Pregnancy supplements 101

When it comes to pregnancy supplementation, the internet is full of confusing contradictions. One site says a pregnant person needs supplements, but another says you should not take anything because it will harm the pregnancy. ARG! How confusing, overwhelming and really unhelpful.

Soooo, I'm going to break down supplementation in pregnancy to help you feel more confident that your nutritional needs are safely being met.  

First, 2 questions I get all the time.

1.  Do we even need to take supplements? 
Answer: YES.

In a dream world, we would get all of our nutrients from our diet. Sadly, the nutrient density of the food we eat (because of processing, lack of variety and the overall decrease in nutrient density of food due to mass farming practices), means our diet is not likely covering all of the nutrient needs we have in pregnancy. So in a nut shell, yes, supplementing is a good idea.

2: Does quality matter?
Answer: YES

Many of the studies that claim supplements don't help, are missing an important piece to their study. Quality. You can’t compare a cheaply made, untested, low quality brand and say that all fish oil pills are rancid and ineffective. Nor can you compare a synthetic form of a supplement to its naturally sourced form. That’s like looking at the nutrient content in a Big Mac and concluding that ALL foods have no nutrients in them. No….the big Mac has very few nutrients (enter defamation lawsuit from McD). A bowl of slow cooked grass-fed beef stew with yams, and greens and beets, or a big kale salad with grilled salmon on it etc., is a whole different story. 

Here is what I suggest as the basics for supporting a healthy pregnancy:

Basics for all pregnant people:

• Prenatal multivitamin – I like the Thorne or Baby and Me brands because they contain the methylated form of Folate/folic acid. Since 40-60% of the population difficulty breaking down folic acid into its useable methylated form, consuming your folate in a methylenetetrahydrofolate form. You can read more about it here
  
• DHA rich omega-3 oils 2000mg – Nordic Naturals* (fish oil- preferred source) or Flora (vegetarian source, contains precursor oils to DHA). The reason why it is important to supplement DHA is because pregnancy depletes the brain of DHA quite significantly, especially if the diet is lacking in omega-3s. Baby will get what it needs from your stores, and so you supplement to make sure you have something left after baby has gotten its fill.
  
• Vitamin D3 – 2,000-4000 IU/day depending on skin tone (darker requires more Vit D than lighter skin) Vitamin D plays an important role in pregnancy. It is essential for fertilization to take place, and higher levels of vitamin D have been linked to higher pregnancy rates overall, as well as lower risk of gestational diabetes, preeclampsia and preterm birth. It also contributes to a healthy immune system.

*note: If you are in your first trimester and you are feeling very nauseous, sometimes swapping out your prenatal for just a folate (ideally in a methylated form called 5’MTHF) can help manage the nausea, or at least aggravate it less. 

Second/third trimester: Taken if a need is identified

•  Iron (if needed) – Bob's iron is my favourite iron supplement –note for vegetarians: floradix is less effective at actually raising ferritin levels during pregnancy. For another vegetarian source, I suggest Innate Iron response.
• Magnesium bisglycinate – up to 350mg of elemental magnesium per day (relaxes tissues and nervous system) This is great if you suffer from leg cramps, constipation and/or insomnia. I like my patients to take it just before bed if possible. 
• Cal/Mag: If your primary care physician or midwife is concerned about your calcium intake, you can look at getting a Calcium/Magnesium 1:1 combo or one that has more Magnesium than calcium for people suffering from leg cramps. A liquid form can also help with heartburn.

Final thoughts:

Supplements aren't a one size fits all. If you are concerned that you are not getting adequate nutrition during your pregnancy, a thorough intake and review of your current and past health is the best place to start. Feel free to reach out if you have any questions.

Dr. Emilie Salomons Dr. TCM, FABORM, OBAAM, Doula.