Q&A: How Do I Pick a Prenatal Vitamin

pregnancy prenatal vitamins
Waiting for a baby. Close-up of pregnant woman touching her belly while sitting in lotus position

Prenatal Vitamins

Q: I’m pregnant or trying to get pregnant and want to start taking a prenatal vitamin, but there are so many choices!  What should I look for?

A: When it comes to prenatal vitamins, there are very few “need-to-have” ingredients and lots of “nice-to-have” ones.

Most importantly, your prenatal should contain 600 micrograms (mcg) to 1 milligram (mg) of folic acid, which is critical for baby’s proper brain and spinal cord development during the very early weeks of pregnancy–before most women even know they’re pregnant.  It continues to be important throughout pregnancy to help support the rapid cell division that takes place as baby grows.

Ideally, a prenatal vitamin would also contain the recommended daily intake of iron for pregnancy–27 milligrams (mg).  However, if the high dose of iron supplements upset your stomach or make you too constipated, it’s fine to skip the iron as part of your prenatal vitamin before you’re actually pregnant.  Your doctor or dietitian can recommend an iron supplementation regimen once you become pregnant that will be better-tolerated and tailored to your individual iron status; for example, they might recommend taking a “slow-release” iron-supplement daily or taking a regular iron supplement with food every other day.  If you have anemia (iron deficiency), your doctor may recommend a higher dose than the standard 27 mg/day.

If your prenatal contains Vitamin A, make sure it’s in the form of beta-carotene rather than retinol, and that the dose does not exceed 100% of the daily recommended intake. High doses of the ‘active’ form of Vitamin A (retinol) can produce birth defects, particularly in early pregnancy.  However, beta-carotene, an inactive pre-cursor to Vitamin A that your body converts, has not been associated with these same risks.

Beyond this, most other ingredients in a pre-natal vitamin are ‘nice to have,’ but not necessarily essential.

  • Some prenatal vitamins contain Vitamin E, which may help support proper implantation of the embryo in the uterus in early pregnancy, based on research in animal models.
  • Vitamin D is a nice bonus as well, but typical doses (usually 100-400 IU) may not be enough to keep your blood levels at optimal amounts, especially if you’re darker-skinned or pregnant during the wintertime.  Talk to your doctor about having your Vitamin D levels checked once you’re pregnant if you fall into either of these categories because a limited number of small studies have suggested that some pregnant women may need doses of up to 4,000-6,000 IU per day to maintain sufficient status.
  • Some prenatal vitamins also contain omega-3 fatty acids (DHA and/or EPA), which is a convenient way to get these essential nutrients that appear to support baby’s brain and eye development.  However, depending on the dose, your doctor may recommend additional omega-3 supplementation, particularly if you’re not eating 6 oz of low-mercury, fatty fish, like salmon, sardines or herring, per week.
  • You may find a variety of B vitamins (thiamin, niacin, riboflavin, Vitamin B6, Vitamin B12) and/or Vitamin C in your prenatal as well.  The vitamin C can help you absorb the iron in your supplement, and the B vitamins, while probably not necessary on top of a regular diet, certainly won’t harm you at reasonable doses around 100% of the recommended daily intake.

Lastly, don’t expect a prenatal vitamin to deliver much by way of calcium; high doses of calcium interfere with iron absorption and therefore usually do not exceed 150mg in a prenatal vitamin which contains iron.  If you’re worried about meeting your calcium needs through diet alone during pregnancy, you might consider taking a separate 500mg calcium supplement once or twice per day at least 2 hours apart from taking your iron-containing prenatal vitamin.


PS – Our personal favorite prenatal vitamins are Rainbow Light Prenatal Multi-Vitamins.  Buy Now.

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  • One thing to remember is only your Dr. can recommend exactly what you need. Don’t take the advice of a pharmacist etc. as they don’t know your specific need. Also, no smoking (not even smokeless cigarettes), no alcohol, eat right and get plenty of sleep.

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