: includes methylated folate and methylated B12, vegan DHA, vitamin D3, iron and iodine!

Dr. Pam