How to Choose the Best Prenatal Vitamin

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About two weeks ago, a fellow dietitian asked me for a prenatal vitamin recommendation. I've written a post on prenatal vitamins before, but nothing in depth. Her simple question inspired me to write a more thorough guide to help you choose the best prenatal supplement.

This post gives guidance and suggestions, not hard and fast rules. If you can't find a vitamin that meets all the criteria, don't worry! Something's better than nothing. And don't forget, what you eat is far more important than any supplement you take.

I've answered eight of the most common questions I get about prenatal vitamins. If you have any other questions about prenatals, please ask in the comments section below or send me an email. 

Also, check out the end of this post for a free prenatal vitamin checklist you can download and take with you to the store. It'll help you sort through all the options you'll find on the shelves.


What if I'm not pregnant, can I still take a prenatal?

Many women take prenatal vitamins even when they're not pregnant. One of the top reasons is the super fast hair and nail growth pregnant ladies experience. Some folks think it's the prenatal vitamin that's behind the growth. If only it was so.

Unfortunately, prenatal vitamins won't give you lustrous hair and speedy nail growth. The reason pregnant women reap those two beauty benefits are all those pregnancy hormones. 

Other women will take a prenatal vitamin because they're trying to get pregnant. In this case, taking a prenatal vitamin is a good idea. Another group of women who might want to consider taking a prenatal vitamin are postpartum and breastfeeding women. 

Some men are interested in taking prenatal vitamins too. If it has iron, men shouldn't take it since they rarely need additional iron.


Why should I take a prenatal vitamin? 

Most pregnant women simply aren't getting enough of the vitamins and minerals they need for optimal health. Women who aren't pregnant aren't faring much better.

  • 24% of pregnant women are lacking in calcium

  • 26% aren't getting enough vitamin A

  • 29% could use more folate in their day

  • 30% are missing the mark for vitamin C

  • 90% are low in vitamin D

  • 94% aren't taking in enough vitamin E

  • 96% of pregnant women don't meet the iron recommendations

Even if you eat only unprocessed, organic, whole foods in the form of plenty of fruit, vegetables, nuts, seeds, oils, quality animal proteins, spices, herbs, and whole grains, it's still really hard to get the recommended amount of each and every nutrient.

With our depleted soil and the simple fact that we don't absorb every drop of goodness our food has to offer, we simply can't ensure that just because we eat "perfectly" we're getting enough of everything.

Does that mean you should depend on supplements and not care about how and what you eat? Of course not! Food will always be superior to supplements and will always be the preferred way to nourish our bodies. But taking a prenatal vitamin is still a wise idea. 

If you're pregnant or trying to conceive there are a lot of benefits to taking a prenatal vitamin.

For the trying to get pregnant crowd:

For the pregnant ladies:

  • Taking a prenatal vitamin might decrease the risk of delivering a baby that is small for gestational age.

  • You'll lower the chance your baby will be born at a low birth weight.

  • The risk of a still birth is lower for women who take a prenatal vitamin.

For postpartum and breastfeeding women:

  • Prenatal vitamins give you some of the nutrients you need to replenish your own body after it gave so sacrificially to your new baby.

  • The nutrients you take in affects the amount of nutrients in your breastmilk. Supplementing ups the amount of many vitamins and minerals in your breast milk.


What should I look for in a prenatal vitamin?

With so many options out there, it's important to choose a prenatal vitamin that has the right nutrients in the form your body prefers in the right amounts. 

Most prenatal vitamins contain around 20 different vitamins and minerals. Some (I'm looking at you gummies) have far less. 

The nutrients below are ones many of us aren't getting enough of. Aim to get them from food (I'll be doing a series on food sources of these "shortfall" nutrients soon) and try to make sure they're in your prenatal, too.

Vitamin A

Recommended Dietary Allowance During Pregnancy:

770 mcg/ day

How Much Should Be in a Prenatal Vitamin: 

Vitamin A is usually reported in IU (international units) on supplement labels. If all the vitamin A is from beta carotene, up to 15000 IU is allowed (though, not advised), but you probably won't find it that high anyway. If your vitamin contains retinyl palmitate or retinyl acetate, there shouldn't be more than 2500 IU from these two. 

Best Form: 

Food based or food created. Beta carotene is a safe bet. Retinyl palmitate or retinyl acetate are fine, but there shouldn't be more than 2500 IU  of vitamin a coming from them. 

Folate

Recommended Dietary Allowance During Pregnancy: 

600 micrograms DFE/ day

How Much Should Be in a Prenatal Vitamin: 

400 mcg-1,000 mcg (1 mg) is what you'll usually find.

Best Form: 

Food based or food created, 5-MTHF, Quatrefolic, and 5-methyltetrahydrofolic acid

Vitamin C

Recommended Dietary Allowance During Pregnancy:

85 mg/ day

How Much Should Be in a Prenatal Vitamin: 

It shouldn't be more than 2,000 mg. I've never seen a multivitamin or prenatal vitamin with that much in it though.

Best Form:

All forms seem to be good choices. If you have a sensitive stomach, consider choosing Ester-C or one of the mineral ascorbates, (calcium ascorbate, sodium ascorbate, magnesium, etc.), food based or food created.

Vitamin D

Recommended Dietary Allowance During Pregnancy: 

600 IU (15 mcg)/ day. 

How Much Should Be in a Prenatal Vitamin: 

1,000 or more IU is ideal, 600 is good, 400 is probably what you'll find.

Best Form: 

Food based or food created, cholecalciferol or D3 is preferred but D2 is fine as well.

Vitamin E

Recommended Dietary Allowance During Pregnancy: 

15 mg (22.4 IU)/ day

How Much Should Be in a Prenatal Vitamin: 

Look for at least 15 mg (the RDA) but up to 1,000 mg (1,500 IU) seems to be safe. But honestly, there's no benefit for going that high unless your doc, nurse practitioner, or midwife recommends it.

Best Form: 

Food based or food created, mixed tocopherols and tocotrienols, and d-alpha forms. Avoid dl-alpha forms.

 Calcium

Recommended Dietary Allowance During Pregnancy: 

1,000 mg/ day

How Much Should Be in a Prenatal Vitamin:

Calcium is bulky. It's nearly impossible to put the full RDA in a multivitamin. If your prenatal has any, great! Your best bet is to focus on eating more calcium rich foods. You might also want to talk to your healthcare provider about taking a calcium supplement.

Best Form: 

Food based or food created, calcium citrate, and calcium malate

Iron

Recommended Dietary Allowance During Pregnancy: 

27 mg/ day

How Much Should Be in a Prenatal Vitamin:

At least 18 mg

Best Form:

Food based or food created, ferrous bis-glycine chelate (FeBC), ferric tris-glycine chelate, ferric glycinate, and ferrous bis-glycinate hydrochloride

Iodine

Recommended Dietary Allowance During Pregnancy:

220 mcg/ day

How Much Should Be in a Prenatal Vitamin:

150 mcg

Best Form: 

As long as there's iodine in it, we're doing pretty good. You'll probably see food based or potassium iodide.

Magnesium

Recommended Dietary Allowance During Pregnancy:

350 mg/ day

How Much Should Be in a Prenatal Vitamin:

If there's any magnesium in your prenatal, that's more than many of them that have ZERO. You'll definitely want to eat more magnesium rich foods, take epsom salt soaks, and consider talking to your provider about taking a separate magnesium supplement.

Best Form:

Food based or food created, magnesium citrate, magnesium malate, magnesium glycinate, magnesium aspartate, magnesium lactate, and magnesium chloride.

Omega 3

Recommended Dietary Allowance During Pregnancy: 

At least 200 mg/ day

How Much in a Prenatal Vitamin:

Some prenatals, but definitely not all, will have omega 3s in them. If they do, the RDA would be nice. If there's less than that (or none at all) you'll probably have to take it separately (I'm a fan of this one from Care/of. They also have an algae oil omega supplement if you need a vegetarian or vegan form. Use promo code LIVEFERTILE to get two weeks worth of supplements for free) or focus on getting enough from low mercury food sources.

Best Form:

No best form here. Just look for mercury and PCB free. You might also see the words molecularly distilled or molecular distillation.


What should I avoid in a prenatal vitamin?

While some prenatals are better than others, there really aren't many I would call terrible. And that's because while many are lacking in some areas, most don't have ingredients that are downright dangerous.

You may have heard from others you should only take supplements without artificial dyes. I say, if you can find a prenatal vitamin without artificial dyes, great. If not, don't let that prevent you from taking a prenatal vitamin. I strongly believe the pros outweigh the cons in this case.

Without question you should avoid any supplements that have ingredients you're allergic to. Supplements will typically have an allergy warning label on their bottles, but if you're not sure, call or email the company. They should be able to provide you with a list of potential allergens in their vitamins. 

I'm not a huge fan of gummy varieties because they tend to be majorly lacking in minerals like calcium, iron, and iodine, but they're helpful if you have trouble swallowing pills. If you can find a gummy that's pretty complete, then by all means, take it. Otherwise, if you can, choose something else. 

Usually women turn to gummies if they're having trouble swallowing the oftentimes ridiculously large prenatal tablets. But there's a lot of options to handle that problem.


I can't swallow pills, what are some other options?

This is a super common concern. Pills, in general, can be hard to swallow, pair that with the horse pill status of most prenatals and you're really in for some trouble. Fortunately there's a lot you can do:

  • Blend your pill into a smoothie.

  • If it's a capsule, pull the two ends apart and stir the contents into apple sauce or another food (unless the label says not to.)

  • Choose a prenatal that comes in three to four small(er) doses instead of one large pill.

  • Cut your vitamin in half and take one piece at a time.

  • Take your prenatal vitamin while eating, between bites of food.

  • Breathe deeply and remain calm; try not to think about how hard it is to swallow pills.


When should I take my prenatal?

There's no right or wrong time of day to take your vitamin, unless of course there's a wrong time for you to take it. For some women that might be in the morning when they may feel a bit more queezy, for others the wrong time is whatever time they're likely to forget about it. 

Here are some tips to help you decide when to take your prenatal vitamin:

  • If you tend to be nauseated in the am, take it at night right after you brush your teeth and right before bed.

  • If lunch is the only meal you're sure to sit down for each day, take it at lunch.

  • If you often forget to take it, put it by something you use or look at daily, like your toothbrush or phone charger.

The most important thing is to choose a time that works for you.


What happens if I forget to take my vitamin?

In short, nothing. One day without your vitamin won't harm you or your baby. If it's ongoing, consider choosing a time you're more likely to remember. Check out the question and answer above for some ideas.


Which prenatal vitamin do you recommend?

There are three I'm fond of: Care/of's Prenatal (use promo code LIVEFERTILE to get two weeks worth of supplements for free), Honest Company's Multi Complete Prenatal Vitamin, and Garden of Life Vitamin Code Prenatal.

Care/of's is the easiest to swallow prenatal vitamin I've tried so far. Which for me, someone who hates swallowing pills, is very important.

The Honest Company's prenatal is probably the easiest to find on the ground (though you can certainly order it online) of all three of them.

The Garden of Life prenatal is easy to find at health food stores, including Whole Foods and on Garden of Life's Website.

All three have the recommended amount of iron, folate, and iodine. Plus, they provide these nutrients in the most bioavailable (fancy for easy for your body to absorb and use) forms.

If you're looking for a Fish Oil Supplement too, I like the one from Care/of. They also have an algae oil omega supplement if you need a vegetarian or vegan form.

.takecareof.com
Best Prenatal Vitamin.jpg

Don't forget to download the prenatal vitamin checklist to take with you on your next trip down the vitamin aisle. It has information on what forms and amounts to look for. I promise it'll make your hunt for the best prenatal vitamin so much easier.

prenatal vitamin checklist

DOWNLOAD YOUR FREE PRENATAL VITAMIN CHECKLIST

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