Supplements during pregnancy are often argued as not being necessary and that they don’t actually do anything to help, other than folic acid. I would argue otherwise.
Life runs at a million miles an hour these days and the part of the brain that controls our basic functions still thinks we live in caves. So, for that bit of the brain, life is stressful. When we have a lot to deal with, we use up more nutrients like the B vitamins and magnesium. Unless we eat incredibly well, I would argue that there is a place for supplementation to help keep our levels topped up.
That doesn’t mean supplements should replace a good diet. Always start with what you eat. Improve that as much as possible and then bring in supplements to help fill the gaps.
Pregnancy is a pretty big nutritional undertaking for your body. You are growing a baby, building a placenta, increasing your blood volume and supporting all of the changes happening inside your body, while still having to deal with normal life on top of it. So, with everything you need when growing a baby on top of life, I think taking a good-quality prenatal and, depending on your diet, an omega-3 supplement is a good place to start.
Obviously, this assumes you are safe to do so and you aren’t taking any medications or have any medical conditions that mean you shouldn’t. If you are unsure, speak to your GP, midwife or an appropriately qualified practitioner.
Do you need a prenatal vitamin?
A prenatal vitamin is essentially a multivitamin and mineral supplement designed with pregnancy in mind. It isn’t a replacement for eating well, but it can help fill nutritional gaps at a time when your requirements for certain nutrients increase.
And pregnancy isn’t necessarily the easiest time to eat perfectly. You might have morning sickness, food aversions, a sudden dislike of vegetables or simply be exhausted and trying to get through the day. A good-quality prenatal can help take some of the pressure off.
I think there is a tendency to swing between two extremes: either you need an enormous collection of supplements to have a healthy pregnancy, or supplements are completely unnecessary and everything should come from food. I don’t think either is particularly helpful.
Food should always come first, but supplementation can help fill the gaps.
The key nutrients to know about
There are lots of vitamins and minerals involved in pregnancy, but these are some of the main ones I would pay attention to.
Folate, folic acid and the B vitamins
Folate is vitamin B9 and is naturally found in foods such as leafy green vegetables, beans, lentils, chickpeas, broccoli, asparagus, avocado, oranges, bananas, strawberries, nuts and seeds.
Folic acid is the form used in supplements and is particularly important during early pregnancy. The NHS recommends 400 micrograms of folic acid every day until 12 weeks of pregnancy, although some women are advised to take a higher dose because of individual risk factors.
Eating folate-rich foods is still important, but it is difficult to get the recommended amount from food alone, which is why supplementation is recommended.
The other B vitamins are important too. B6 can be found in foods including chicken, beef, tuna, eggs, brown rice, bananas, sweet potatoes, lentils, beans, spinach, avocado, nuts and seeds, while B12 is found mainly in animal foods such as beef, lamb, chicken, eggs, salmon and trout.
If you are vegetarian or vegan, I would advise speaking to a professional about B12, iodine and iron, as it can be much harder to get enough of these nutrients from a diet that doesn’t contain meat, fish, dairy or eggs.
Vitamin D
Vitamin D is important for your own bones and muscles and for your baby’s developing bones and teeth. Our main source is sunlight, although there are some food sources including oily fish and eggs.
The current UK recommendation is 10 micrograms (400 IU) of vitamin D a day during pregnancy.
Iron
Your need for iron increases during pregnancy because you are making more blood to support both you and your baby. Good food sources include red meat, lentils, beans, chickpeas and other pulses.
Plant-based iron is less easily absorbed than iron from animal foods, so eating plant sources alongside vitamin C-rich foods can help.
I don’t think everyone should automatically take a high-dose iron supplement “just in case”. Your iron levels are checked during pregnancy and, if they are low, your midwife or GP can advise whether you need additional supplementation.
Iodine, selenium and zinc
Iodine is needed to make thyroid hormones, which are important for growth and development. Good sources include oily fish, dairy products and eggs, so this is another nutrient worth paying attention to if you follow a vegetarian or vegan diet.
Selenium and zinc are also important during pregnancy and can be found in foods including Brazil nuts, fish, meat, eggs, oats, beans, nuts and seeds.
As always, start with food and then look at what your prenatal provides before deciding whether you need anything extra.
Choline
Choline doesn’t get nearly as much attention as folic acid or iron, but it is important during pregnancy and plays a role in normal brain and nervous system development.
Eggs are a particularly useful food source, but it is also found in meat, fish and some beans and pulses.
Omega-3 and DHA
Omega-3 fatty acids, particularly DHA, are important during pregnancy, with DHA being particularly important for your baby’s developing brain and eyes.
Oily fish such as salmon, sardines, mackerel, herring and trout are excellent sources. If you don’t eat oily fish regularly, an omega-3 supplement can be a useful addition.
There are limits around oily fish during pregnancy, so it isn’t a case of eating as much as possible. And cod liver oil should be avoided because it contains vitamin A in the form of retinol.
How do you choose a good prenatal supplement?
This is where I think it is worth looking beyond the pretty packaging and claims on the front of the bottle.
There are a huge number of pregnancy supplements available, and they are not all created equal. The reason I am not very pro supermarket and readily available supplements is because they are often made using lower-cost forms of nutrients alongside bulking agents and fillers, which make the supplement cheaper to produce. Personally, I prefer good-quality practitioner supplements where possible.
However, if you’re on a low budget, an affordable pregnancy supplement that is appropriate for pregnancy is better than nothing.
When choosing one, look at the actual doses rather than simply looking for the highest amounts. More isn’t automatically better. Look at the forms of the nutrients, check that it is actually suitable for pregnancy and, importantly, check for duplication.
If you are taking a prenatal containing B vitamins, zinc, selenium and vitamin D and then add a B-complex, magnesium containing B6 or another supplement containing zinc and selenium, you can very quickly end up taking much more than you realised.
And don’t assume that “natural” automatically means better. Natural doesn’t automatically mean safe or appropriate during pregnancy.
Do you need extra iron, B vitamins or other supplements?
Sometimes you do, and sometimes you don’t.
This is where I think supplementation needs to be individualised rather than everyone taking the same collection of supplements “just in case”. If your iron or ferritin is low, you may need additional iron. If you are vegetarian or vegan, you may need additional B12 and other nutrients depending on exactly what you eat. If you don’t eat fish, your omega-3 intake will obviously be very different from someone eating oily fish regularly.
Supplements should fill gaps rather than become another thing you feel you have to take.
Supplements to be careful with during pregnancy
There are an enormous number of supplements marketed towards pregnant women, and I would be very cautious about taking anything simply because the marketing tells you it is good for pregnancy.
The main vitamin to be aware of is vitamin A in the form of retinol. Vitamin A is essential and important for normal development, but too much preformed vitamin A during pregnancy can harm your developing baby. This is why pregnant women are advised to avoid liver and liver products such as pâté, as well as cod liver oil and supplements containing retinol.
You may see beta-carotene in a pregnancy supplement instead. Beta-carotene is a precursor of vitamin A and the body converts it to vitamin A as needed, so don’t panic if you see beta-carotene on the label of your prenatal.
I would also be very cautious with herbal supplements. Herbs can be wonderful and supportive, but they can also be unnecessary and potentially dangerous. When it isn’t ethical to carry out the same sort of research on pregnant women that we can in other populations, there are herbs and herbal combinations where we simply don’t have enough evidence to know that they are safe.
I don’t want to scaremonger or cause fear and upset. I just want you and your baby to be safe. If the outcome is unknown, I would rather err on the side of caution.
The same applies to high-dose supplements, “detox” products and hormone-balancing supplements. Pregnancy isn’t the time to experiment with a cupboard full of supplements simply because someone online says you need them.
So, what do you actually need?
Start with your food and make that as good as you can. Eat a varied, nutrient-dense diet with plenty of vegetables, fruit, good-quality protein, healthy fats, wholegrains, pulses, nuts and seeds, and include foods rich in iron, B vitamins, iodine, zinc, selenium and omega-3.
Then look at supplementation.
Folic acid and vitamin D are the key supplements specifically recommended during pregnancy in the UK, while additional nutrients such as iron and B12 may need to be considered depending on your diet and individual circumstances.
A good-quality prenatal can help fill nutritional gaps, particularly when your nutritional requirements are increased and eating perfectly every day isn’t always realistic. If you don’t eat oily fish, an appropriate omega-3 supplement may also be worth considering.
And then be sensible about everything else. You don’t need to take a supplement simply because someone on Instagram has told you that every pregnant woman needs it, and you definitely don’t need to take five different supplements without checking whether they contain the same nutrients.
Pregnancy is already a time when there is enough to think about. Your supplements should help fill genuine nutritional gaps rather than becoming another complicated daily job.
Need more support during your pregnancy?
If you’d like some help with this, you can book a Quick Food Blitz, where we can look at your current diet and supplementation and work out where you could make some simple, realistic improvements without making your life more complicated.
If you feel you need more support, we can also work together over a series of sessions to look more closely at your diet, nutritional needs and supplementation throughout pregnancy.
My approach isn’t to give every pregnant woman the same list of supplements, because your diet, health, medical history and individual circumstances all matter.
If you would like more than a one-off look at your diet and supplements, I also offer pregnancy support packages throughout the first, second and third trimesters.
The Natural Starter packages combine personalised nutrition support with practical advice around pregnancy symptoms and, where appropriate, reflexology and gentle bodywork. We look at what you are eating, what nutrients you need more of as your pregnancy progresses and what is safe and appropriate for you, rather than giving you a generic list of things you should be taking.
There are packages for each trimester, with the sessions spread out over several weeks and the timing adapted depending on when you book and what support you need. You can also add individual sessions if you need a little more support along the way.
Find out more about my Pregnancy Support Packages →
Please note: Nutritional and supplement advice is not a substitute for medical care. Always tell your GP or midwife about any supplements you are taking, particularly if you take medication or have a medical condition, and do not stop prescribed medication without speaking to your doctor.
