What’s the Best Prenatal Vitamin?

I don’t know and neither does anyone else. Vitamins and supplements are not FDA regulated in this country and that means that there are no rigorous double blinded trials of prenatal vitamins out there. In order to be a prenatal vitamin, a vitamin must contrain 400 mcg of folic acid (or more), and calcium. Most also contain iron unless they are gummy vitamins, which often don’t have iron because they look like candy and children have been harmed by overdosing on vitamins.

We have good evidence that supplementation with folic acid helps to prevent a group of birth defects known as neural tube defects. These are a group of defects that affect the formation of the spine an brain. At it’s most minimal is spina bifida occulta - an asymptomatic condition often discovered incidentally when looking for something else and you find that there is a weak spot at the base of the spine. At it’s most severe is anencephaly - a devastating condition where the top of the head and brain don’t form that is incompatible with life outside the womb. The dose of folic acid for the general public is 400 mcg. It’s recommended you take more if you are having twins, have a personal history of spina bifida or have a positive family history. Each of these requires a specific dose, so don’t forget to check with your doctor for speciic recommendations.

Calcium is responsible for building a strong skeleton for the baby as well as being important in muscle contraction. The recommendation is 1.5-2 gm/day of calcium. You should take it with food.

It is recommended that all women get iron regularly in pregnancy. You are likely to get anemia if you aren’t taking prenatal vitamins or an iron supplement. Iron is a necessary component of hemoglobin that allows red blood cells to carry oxygen. During pregnancy, you will need to increase your blood counts by approximately 50% and to top it off, baby needs to grow a blood supply as well. Symptoms of iron deficiency include fatigue, shortness of breath and sometimes swelling of the lower extremities. Bascially all the symptoms of pregnancy.

So, if there isn’t a best prenatal vitamin, how do you chose one? I recommend taking whichever one doesn’t make you feel nauseated. There are no significant side effects outside of nausea and therefore you are safe to choose a brand that fits with your values and your budget.