Does the Perfect Prenatal Exist?

Short answer:

NO! But the perfect prenatal might exist for YOU, if considered properly.

Why do I need to take a prenatal?

Whilst you should always aim to obtain nutrition from food first, when it comes to pregnancy, we know many women are not meeting the increased needs for certain key nutrients. A prenatal ensures a basic level of coverage, particularly if you are struggling with nausea during the first trimester.

The National Health and Medical Research Council recommends starting a prenatal 1 to 3 months out from conception, but really you should be aiming for a minimum of 3 months (6 months is ideal in my eyes). If you are someone coming off the pill, you may need to start taking a prenatal before you do, to mitigate any nutrient deficiencies that have been masked.

It is also important that your supplementation needs are re-evaluated every 12 weeks – nutrient demands change throughout pregnancy and then into postpartum, hence the “one size fit’s all” approach to prenatals does not work. I offer express Prenatal Supplement Consultations for exactly this reason. These are 30 min sessions where I build a supplement protocol specifically for your needs. Click the link below for bookings and use the code FEEDINGTHEBUMP10 to get $10 off your appointment:

What you should be looking for:

– A formulation made from high quality ingredients, ideally with no / minimal fillers, binders & additives. Many off the shelf products are crammed with poor quality, synthetic nutrients which allow them to be cheaper, but often harder to digest and for the body to utilise.

– Bonus points if it is organic and sourced / based-on wholefoods.

– Methylfolate, not folic acid. This is the activated form of folate and is ready to go once digested by the body. Folate is critical in the prevention of neural tube defects (NTD’s) in your baby. Folic acid is the synthetic form of folate, which the body needs to convert to its active form (found in many common prenatals!). The problem is, around 60% of people have a gene mutation that prevents the body from completing this conversion, therefore limiting absorption (Greenberg et al., 2011). So always choose a prenatal with active folate – It may be represented as 5-MTHF, MTHF, L-5-MTHF, Levomefolate calcium, 5-L-methylfolate, follinic acid or calcium follinate (see how confusing it can be trying to select one on your own!!). Also continue to include folate-rich foods daily, such as liver, lentils, strawberries, leafy greens and asparagus. The amount of folate you need from diet / supplements will differ depending on your health + medical history.

 Iodine, which is important for proper thyroid function and plays a key role in conception. Low iodine consumption is becoming increasingly common, since many are switching from table salt (which is enriched with iodine) to Himalayan pink salt (which does not contain iodine). You want a prenatal with at least 150 micrograms of iodine.

– Choline, which is just as important as folate in preventing NTD’s, although not always added to prenatals so additional support may be required depending on your diet / history. Eggs are the best food source, try to eat them daily! It is also critical for brain development in the later stages of pregnancy (another important example why you should constantly have your supplementation needs reviewed). You want to be aiming for at least 450mg / day, but this requirement fluctuates by trimester.

– Vitamin D is necessary for the regulation & absorption of calcium in bones. It also plays a role in immune function (for you + bub). The best form to look for is cholecalciferol and should be in a fat-based capsule, as vitamin D is a fat-soluble vitamin, so requires fats for absorption (not always the case with prenatals). On average, up to 50% of women can be deficient in vitamin D, so important you have your levels checked (via a blood test) before pregnancy, at each trimester and in the postpartum period. You also want to make sure you have enough vitamin D to enrich breastmilk when baby is born, so I recommend speaking to a Nutritionist to make sure this is covered!

– Iron is another common nutrient which women tend to be deficient in during pregnant. It is estimated that only 20% of women begin a pregnancy with sufficient iron stores (McMahon, 2010). Iron is an essential component of blood, transporting oxygen from our lungs to tissues and is necessary for growth and development. Requirements for iron increase during the 2nd and 3rd trimester, as blood volume and foetal demands increase. The issue with iron supplementation, is that many contain poor quality forms which cause constipation and can aggravate nausea in some (Tolkien et al., 2015). Look for a supplement that contains iron bisglycinate, ferrous bisglycinate or iron amino acid chelate which have a high rate of absorption, but easier on your digestive system. You also need to be wary of when you take an iron supplement, as it interacts highly with other nutrients. Calcium and zinc inhibit iron absorption, whilst vitamin C increases absorption. So always take an iron supplement at a different time to your prenatal and consume with vitamin C-rich foods (just as strawberries or oranges).

– Vitamin B12 is important at all stages of pregnancy, as it plays a role in the metabolism of folate and is important for the proper functioning of our nervous system. Luckily we don’t need too much (the Australian recommendation is 2.6 micrograms per day) and it is usually found in abundance in a prenatal and also in good amounts in food such as dairy, salmon and beef. Look for methylcobalamin in your prenatal (best absorbed) and don’t worry if your wee turns bright yellow – this is the body getting rid of excess B12 (as it is a water-soluble vitamin, so easily excreted through urine).

– Omega 3 / DHA: This is my favourite nutrient because it provides SO many benefits for mother and baby, both in pregnancy and postpartum. In a study of over 12,000 women, it was found that 95% were not meeting their daily requirements of EPA and DHA (Zhang et al., 2018). DHA / EPA are extremely beneficial for health and are found in fatty fish such as salmon, sardines, cod, trout, mackerel and herring. Importance in pregnancy rises in the 3rdtrimester to support the rapid development of baby’s brain. Maternal DHA levels have been found to positively impact upon baby’s behavioural attention scores, visual recognition, memory, language and hand / eye coordination (Dunstan et al., 2008Morse, 2012). Plus, they can also reduce the risk of postpartum depression (Markhus et al., 2013) and may lead to fewer complications during birth. If you don’t get enough fatty fish each week, or you are plant-based, high quality Omega 3 supplementation is strongly recommended in pregnancy and postpartum (aiming for at least 1,000mg / day of Omega 3’s, with at least 300mg / day coming from DHA).

The amount you require for each of these nutrients depends on a few factors: your medical history, diet, recent blood test results and the stage you are at from conception, through pregnancy into postpartum. A GP can help you obtain a blood test, which the results can then be shared with a nutritionist / dietitian, and they can help tailor the right plan for you. There are also many amazing products that are classed as “practitioner only”, so we have a wider variety available that can be recommended based on your needs. So, as you can see, it is a little more complicated than just picking a product off the pharmacy shelf. It is so beneficial for you & baby to ensure you are taking the right products for your needs. I can assist with this, either through my 1:1 Bespoke Consultation or an Express Prenatal Supplementation Consultation