As a mother of two boys, maternal and child health are very dear to my heart. Pregnant women in my practice often ask me which supplements they should be taking during their pregnancy. These five supplements are what I recommend to every woman of child-bearing age who might one day get pregnant. Why you ask? Because these are the supplements that keep on giving. Even after a mother has had her baby, these supplements continue to benefit both the mother and baby.
1. Iron: is an important vitamin for both maternal and fetal health. It is involved in the transport and storage of oxygen. It is required for energy and it supports the growth and development of the fetus and placenta. It is also involved in brain development and cognition. Anemia in pregnancy may result in a baby with a low birth weight.
Interestingly enough, iron in breast milk is small but much more absorbable and the amount of iron is more dependent on maternal stored iron. A recent research study found that mother’s that were supplemented with iron during pregnancy had higher iron levels in their breast milk. Meaning that it is important for pregnant and soon to be pregnant women to have a healthy iron level before they give birth. An anemic mother will lead to an anemic baby once born. Most women at some point or another in their pregnancy become anemic. It is always a good idea to start out with a reservoir of iron instead of a deficiency.
It is important to get a good digestible source of iron that will not cause constipation. My preference is chelated iron bisglycinate. It is relatively inexpensive and it works well. According to the University of Maryland Medical Centre, pregnant women need 27mg of iron daily. Even if a woman is mildly anemic, I still treat them with supplemental iron due to an increase risk of post partum bleeding. As always please consult a licensed care provider before taking any supplement.
2. Probiotics: these are microorganisms that live in our entire digestive tract. Lactobacillus and bifidobacterium are the major microorganisms and they play an important role in digestive and immune health. There is research to suggest that maternal levels of bifidobacterium affect infant levels as early as 3 days. Bifidobacterium readily passes from the breast milk to the nursing baby. Probiotics enhance our immune system, enhance the assimilation and absorption of vital nutrients, promote healthy skin, decrease atopic disease (asthma, allergies, eczema) and act as Group B Strep prophylaxis. While you can get probiotics in supplement form, I always encourage people to get additional probiotics through foods such as sauerkraut, kim chee, yogurt, miso or anything fermented.
3. Omega 3 fatty acids: the 3 main types of essential fatty acids are EPA, DHA and ALA. They are called essential fatty acids because they must be obtained from the diet. EPA and DHA are readily found in seafood such as fish, squid and algae. ALA is mainly found in flaxseeds, soybean oil, canola oil. I will discuss the problems with soybean and canola oil in a later blog. ALA is not readily converted to DHA by the body so I usually just supplement patients with DHA and EPA. During pregnancy and breastfeeding, the mother is the primary source of essential fatty acids. DHA in the developing infant is needed for visual and neurological development, cognition and hand/eye coordination. For pregnant and nursing mothers, essential fatty acids can help with mood stabilization and to banish baby brain.
4. Vitamin D: with the war against sun exposure in full bloom, Vitamin D deficiency is becoming rampant. I have my issues with the whole everyone must wear sunscreen year round campaign but this is not the place for that discussion. Being a physician in the Pacific Northwest, I see and treat a lot of Vitamin D deficiency. Vitamin D deficiency is now becoming a significant public health concern especially the further away you are from the equator. Vitamin D deficiency has been linked to gestational diabetes, pre eclampsia, infection, Cesarian section and fetal growth restriction. Vitamin D in addition to calcium is also required for proper bone development. A recent paper published in February of this year suggested that supplementation may be a simple way to reverse adverse risk factors associated with low Vitamin D status. A licensed health care practitioner can check your Vitamin D status for you and suggest an appropriate Vitamin D dosage based on your lab results.
5. Prenatal Vitamin: research is just now starting to focus on the role of micronutrients in pregnancy outcomes. According to recent research, reduction in essential micronutrients may contribute to recurrent spontaneous abortions. A good quality prenatal will provide you with all the important micronutrients such as magnesium, selenium, zinc, copper, chromium, manganese among others. In addition, these vitamins and minerals will be in a form that is easily absorbed by the body. Not all supplements are created equally. For example, most supplement companies sell magnesium in oxide form. This form is not readily absorbed by the body whereas the malate or citrate form is much better absorbed. I always advise women to start taking their prenatal vitamins well before they are thinking of getting pregnant. The worse thing that can happen is your hair grows thicker and faster. I also tell women that they need to think of their womb as a garden. The egg and sperm represent the seed. In order to get a good yield of produce, you have to prepare your garden and fertilize it preferable with organic manure. When you have good soil and good seed, you have a good harvest. Pregnancy is no different.
Are there any supplements you find helpful for pregnancy and post partum?