02.Do you need a special supplement?
Clinical trials have shown the benefit of taking vitamins and mineral supplements designed for pregnancy, but almost all have been conducted in low- or middle-income countries where malnutrition is common. The main benefits reported are reduced risk of neural tube defects and maternal anaemia, and where there’s a risk of malnutrition they reduce the risk of low birthweight babies.
If your diet is generally healthy, with plenty of fruit, vegetables, nuts, pulses and dairy products (or calcium-fortified alternatives), you’re unlikely to benefit from a pregnancy supplement. There are many nutritional benefits from food that can’t be obtained from a vitamin pill - and no pill will undo the negatives of a diet of pies, chips and thick shakes.
That’s the ideal. The reality, however, is that many women don’t have a diet that’s healthy in every respect, and some women struggle to eat well if they suffer severe morning sickness, in which case the extra nutrients in pregnancy supplements may be useful.
The Royal Australian and New Zealand College of Obstetricians and Gynaecologists states that “although, in the general population, a healthy balanced diet should largely obviate the need for vitamin and mineral supplementation, pregnancy and lactation create extra nutritional demands that, for some individuals, may make supplementation advisable.”
The college recommends supplements in the following situations, in consultation with your doctor:
iodine and folic acid supplementation for all pregnant women.
additional folic acid (5mg per day) for women with a multiple pregnancy, taking anti-convulsants, people with diabetes and those who have a tendency to blood clotting or a family history of neural tube defects.
vitamin B12 for vegans.
iron for vegetarians and vegans, and women with a multiple pregnancy
calcium for people who avoid dairy (eg lactose-intolerant or vegan).
vitamin D may be necessary for people at risk of deficiency.
“Pregnancy multivitamins won’t cause any harm, and may confer some benefit for women who don’t have a healthy diet,” says Dr Louise Farrell, Chair of the College’s Women’s Health Committee. She points out that maternal micronutrient supplementation and foetal health is a developing science and under continual review.
We looked at the ingredients of various pregnancy and breastfeeding formulations. All contained the recommended intake of folic acid and iodine, which many regular multi-vitamins do not. Many contained unnecessary vitamins and minerals, or pointlessly low levels of nutrients, particularly calcium. If you’re only after the iodine and folic acid, you can buy on price, and whether or not it contains fish oil. Those listed below will cost about 50 cents per day, though heavy discounting can reduce this to less than 30 cents.
- Some of the cheaper fish oil products include Nature's Own Pregnancy Platinum, Swisse Pregnancy + Ultivite, Microgenics Pregnancy & Breastfeeding Multivitamin and Healthy Care Pregnancy Care & Breastfeeding (available from Chemist Warehouse, this one is by far the cheapest, but doesn't contain vitamin D - if that's an issue for you). Blackmore's Pregnancy & Breastfeeding Gold had a RRP higher than these, but was 'on special' just about everywhere we looked, so it's worth shopping around.
- Of the products that don't contain fish oil, we found Fabfol Plus and Swisse Pregnancy Ultivite to be slightly cheaper than others.
Breastfeeding - special needs
After birth, the need for some nutrients, such as iron, decreases from the levels required during pregnancy. But there are increased needs for some nutrients: vitamins A, all the B complex vitamins, C and E, and especially iodine. A healthy diet and increased appetite should ensure adequate levels of most of these nutrients, although an iodine supplement may be necessary.