You want the healthiest pregnancy possible, but does that mean you should continue to take your nutritional supplements during pregnancy? This guide will help you to know which supplements are fine to continue in pregnancy and which should be discontinued.
If you are like most women, you are probably already taking some nutritional supplements. This could be a multivitamin, extra B vitamins, or perhaps you are on a preconception supplement program. No matter what you are taking, you want to take care of yourself and your developing baby, so questioning supplementation intake comes naturally. The problem is it can be difficult to find the right answers about the safety of taking nutritional supplements in pregnancy.
To be safe, there is a common-sense rule of thumb doctors and midwives like to stick to: Don’t take any nutritional supplements or herbal supplements during pregnancy, unless directed to do so by your healthcare practitioner. I agree with this. A pregnancy should be supported first and foremost with good nutrition, including a high-quality whole food prenatal vitamin, plenty of filtered water, adequate rest and regular moderate exercise.
So, let’s get down to the nitty gritty of taking nutritional supplements in pregnancy…
Top nutritional supplements to continue in pregnancy:
Note: Please consult with your doctor or midwife before using any supplements during pregnancy.
Every single pregnant woman should be taking a prenatal multivitamin. We encourage pregnant mamas to take a prenatal vitamin that is 100% whole food. Prenatal multivitamins ensure mother and child are getting all the vital nutrients required for pregnancy. Prenatal multivitamins should not be a replacement for eating a nutrient-rich diet; instead, they should be the bridge to complete nutritional wellness. We like Baby and Me Multivitamin by MegaFood.
During pregnancy, a woman’s daily intake requirements for certain nutrients, such as folic acid (folate), calcium, and iron will increase. Vitamins and minerals such as iron, calcium, and folic acid are vital for proper fetal growth, development, and healthy adult living. ~American Pregnancy Association
Cod Liver Oil – Omega-3 Essential Fatty Acids
There is a lot of research showing the benefits of supplementing with omega-3 essential fatty acids. We find the number one way to get high quality omega-3 is to supplement with cod liver oil.
Dr. James A Greenberg of Harvard shares of many clinical trials on Omega-3 fatty acid supplementation during pregnancy involving women in the Faroe Islands, Denmark, Norway, Australia and Inuit women of Canada in the journal Reviews in Obstetrics and Gynecology, stating as a result, “There is little doubt that pregnant women need at least as many omega-3 fatty acids as non-pregnant women, and likely need more DHA.” It’s a great read that you’ll find in the references below.
Omega-3 fats contain two acids that are crucial to good health: DHA (docosahexaenoic acid) and EPA (eicosapentaenoic acid). These two acids have been shown to be extremely healthy for the body. Low levels of DHA and EPA have been linked to depression and other mental health issues. DHA is essential for proper brain development, while EPA supports healthy behavior and mood. These are not only critical for the development of your baby, but to help prevent postpartum depression as well. Cod Liver oil is also naturally rich in vitamin A & D3, which are other key nutrients for proper development of a baby.
For vegan or vegetarian mothers, supplementing with a DHA supplement instead of cod liver oil is going to be important.
Several studies have shown that humans are vitamin D3 deficient due to overuse of sunscreen, lack of sun exposure, and lower dietary consumption.
Vitamin D3 helps with calcium and phosphorus absorption, essential to healthy bone formation. It also helps to support the immune system, regulation of cell growth, helps reduce inflammation, increases muscle strength, aids the body in hormone production, and may help prevent depression.
New research is showing that pregnant mothers may benefit from supplementing additional vitamin D3 outside of their prenatal vitamin to help prevent premature labor, preeclampsia, gestational diabetes, and infections. Research has also shown that vitamin D3 supplementation in pregnancy promotes optimal bone-mass in the child later in life.
Traditionally 400 IU of vitamin D3 daily is the suggested recommendation for pregnant women, but several experts are now suggesting supplementation should be up to 1000 IU per day in pregnancy. Because prenatal vitamins typically already contain 400 IU and cod liver oil contains around 300-400 IU depending on the product purchased, it is important to be sure not to exceed the suggested daily maximum dosage of 1200 IU per day. Supplementing with too much vitamin D in pregnancy may cause hypercalcemia which can cause placental calcification and fetal arterial stenosis (narrowing of the aorta), both of which limit blood and oxygen supply to the baby. Choose a whole food sourced vitamin D3 supplement.
Calcium is necessary for the proper formation of bones and teeth. It enables the blood to clot and muscles to work smoothly. This mineral may also help to prevent high blood pressure and preeclampsia.
It is important to get enough calcium every day because your baby’s body will be calcifying its bones. If you do not consume enough calcium, your baby’s placenta and body will take it from your bones. Lack of calcium can also cause painful leg cramps in pregnancy.
Even if you are taking a good prenatal vitamin you may need to supplement calcium. It is best to take calcium on an empty stomach with magnesium and vitamin C for proper absorption. Most high-quality calcium supplements should include these. Suggested supplementation is 1000mg a day. Do not exceed 1200 IU per day, as this may increase the risk of kidney stones for the mother and hypercalcemia of the placenta. Be sure to avoid dolomite, bone meal, and oyster-shell sources of calcium, as these tend to be high in lead. A whole food source of calcium would be best.
This mineral plays an important role, along with vitamin D3 and calcium, in bone and tissue development in the fetus, as well as your own body. Along with calcium it may also help prevent leg cramps and promote restful sleep. Sleep is invaluable during pregnancy and lactation!
500 mg is the maximum dose per day, so be sure if you supplement additionally, you do not exceed this amount. Many calcium supplements include magnesium.
Coconut oil supplies rich amounts of saturated fat with high amounts of lauric acid. Not only will your body benefit, but your baby will receive the same benefits. The saturated fat content helps you to build-up adequate fat stores in pregnancy and in preparation for breastfeeding. Fat stores are vital to maintaining adequate energy and proper body function for both pregnancy and lactation.
Lauric acid, found in coconut oil and also in breast milk, has been found to have antiviral, antibacterial, and parasiticidal (kills parasites) properties that support proper immune function. This may help to protect your and your baby’s health in pregnancy.
Coconut is a medium-chain fatty acid, which makes it easily metabolized by the body. It withstands high heat for cooking, making it a superior choice to olive, vegetable, and canola oil. Add 2 Tablespoons of raw organic virgin coconut to your diet each day. It is excellent in smoothies or on toast, or even raw! Coconut oil is delicious and nutritious.
If you know anything about the work we do and the diet we support, you know we are huge proponents of green foods. Spirulina can be eaten as a food during pregnancy, added to smoothies, soups, and sauces. This cyanobacterium is the most protein-dense plant source known to man and is very high in a variety of vitamins and minerals.
Researchers in Mexico found that supplementation with spirulina in pregnancy may help to treat preeclampsia and prevent it from occurring at all, by providing pregnant mothers with nutrient-dense nourishment. The maximum consumption of spirulina a day is 3000 mg.
Probiotic supplementation can help to keep your good gut bacteria at optimal levels. This will help to prevent illness and yeast infection and promotes healthy digestion. Did you know that babies are born with a sterile gut and their gut flora is established by the time they are 3 years of age? Their first exposure to good bacteria is during birth, as they move through the birth canal. A mother contains good bacteria in the vagina. A baby also receives good bacteria through healthy breast milk, so supplementation is suggested while nursing as well.
Be sure if you choose to take a probiotic supplement, make sure it lists the genus, species and strain(s). Probiotics’ names are in three parts, listed in order. First is the genus name, second is the species and last is the strain. For example, the label may say L. acidophilus NAS, which may simply be shortened to just Acidophilus. Be sure to avoid products that don’t list the genus, species and strain. Choose probiotics that are refrigerated, not pasteurized, and say “contains live cells.” The supplement should contain at least a billion colony forming units (CFUs).
Whey Protein Powder
Proteins are required for building and repair of the body’s tissues. The amino acids that make up proteins are the building blocks of the body’s cells, including those of your baby. Protein is also an excellent source of energy. During pregnancy, a mother requires 70-90 grams of protein per day. Whey protein powder added to smoothies, soups, stews, etc., can help a woman to meet those requirements.
Our FertiliWhey contains 15 grams of protein per serving. It is derived from the milk of grass-fed cows that graze year-round on natural pastures, is hormone-treatment-free, pesticide-free, chemical-free, and does not contain GMOs.
If you are allergic to dairy, lactose intolerant or vegan, consider hemp protein powder instead.
Nutritional supplements that may be safe in pregnancy to continue individually, along with a prenatal vitamin:
The best way to get vital nutrients is through consuming whole foods rather than through supplementation. You can avoid having to take a variety of nutritional supplements, in most cases, if you eat a nutrient rich whole food diet and take a whole food prenatal vitamin.
In some cases nutritional deficiencies may occur during pregnancy, even while taking a prenatal vitamin. In the case of nutritional deficiency, a healthcare provider may suggest additional supplementation of a specific vitamin or mineral to help keep you and your baby healthy during pregnancy. Remember, always follow the product label guidelines for suggested daily use. Never exceed the recommended dose.
Folic Acid in the form of Folate
It is important that you begin taking folic acid before pregnancy occurs; this is because in the first few weeks of embryo formation, your baby’s spinal cord is forming. Folic acid has been found to help proper formation of the spinal cord and proper formation includes the closing up of the back around the cord. A good whole food prenatal vitamin should contain 800 mcg of folate, so you should not need to supplement additionally with folic acid, unless directed to do so by your healthcare practitioner. Up to 1200 mcg of folate is safe for pregnancy.
Your doctor or midwife will be checking to see if your iron levels are adequate, if they are not, they will encourage you to supplement with iron. Iron helps with increased blood volume because it is vital for formation of blood cells, as well as transportation of oxygen to blood cells. Iron deficiency can lead to anemia.
Most iron supplements are constipating, which is extremely uncomfortable when you are pregnant. Choose a whole food iron supplement such as Blood Builder by Megafood or Iron and Herbs by Floradix. They are non-constipating and are easily absorbed. Suggested supplementation is 30mg a day. Consuming vitamin C rich food sources will help the body to absorb and utilize iron properly.
Vitamin E in amounts up to 600 IU per day in the first trimester of pregnancy (use only 50 IU if you have high blood pressure, heart disease, or diabetes) has been shown to help prevent miscarriage in women with a history of recurrent miscarriage.
Vitamin E supplementation has been shown to help prevent premature rupture of the membranes (amniotic sac) in pregnancy. It appears that vitamin E may increase the quality of the amniotic sac.
Vitamin E may inhibit proper coagulation of the blood; therefore, it should not be taken in high amounts close to delivery. Pregnant mothers should avoid taking more than 800 IU per day during the 3rd trimester onward; this will decrease the risk of hemorrhage during and after delivery.
Vitamin C supplementation, in addition to a healthy, vitamin C-rich diet has been shown to reduce the likelihood of preeclampsia and premature rupture of the membranes in pregnancy. Large quantities of ascorbic acid are utilized by the female during conception and is necessary to the formation and integrity of the fetal membranes. Research suggests vitamin C supplementation may also help prevent birth defects.
Suggested daily supplementation is 500 mg a day in addition to a healthy whole foods diet rich in vitamin C. Avoid taking more than 1000 mg per day.
Zinc helps you to keep a strong immune system, heal wounds, metabolize fats, and helps to regulate gene expression. Vegetarians and vegans are more likely to have a zinc deficiency. Deficiency in zinc may cause preterm labor and/or poor fetal development. The suggested amount of zinc supplementation intake in pregnancy is 15 mg per day. Since vegetarians and vegans tend to absorb less zinc from foods, a health care practitioner may suggest additional supplementation.
Systemic enzymes have been shown to be helpful throughout pregnancy to help prevent recurrent miscarriage due to immunological imbalances (see one study here) with the agreement/approval of your doctor. Your doctor will be able to suggest the correct dosage for your needs.
Nutritional supplements that should not be continued into pregnancy:
DIM supports the body in metabolizing estrogen. It is not recommended for use during pregnancy or lactation.
If estrogen dominance was an issue for you prior to pregnancy, a great alternative during pregnancy for continued estrogen metabolism support would be to consume 1-2 tablespoons of fresh ground flaxseed daily.
This amino acid is not suggested for pregnancy because it may increase bleeding risk. It is also not suggested for use during lactation. L-Arginine is best taken in preparation for pregnancy.
Research in the British Medical Journal has shown its safety for use in combination with antioxidants in preventing preeclampsia for women with a history of preeclampsia due to nutritional deficiencies. In this case, it should only be used while under the supervision of a doctor.
Green food powder mixes
Only consume green food supplements in pregnancy that do not contain any herbs or nutritional supplements that are not recommended for pregnancy such as royal jelly. Our FertiliGreens is not suggested for pregnancy because it contains some herbs not meant to be continued in pregnancy. A pure powdered spirulina or nutritious herbal pregnancy infusion is a better option for pregnancy.
Antioxidant supplements shouldn’t be necessary to take during pregnancy. Not all nutrients considered to be antioxidants have been studied for their safety in pregnancy or during lactation, so it is best to avoid them. Some antioxidant blends contain medicinal herbs. Most all medicinal herbs should be avoided during pregnancy and lactation. Antioxidant blends are best taken in preparation for pregnancy.
Important antioxidants like vitamin A, E, & C should all be included in your prenatal vitamin and are an important part of preventing preeclampsia.
In very rare cases, severe nutritional deficiencies have been found in pregnant women. In those cases, a doctor may require the pregnant mother to take an antioxidant blend.
Bee Products: Bee Pollen, Royal Jelly, Bee Propolis
Do not use bee products during pregnancy if either side of your family or the father’s family has a history of bee, pollen or honey allergy. Royal jelly has an action on hormones, which is considered by some, to be unsafe for use in pregnancy. If you choose to continue bee products in pregnancy, notify your healthcare practitioner.
There is limited research done to prove that CoQ10 ubiquinol supplementation is safe for pregnancy or lactation in the general population of pregnant women. One study in the International Journal of Obstetrics and Gynecology of 235 women at increased risk of preeclampsia, showed that 200 mg supplementation daily of CoQ10, lowered the risk of developing preeclampsia. Women with a history of preeclampsia may wish to speak to their doctor about CoQ10 supplementation during their pregnancy. In general, it is best to take this supplement prior to pregnancy.
Vitamin B Complex
B complex supplements include thiamine (vitamin B1), riboflavin (vitamin B2), niacin (vitamin B3), pantothenic acid (vitamin B5), pyridoxine (vitamin B6), biotin, folic acid, and the cobalamins (vitamin B12). Vitamin B complex is not suggested in pregnancy because a good quality prenatal multivitamin contains or exceeds a pregnant woman’s daily needs of all these important B vitamins.
Omega Essential Fatty Acid Blends
Due to the omega-6 content in these blends, they are not recommended for use during pregnancy. Borage oil is often the source of the omega-6 in these blends, which may cause uterine contractions.
Greenberg and associates share these tips:
- Intake of omega-6-rich oils found in sunflower, corn, and cottonseed oils should be minimized because they are converted to substrates that compete with EPA. Pregnant women should reduce their intake of these oils and substitute others that are rich in omega-3 fatty acids like flaxseed, canola, and soybean oil.
- Choose vegetable oils that are rich in the omega-3 fatty acid linolenic acid and low in the omega-6 fatty acid, linoleic acid.
- Reduce intake of vegetable oils rich in omega-6 fatty acids (eg, sunflower oil, corn oil, cottonseed oil) (Rev Obstet Gynecol).
Thyroid supplements usually contain key vitamins and minerals for proper thyroid function. They may also include herbs for thyroid and endocrine system support. Thyroid supplements are not suggested for use during pregnancy or lactation, unless directed to do so by your healthcare practitioner. Thyroid health is best monitored by a doctor.
Adrenal Health Supplements
Adrenal health supplements usually contain key vitamins and minerals for proper adrenal gland function. They may also include herbs for adrenal gland and endocrine system support. Adrenal health supplements are not suggested for use during pregnancy or lactation, unless directed to do so by your healthcare practitioner.
Most all medicinal herbal supplements should be avoided during pregnancy. There are some that are safe to consume in pregnancy, but for the most part they should be avoided. If you are interested in taking herbs during pregnancy, it is imperative you work with a midwife trained in herbal medicine or with an herbalist in your area.
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- Greenberg, J. A., Bell, S. J., & Ausdal, W. V. (2008). Omega-3 Fatty Acid supplementation during pregnancy. Reviews in obstetrics & gynecology, 1(4), 162-9. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2621042/
- Vadillo Ortega F, Perichart Perera O, Espino S, Avila Vergara MA, Ibarra I, et al., (2011 May 19). Effect of supplementation during pregnancy with Larginine and antioxidant vitamins in medical food on preeclampsia in high risk population: randomised controlled trial. BMJ. 342:d2901. doi:10.1136/bmj.d2901. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3100912/
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