Choosing the Right Prenatal Vitamin

Whether you’re trying to conceive, planning on starting I.V.F., or recently learned you are pregnant, your baby needs essential nutrients to grow and develop. Research links deficiencies in certain vitamins with certain types of birth defects, so taking a prenatal vitamin can potentially protect your baby from developing birth defects associated with vitamin deficiencies. But with so many prenatal vitamins on the market, how to choose the one that is right for you and your baby? Many websites on the internet offer their own “top ten lists” of the “best prenatal vitamins on the market” but these websites may not always disclose the methods by which they determined their “top ten.” That leaves expecting mothers and mothers to be facing the tough choice of choosing the right prenatal vitamin without a clear guide for the kind of standards they should be looking for in their vitamin.

We’ve put together a guide below to help you choose the right prenatal vitamin for your needs. Prenatal care is essential, and certain medical conditions may require you to take vitamins in addition to those noted below, so before choosing any prenatal vitamin, it is best to consult with your doctor. Finding the right balance of vitamins and minerals may require blood work to identify potential deficiencies and needs.

Step 1: When Choosing a Prenatal Vitamin, Check That It Has the Essentials

There are certain vitamins and minerals recommended for healthy pregnancy. Before buying any prenatal vitamin, your first step should be to read the label to make sure it has the recommended doses of these essential vitamins and minerals. The World Health Organization has published a list of vitamins recommended for pregnant women. The list of vitamins and doses recommended for pregnant women includes:

• Vitamin A (µg 800/0.8 mg)
• Vitamin D (µg 5/0.005 mg)
• Vitamin E  (15 mg)
• Vitamin C (55 mg)
• Thiamine (vitamin B1) (1.4 mg)
• Riboflavin (vitamin B2) (1.4 mg)
• Niacin (vitamin B3) (18 mg)
• Vitamin B6 (1.9 mg)
• Vitamin B12 (μg 2.6/0.005 mg)
• Folic acid (μg 600/ 0.6 mg)
• Iron (27 mg)
• Zinc (10 mg)
• Copper (1.15 mg)
• Selenium (μg 30/0.03 mg)
• Iodine (μg 250/0.25 mg)

The American College of Obstetricians and Gynecologists also recommends some additional vitamins and minerals:

• Calcium: 1,000 milligrams
• Choline: 450 milligrams

Finally, according to Reviews in Obstetrics and Gynecology, Omega-3 fatty acids are essential to brain and eye development of the fetus. You can get your Omega-3 fatty acids by eating seafood and algae, but American women may not eat enough seafood in their diets and some women actively avoid seafood due to the risk of mercury poisoning. Women can get enough Omega-3 fatty acids by consuming at least two servings of seafood each week, but they must balance this with the risk that certain seafoods pose for having high mercury levels. Researchers recommended that women be advised to eat two servings of low-mercury fish each week. Women who want to ensure that they consume enough Omega-3 fatty acids who do not eat fish can take fish oil capsules or consume eggs enriched with Omega-3 fatty acids.

Key Takeaways for Prenatal Vitamin Basics:

When looking for the right prenatal vitamin for your needs, the vitamin should at least contain the minimum World Health Organization’s requirements for pregnant women and also calcium. Women who are vegetarians and vegans who do not consume fish may want to consider taking a supplement designed specifically for vegans and vegetarians or consider speaking to their doctor about how they can get Omega-3 fatty acids. Finally, some women with medical conditions like anemia, or a past history of having a baby with neural tube defects may be prescribed higher doses of some vitamins by their doctor. But, because higher doses of some vitamins can also pose a risk to the fetus, and because every woman’s needs are unique, you should speak to your doctor before choosing a prenatal supplement or taking extra supplements during pregnancy.

Step 2: Understanding Why Some Vitamins Are Important to Fetal Development

At Daily Wellness, we have written in detail about why certain vitamins and minerals are essential to a healthy pregnancy. Even if you are carefully managing your diet, it can be hard to know exactly how much of a given vitamin or nutrient you are getting. Prenatal vitamins are a back-up to a healthy diet and can help you get exactly what you need when you’re pregnant. When buying a prenatal vitamin, look closely at the label. The vitamins and minerals listed above are just some of the vitamins needed for a healthy pregnancy. Why are these vitamins and minerals so important? Why is it essential that you take your prenatal vitamin every day, especially during early pregnancy? Let’s explore:

• Folic Acid. Folic acid is needed for the proper development of the neural tube. Women who are low in folic acid risk delivering babies with neural tube defects. Women need folic acid most in the first month of pregnancy, when the neural tube forms. This means that many women may need folic acid most when they may not yet know they are pregnant. So, if you are planning to begin a cycle of I.V.F., trying to conceive, or are a young woman of childbearing age, taking a prenatal vitamin or a vitamin supplement with folic acid is important.
• B Vitamins. The B vitamins are needed for proper fetal nervous system development and muscle function, according to Oxford Medicine. Low levels of vitamin B12 have also been linked to neural tube defects according to the Food and Nutrition Bulletin. Many people are low in vitamin B12 and may not know it, according to a USDA study. Taking a prenatal supplement with proper vitamin B12 levels can help you get the nutrients you need for a healthy pregnancy.
• Vitamin D. If you’re planning to start I.V.F., or are trying to get pregnant, higher levels of vitamin D were associated with higher chances of pregnancy success according to the journal of Fertility and Sterility, and vitamin D could reduce the risk of pre-eclampsia and preterm birth.

These are just some of the ways that taking proper vitamins and minerals can prevent adverse pregnancy outcomes and even help you if you are trying to get pregnant. Of course, every woman’s needs are unique, and if you are concerned about vitamin deficiencies and your pregnancy, your first step should be to talk to your doctor about your dietary needs.

Step 3: Check Labeling for Independent Certification

After checking the label of several prenatal vitamins, you might find that many brands meet the minimum requirements noted above. So, how can you differentiate between brands? Standards for purity and manufacturing can vary from company to company.

In fact, an alarming study published by Toxicology Reports found that half of prenatal vitamins tested had unacceptable lead levels, and some prenatal vitamins had arsenic at unacceptable levels. The researchers called for increased regulation of the prenatal vitamin industry, but until that occurs, consumers need to be savvy about which prenatal vitamins they choose. The reality is that lead is present in the environment. It can be found in the soil, can be absorbed by plants as they grow, and can enter food through processing and manufacturing. Exposure to lead is inevitable. As of this writing, you should not avoid taking a prenatal vitamin because of concerns about lead. Virtually everything we eat has some level of lead. The goal then should be to reduce the amount of lead in your food, especially in foods like vitamins that we take daily.

The F.D.A. regulates what it considers to be safe lead levels, calculating these safe levels to be ten times less than the actual amount of lead intake that would be required for a person to reach levels the C.D.C. determines to be unsafe. Currently the F.D.A. sets safe lead limits at 12.5 micrograms per day, which is a limit deemed safe for pregnant women. A recent F.D.A. analysis of prenatal and children’s vitamins revealed just how much lead could be found in popular prenatal and children’s vitamins. While none of the vitamins listed exceeded the F.D.A. recommendations, some vitamins indeed had higher lead levels than others, some at levels that were alarming. A look at the list published here can help you make better informed choices about which prenatal vitamins you want to choose.

Another way to help you choose a prenatal vitamin is by checking the label for independent certification. The F.D.A. doesn’t regulate dietary supplements like prenatal vitamins for their effectiveness or safety. Because the F.D.A. doesn’t test each batch of prenatal vitamins to ensure that there are no impurities nor does it test to ensure that the batches contain the right balance of vitamins and minerals, being a smart consumer is important. Does the maker of your prenatal vitamin follow good manufacturing practices? Some prenatal vitamin companies submit their vitamins to independent organizations for testing. The different certification programs include: United States Pharmacopeia (USP), NSF, Consumer Lab, and Good Manufacturing Practices:

• USP certification tests vitamins for heavy metals and for consistency. According to USP, verification indicates that the vitamin contains the ingredients listed; verification checks that the amount of each vitamin found in the supplement matches the amount indicated on the label. The USP also tests for harmful levels of lead, mercury, microbes, pesticides, and other contaminants. Vitamins only receive certification when they don’t have impurities. USP certification also verifies that the vitamin has been manufactured in accordance with Good Manufacturing Practices according to the F.D.A. Finally, USP certification indicates that the vitamin will break down in the body according to performance standards listed on the label. Not many prenatal vitamins have USP certification.
• NSF certification certifies vitamins for specific qualities, like being gluten-free. Vitamins with the NSF mark indicate that the product has undergone an impartial review. NSF also certifies that claims made by the manufacturer have been reviewed by an impartial third-party.
• The D.A. regulates Good Manufacturing Practices for pharmaceuticals, but doesn’t regulate these practices for vitamins and supplements. Manufacturers of medications must meet strict F.D.A. quality standards for strength, purity, and quality. When it comes to drug doses, consumers need to know that they are getting the right dose in accordance with the label. Good manufacturing practice involves having “a formal system of controls” regarding every aspect of the drug manufacturing process, from the top down. This means strong management systems, obtaining quality materials to produce the drug, creating strong operating procedures that ensure quality, having a system in place to detect deviations from the standard of quality and purity, and maintaining reliable testing laboratories to test for quality, purity, and strength. The F.D.A. oversees that drug manufacturers meet GMP standards. Vitamin companies can choose to voluntarily implement these stricter standards in their manufacturing procedures.
• Consumer Lab independently tests vitamins, minerals, and nutritional products to determine whether the product meets a standard of quality listed on the label. Products are tested to determine whether the strength of the vitamin matches the strength advertised on the label. Finally, products are tested for purity to determine whether they contain unsafe levels of contaminants. Consumer Lab (paywall) routinely publishes its reviews of different products and those that pass the independent tests can pay a fee to include the CL Seal of Approval. Not all manufacturers that pass will choose to use this label, but consumers can check to see if their brand of choice has been tested by Consumer Lab by purchasing the company’s independent reports.

Checking for USP, NSF, or GMP certification is a good step when choosing which brand of prenatal vitamin to take and trust. Of course, some vitamins may not have all these certifications, and some may only have one certification, and still be just as pure at those with certification. Moreover, vitamins lacking any independent certification may be as pure as those that are certified. Doctors may not always have a recommendation of which prenatal vitamin to choose, so women are often left on their own to decide which one is best. For women who may not be getting clear guidance on what prenatal vitamin is best, looking to independent certifiers and reviewers can help guide you toward the prenatal vitamins that have been independently certified and tested for quality.

Step 4: Gummies or Pills?

Prenatal vitamins come in both gummy and pill form. Is one better than the other? Overall, it doesn’t make much of a difference, though gummies may not contain the same level of iron as pills. Gummies also give you added sugar with each dose, something to consider if you need to limit your sugar intake. At the end of the day, though, if you have trouble swallowing pills, taking gummies can be a good option.

Step 5: Special Vitamin Needs

Vegetarians and vegans will have different dietary needs than those who eat meat and fish. Some prenatal vitamins contain gelatin, which many vegans and vegetarians consider unacceptable because it is an animal product. If you have certain health conditions, you may also need to supplement your diet beyond what is provided in a prenatal vitamin. Other women may struggle to take prenatal vitamins because of morning sickness. Speaking to your doctor about your dietary needs, getting blood work done, and following your doctor’s instructions is important. There are prenatal vitamin products on the market targeted to women who have these special needs.

Vitamin Needs for Women Undergoing I.V.F.

If you are trying to become pregnant through I.V.F., there are also several vitamins and minerals associated with greater fertility and improved outcomes. Low levels of certain vitamins were associated with higher risk of lost pregnancy and poorer pregnancy outcomes. Which vitamins have been associated with better pregnancy outcomes?

• Vitamin B6. Researchers writing for the American Journal of Epidemiology found that low vitamin B6 levels were associated with lower chances of conceiving and early pregnancy loss.
• Vitamin D. Taking vitamin D during your I.V.F. embryo transfer could potentially be beneficial. Researchers writing for the journal of Fertility and Sterility found that women with higher levels of vitamin D in their bodies were more likely to become pregnant with I.V.F.
• Vitamin E. According to Reproductive BioMedicine Online, women undergoing I.V.F. and I.U.I. saw better chances of achieving pregnancy when their vitamin E levels were higher.
• Coenzyme Q10. The journal Antioxidants notes that women with reduced ovarian reserve saw better outcomes during follicular stimulation treatment when they took 600 mg a day of Coenzyme Q10 for 60 days when undergoing I.V.F. treatment.

A daily wellness supplement like FertilityBlend for Women may be able to provide you with the additional vitamins and supplements you need as your body prepares for pregnancy and as you prepare for I.V.F.

For women who are trying to become pregnant, who have not previously experienced infertility, taking a prenatal vitamin can help prepare your body for pregnancy, and it can also provide your body with important vitamins needed to potentially increase your likelihood of pregnancy success. Of course, if you have any nutritional concerns as you embark on your pregnancy journey, talk to your doctor, get  appropriate blood, urine, and saliva tests, and remember that taking any supplement is no replacement to healthy living and exercise.

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