Vitamins and supplements during pregnancy

Vitamins and minerals are nutrients that your body needs in small amounts to work properly.

Most of the nutrients you need come from food. This includes vitamins and minerals.

Dietary supplements are products designed to give you nutrients that might be missing from your diet.

Your body needs extra nutrients when you are pregnant. You should try to eat a healthy, balanced diet to stay well and support the growth of your baby. Include fresh fruit and vegetables in your meals.

Good nutrition in pregnancy is important for the development of your baby. Your body needs a variety of nutrients for good health, such as:

• carbohydrates
• protein
• fats
• fibre
• vitamins and minerals

While you are pregnant, you don't need to eat for 2. But you do need enough nutrients to meet both yours and your baby's needs. Aim for high quality nutritious food, and consider adding extra protein to your diet while pregnant.

When you're pregnant, you need to eat:

• protein — to form new body tissues
• iron — to help form red blood cells and stop anaemia
• iodine — needed for brain and nervous system development
• folate (folic acid) — to prevent neural tube defects
• omega-3 — these polyunsaturated fats support healthy brain, nerve and eye development in your baby
• calcium and vitamin D — to make sure your baby has healthy bones

Talk to your midwife or doctor for advice.

A healthy balanced diet should provide most of the nutrients you need. However, in Australia, it's recommended that all pregnant women take a:

• folic acid supplement
• iodine supplement

Some women also need a:

• vitamin D supplement
• iron supplement

Folic acid

Folate, also called folic acid, is important for brain development. You need folate to reduce the chance of your baby being born with a neural tube defect, such as spina bifida. It's found naturally in green leafy vegetables. It's also added to foods such as bread and breakfast cereals. As your body needs twice as much folate when you are pregnant, it's not easy to get enough from food.

The best way to make sure you get enough folic acid is to take a daily folic acid supplement when you are pregnant or trying to conceive.

Ideally, you would start taking 0.5 milligrams (mg) of folic acid daily at least one month before a planned pregnancy. A baby's brain grows quickly in the first few weeks after conception — some parts are formed before you know you are pregnant.

Continue taking 0.5mg of folate for the first 3 months of pregnancy. A supplement that contains 400 micrograms (mcg) of folic acid is another good option.

Your doctor may recommend a higher dose of folic acid (5mg) if you:

• have diabetes
• are living with overweight or obesity
• take anticonvulsant (epilepsy) medicine
• have a member of your family affected by a neural tube defect
• are at risk of poor food absorption

Iodine

Iodine is important for your baby's brain development. An iodine supplement is recommended pre-pregnancy, during pregnancy and while breastfeeding. Look for a supplement that contains 150mcg per day.

Vitamin D

Your body needs vitamin D to take-up and use calcium. Your skin makes vitamin D when you are exposed to sunlight. If you are likely to be low in vitamin D, your midwife or doctor may recommend a blood test to check your vitamin D levels. Depending on these results, your healthcare team might recommend that you take a supplement during pregnancy.

Speak to your midwife, doctor or dietician to understand if this test and a vitamin D supplement may be recommended for you.

Iron

In the second and third trimesters of pregnancy, your body has increasing iron demands. This infographic shows how to meet your iron needs at different stages of life.

Your doctor or midwife can order a blood test to find out if you have iron deficiency or anaemia. If you do, they will likely recommend that you should take an iron supplement.

Calcium

During pregnancy, calcium is important for your baby's growth. However, there is usually no need for extra calcium supplements when you are pregnant if you eat a healthy diet. This is because your body adapts to make more efficient use of the calcium from your usual food.

There is some evidence that taking calcium supplements lowers your chance of high blood pressure during pregnancy.

Your body only needs a small amount of each vitamin and mineral. The Australian Government publishes a Recommended Dietary Intake (RDI) for each of the vitamins.

Having more of a vitamin is not always better. In fact, consuming more than you need can sometimes cause harm.

For example, high doses of some vitamins can be dangerous:

• vitamin A
• vitamin C
• vitamin E

It's best not to take these vitamins as supplements during pregnancy.

Vitamin A

The best way to get enough vitamin A in pregnancy is from foods such as:

• eggs
• dairy products
• orange and yellow vegetables
• green leafy vegetables
• oily fish such as salmon
• meat

If you take extra vitamin A in a supplement during pregnancy, it might increase the chance of birth defects in your baby. Supplements usually contain vitamin A as retinyl esters, which are converted to retinol. Retinol can harm your growing baby.

Do not take more than 10,000 international units of vitamin A per day when pregnant. It's also best to avoid eating foods that are very high in vitamin A. This might include liver and pâté.

Vitamin C

Vitamin C is found in a wide variety of fruits and vegetables. It is also called ascorbic acid. A balanced diet can give you all the vitamin C you need. Vitamin C might help improve the absorption of iron from your diet.

Very high doses of vitamin C can cause side effects such a stomach cramps and diarrhoea.

Vitamins and supplements can have side effects. Just as you should check with your doctor before taking any medicines while pregnant, it's best to do the same with supplements.

In Australia, the Therapeutic Goods Administration (TGA) regulates all vitamins for safety and quality.

Your midwife or doctor might suggest you take a supplement for your own health. Depending on your individual needs, they might also refer you to a dietitian.

Your midwife or doctor may suggest you take:

• vitamin B12 — if you follow a vegetarian or vegan diet
• iron — if you have iron-deficiency anaemia
• calcium — if your usual diet does not have enough or you have certain medical conditions
• omega-3 fatty acids — if you're low in omega-3

Vitamin B12 is important since it supports the development of your baby's nervous system.

Omega-3 supplements during pregnancy may lower your risk of premature birth.

A multivitamin is a mix of different vitamins and minerals, usually taken as a tablet. If you eat a balanced, healthy diet, you should be getting most of what you need from your food.

Some multivitamins are designed especially for pregnant people. These often contain extra folate, iodine and iron.

Formulations vary, so check the label or ask your pharmacist, midwife or doctor if a pregnancy specific multivitamin product is suitable for you.

Only take a high dose vitamin supplement if it is recommended by your doctor.

For more information about vitamins and supplements during pregnancy, you can:

• check the Australian Dietary Guidelines for advice — they also have a leaflet on Healthy eating during your pregnancy
• read the Food Standards Australia and New Zealand (FSANZ) advice on Pregnancy and healthy eating.
• talk to your pharmacist, doctor, midwife or dietitian
• call 1300 MEDICINE on 1300 633 424 to speak to a pharmacist about medicines.