What kind of prenatal vitamin should I take? (Hint: probably none)

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Everybody knows that taking a prenatal vitamin is important to growing a healthy baby, right? We are commonly asked, “What kind of prenatal vitamin should I take?” The short answer is, probably none.

What?! What about all those micronutrients?

 

It is true that micronutrients are important to growing a healthy baby. Midwife Heather Mason wrote about some of the theory behind the statement, “You are what you eat.” And midwife Becca Raper summarized the important nutrients for a healthy pregnancy. But here’s the thing – there is no evidence that people who take prenatal vitamins have healthier babies. 

Does anyone need a prenatal vitamin?

Research shows that most people don’t need a pregnancy multi-vitamin. People who are undernourished or malnourished might benefit from a prenatal vitamin. If you often have to go hungry because you don’t have access to enough food then a prenatal vitamin might benefit you. But the cost of prenatal vitamins adds up quickly. You can make a bigger difference if you use that money to purchase food (or transportation to a food bank) rather than vitamins.

People who struggle with frequent nausea and vomiting in pregnancy are often worried that they are not eating enough healthy foods and so take a prenatal vitamin to fill the gap. If you were healthy and ate well before the pregnancy then this is not necessary. Plus, prenatal vitamins often make nausea and vomiting worse. And so people eat less. Prenatal vitamins can actually make the problem worse!

Should I take any vitamins?

Maybe! There is good evidence that folate can improve outcomes by reducing the incidence of neural tube defects. The neural tube is the tube that the spinal cord is in. It is a pretty important container! The best situation is when you have enough folate in your diet or take a folate supplement three months before your pregnancy and for the first three months you are pregnant. 

Vitamin D is another important nutrient that many people would benefit from supplementing. We get some vitamin D from our diet but most of it comes from exposure to the sun. Many people will not have enough vitamin D if they live in northern climates where we get little exposure to the sun for a lot of year. We don’t really store a lot of vitamin D in our bodies so we need to keep taking it in. Many of us would benefit from a vitamin D supplement whether we are pregnant or not.  Vitamin D is also recommended for breastfed babies.

Some people will benefit from iron supplements. Your health care provider will offer to check your iron levels at the beginning of your pregnancy and then later on. If you have low iron or are told you are anemic then you should consider supplementing based on the advice of your care provider. The Association of Ontario Midwives has a great resource explaining anemia. Iron is one of the supplements that can cause nausea. If you don’t need it, don’t take it!

The Good News

Folate and Vitamin D are cheap and don’t cause nausea. They are also usually small pills or capsules. So you can ditch those large, expensive prenatal vitamins. Replace them with specific supplements that are easier to swallow. You and your baby will be better off!

Before you make any decisions, talk to your health care provider about what is right for you. Only take supplements that are actually going to improve your health or your baby’s health. Spend the money you save on healthy foods!

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Genia Stephen is a registered midwife and lactation consultant with Generations Midwifery Care. You can learn more about Genia here.