Prenatal Vitamins

Did you know calcium is responsible for healthy bone mineralization, muscle contractility, and hormone functioning? When you’re pregnant, calcium requirements increase to support the formation of a new skeleton as well as support the physiologic functioning of that little body. 

Additional benefits of sufficient calcium include more stable blood pressure and a decrease in the risk of pregnancy-induced hypertension, preeclampsia (a disorder of pregnancy characterized by the onset of high blood pressure), and preterm birth.

Keep in mind, phosphorus, calcium and vitamin D are intricately interwoven in the physiology of our bodies. It’s essential to encourage adequate intake of these synergistic nutrients to support the formation and maintenance of your baby’s musculoskeletal system. The importance of calcium increases during lactation too! Nursing mamas need plenty of vitamin D3 and vitamin K2 for proper bone mineralization. 

Not consuming enough calcium is linked to skeletal anomalies including rickets, low birth weight, and low bone density of newborns.

Daily calcium intake during pregnancy = 1,000-2,500 mg (RDA-UL)
Daily calcium intake during lactation = 1,000-2,500 mg (RDA-UL)
RDA = Recommended Dietary Allowance
UL = Tolerable Upper Intake Level

Real food portion size examples to achieve 1,000 mg calcium intake
1½ cups of tofu  or  4 cups of milk  or  3 oz. mozzarella

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Choline is a type of B vitamin vital for normal cellular metabolism and it’s essential for establishing cell membrane integrity. Choline affects neural and motor development, has impacts on placental function, and acts as a precursor to the neurotransmitter acetylcholine, which is necessary for modulating memory, muscle control, and mood. Diets supplemented with choline are shown to have improved outcomes for placental functioning, newborn stress response, as well as promising data concerning memory and cognitive development.

Studies of 900 mg of choline in pregnancy have shown benefits from improved placental function to decreased risk of preeclampsia (a disorder of pregnancy characterized by the onset of high blood pressure). Plus, adequate levels of both folate and choline (which affect one another) are known to decrease the risk of neural tube defects. How cool is that? 

Eggs (especially the yolk!) and meats are high in choline. Salmon, shiitake mushrooms, and legumes also contain choline, as do cruciferous vegetables. So be sure to eat up, Mama!

Daily choline intake during pregnancy = 450-3,500 mg (RDA-UL)
Daily choline intake during lactation = 550-3,500 mg (RDA-UL)
RDA = Recommended Dietary Allowance
UL = Tolerable Upper Intake Level

Real food portion size examples to achieve 450 mg choline intake
3 eggs  or  12 oz. beef  or  3½ cups dry black beans  or  19 oz. chicken breast

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Folate, also known as B9, is essential for cellular division and DNA and RNA synthesis in our bodies. You’ll find folate in a variety of foods from beef liver and leafy greens to eggs, avocados, asparagus and kidney beans. Achieving optimal levels of folate by diet alone is challenging, which is why taking folate is universally recommended for Mamas like you. 

Folic acid is a synthetic form of folate that has been added to processed foods in the United States since the 1940s. Enriching diets with folic acid led to a decrease in neural tube defects (NTDs) among the general population. For women able to metabolize folic acid, 400 – 600 mcg are recommended as a daily supplement. For those who cannot, 1,000 mcg (1 mg) of folate daily are advised. 

Folate deficiency in pregnancy is known to cause NTDs such as spina bifida and anencephaly. Because NTDs occur in the first month of pregnancy, it’s suggested that women contemplating pregnancy supplement their diet with folate prior to conceiving and continue to do so for the first several months of gestation. Keep in mind, low folate levels are associated with increased risk of cancer, stroke, and heart disease.

Daily folate intake during pregnancy = 1,000 mcg (1 mg) (RDA)
Daily folate intake during lactation =  1,000 mcg (1 mg) (RDA)
RDA = Recommended Dietary Allowance
Note: you might notice measurements are listed as DFE (Dietary Folate Equivalents) for folic acid/folate.

Real food portion size examples to achieve 1,000 mcg folate intake
4 cups cooked spinach  or  5 cups cooked rice  or  40 spears asparagus

Daily folic acid (synthetic folate) intake during pregnancy = 600 mcg (RDA)
Daily folic acid (synthetic folate) intake during lactation = 500 mcg (RDA)
RDA = Recommended Dietary Allowance

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Glycine is essential for production of the neurotransmitter serotonin as well as elastin, a hormone that influences vascular health. It’s also a vital component in the synthesis of collagen. Glycine is utilized in bone and collagen synthesis, DNA synthesis, and is protective of the cardiovascular system too. Healthy glycine levels are associated with lower risk of high blood pressure and improved memory/cognitive functioning. 

Meat on the bone and slow-cooked tougher cuts of meat, like pot roast, are good sources of glycine. 

Vegetarian? Legumes like peanuts and mung beans contain glycine, as well as nuts. 

Deficiency in glycine is associated with an increased risk of preeclampsia as well as deficits in motor skills in the neonate. All that to say, it’s very important to include in your diet. That goes double for you if you’re a vegetarian, Mama!

No glycine RDA (Recommended Dietary Allowance) or UL (Tolerable Upper Intake Level) for pregnancy or lactation; most (non-pregnant) people consume about 2 grams daily.

Real food portion size examples to achieve 2 g glycine intake
2 oz. turkey or  4 oz. scallops  or  4 oz. pepitas  or  10 oz. Parmesan

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Iron is essential for DNA synthesis, oxygen transport, and energy production as well as many other biologic processes in the body. 

A component in enzymes, proteins, myoglobin, and hemoglobin—adequate iron levels throughout your pregnancy support the proper development of fetal red blood cells, muscle cells, organs, and the brain. 

In fact, the fetus acquires iron stores from Mama sufficient to last for the first 4-6 months of life!

You can find iron in a wide variety of foods from leafy greens and legumes to beef. Consuming animal and plant sources of iron at the same time can aid in absorption. Adding Vitamin C-rich foods to iron-rich foods optimizes absorption as well. 

Iron deficiency can increase the risk of preterm birth and low birthweight. Preterm birth and low birth weight can, in turn, lead to iron deficiency in the neonate. Low iron is also linked to increased risk of preeclampsia (a disorder of pregnancy characterized by the onset of high blood pressure), fetal death, and later cognitive delays in the neonate. So make sure you load up on iron, Mama!

Daily iron intake during pregnancy = 27-45 mg (RDA-UL)
Daily iron intake during lactation = 9-45 mg (RDA-UL)
RDA = Recommended Dietary Allowance
UL = Tolerable Upper Intake Level

Real food portion size examples to achieve 27 mg iron intake
1½ cups tofu  or  3½ cups cooked white beans  or  4½ cups cooked spinach

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Niacin, also known as vtamin B3, is a water soluble vitamin—meaning your body will not store it. That’s why consuming niacin-rich foods daily is important, especially during pregnancy and lactation when your body requires more of it. 

An active contributor to more than 400 enzymatic reactions in the body, niacin extracts fuel from food to give you energy, manage cell repair and maintenance, and regulate communication between cells. Healthy intake of niacin during pregnancy is also important for fetal brain development. 

Niacin can be created in the human body from tryptophan, so turkey is also considered a niacin-rich food. Niacin deficiency is rare and except in rare instances, adequate levels of niacin can be achieved by eating a varied diet.

Suggested daily niacin intake during pregnancy = 18-35 mg (RDA-UL)
Suggested daily niacin intake during lactation = 17-35 mg (RDA-UL)

RDA = Recommended Dietary Allowance
UL = Tolerable Upper Intake Level
Note: Niacin Equivalent (NE) is a term you might hear regarding daily intake recommendations.
NE is used to refer to all varieties of niacin intake.

Real food portion size examples to achieve 18 mg niacin intake
6 oz. chicken breast  or  4 oz. peanuts  or  6 oz. salmon  or  3½ cups brown rice

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One word—ENERGY. Omega-3 ALA (alpha-linoleic acid) primarily supports energy creation in your body. You’ll find Omega-3 ALA in seeds and oils like walnut oil, flaxseed oil, and rapeseed (canola oil). A small amount of ALA is converted to EPA and then DHA; however this isn’t exactly an efficient process. It’s estimated conversion rates are anywhere between 2-21%, meaning consumption of fish or supplementation with fish/krill oils or algae is necessary to achieve recommended levels of DHA and EPA.

Suggested daily omega-3 ALA intake during pregnancy = 1.4 g (AI)
Suggested daily omega-3 ALA intake during lactation = 1.3 g (AI)
AI = Adequate Intake

Real food portion size examples to achieve 1.4 g omega-3 ALA intake
¼ oz. chia seeds  or  ½ oz. walnuts  or  ¾ tablespoon flaxseeds

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Omega-3 EPA (eicosapentaenoic acid) has anti-inflammatory and antidepressant effects in your body, as well as synergistic effects with DHA on fetal development. Plus, it’s associated with lower rates of preterm birth and preeclampsia—a disorder of pregnancy characterized by the onset of high blood pressure. 

Your daily intake is most important in the third trimester, a time when rapid fetal brain development is underway.  Recommended dosage of EPA/DHA for pregnancy is at least 500-600 mg, with 250-350 mg of that being DHA. 

Food servings of EPA/DHA foods are generally limited in a Western diet due to concerns about levels of mercury in marine animals. 2-3 servings of fish a week (12 ounces total) is generally recommended. For example: a 3.5 oz serving of wild salmon contains an average 1,000 mg of EPA/DHA. 

Fish and krill oil supplements can be designated “mercury-free” and wild-caught.

Vegan or vegetarian? Algae supplements are a good alternative. Note: cold water, fatty fish naturally contain both DHA and EPA; a supplement will need to be checked to make sure it contains both. 

Keep in mind—It’s important to continue to consume/supplement omegas throughout your postpartum period and while nursing to support your baby’s immense neurological development.

Suggested daily omega-3 EPA intake during pregnancy = 250-350 mg
Suggested daily omega-3 EPA intake during lactation = 200-300 mg
Note: These ranges are general recommendations.

Real food portion size examples to achieve 250 mg omega-3 EPA intake
1½ oz. halibut  or  ¾ cup shrimp  or  1 oz. salmon

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Did you know healthy potassium levels are associated with lower levels of pregnancy-induced hypertension? 

A mineral essential for proper functioning of nerve impulses, muscle contractility, communication between cells, and blood pressure—potassium is tightly regulated by the body and supplements are not generally recommended.

During pregnancy your body has an increased need for potassium for the development of the fetus as well as the maintenance of the increased demands on your body.  You can consume enough potassium in a whole foods diet and should not need supplementation unless you suffer from Nausea and Vomiting of Pregnancy (NVP) that limits intake and retention. 

Incorporate more fruits and vegetables into your diet in the shape of potatoes, bananas, beans, dried fruit, and leafy greens. 

Inadequate levels of potassium are linked to muscle weakness, fatigue, and irregular heartbeat (arrhythmia). All that to say, be sure to eat plenty of potassium!

Suggested daily potassium intake during pregnancy = 4,000 mg (RDA)
Suggested daily potassium intake during lactation = 4,400-5,100 mg (RDA-UL)
RDA = Recommended Dietary Allowance
UL = Tolerable Upper Intake Level

Real food portion size examples to achieve 4,000 mg potassium intake
3½ cups raisins  or  2 cups dried apricots  or  2½ potatoes  or  1¾ cups dry adzuki beans

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Riboflavin, aka Vitamin B2, is essential for the healthy development of your baby’s skeleton and muscles as well as her (or his! or their!) nervous and digestive systems. 

In fact, Riboflavin is a cofactor in many physiologic processes, especially relating to the metabolism of other vital nutrients like folate, niacin, and iron. 

Increased needs in pregnancy and lactation are generally recommended to be 1.4-1.6 mg daily. 

Inadequate intake of riboflavin increases your risk of preeclampsia (a disorder of pregnancy characterized by the onset of high blood pressure) in pregnancy and is associated with heart defects.

Suggested daily riboflavin intake during pregnancy = 1.4 mg (RDA)
Suggested daily riboflavin intake during lactation = 1.6 mg (RDA)
RDA = Recommended Dietary Allowance

Real food portion size examples to achieve 1.4 mg riboflavin intake
1½ cups yogurt or  10½ oz. beef  or  2½ cups portabella mushrooms

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Vitamin A plays an important part in fetal development from cellular differentiation and division, the development of teeth and hair, immune system function, reproductive organ functions, eye health, and bone development. 

Vitamin A is found in two forms: 

 • Preformed Vitamin A is found in fatty fish oil, milk and yogurt, and liver and eggs. Current guidelines suggest preformed vitamin A not exceed 3,000 mcg daily. 

 • Provitamin A is found in plant sources such as sweet potatoes, carrots and spinach. Because provitamin A is not efficiently assimilated in the body, animal sources are recommended for adequate intake. 

Low vitamin A levels increase the risk of diabetes for both Mama and baby and are associated with increased rates of miscarriage, skeletal anomalies, and cardiac defects. Vitamin A supplementation is not recommended in pregnancy except in developing countries. 

Suggested daily vitamin A intake during pregnancy = 770 mcg (2,567 IU) – 3,000 mcg (10,000 IU) (RDA-UL)
Suggested daily vitamin A intake during lactation = 1,300 mcg (4,333 IU) – 3,000 mcg (10,000 IU) (RDA-UL)
RDA = Recommended Dietary Allowance
UL = Tolerable Upper Intake Level

Real food portion size examples to achieve 700 mcg (2,567 IU) vitamin A intake
½ sweet potato  or  1 cup carrots  or ½ cup cooked collard greens  or  3 cups ricotta cheese

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Vitamin B12, aka cobalamin, is a water-soluble vitamin necessary for proper cellular division and central nervous system functioning. It’s an important cofactor across multiple processes in the body from amino acid and fatty acid metabolism to the synthesis of myelin and red blood cells. 

Adequate daily consumption of B12 is essential as it’s sequestered in the placenta and preferentially shunted to the fetus, depleting maternal levels. 

Vitamin B12 is not synthesized in the body, meaning you must consume it in your diet. It’s only available naturally from animal sources—although some nutritional yeast has been fortified with B12. Beef liver and clams are the foods highest in vitamin B12. Additional sources include fish, beef, and milk. 

U.S. guidelines suggest 2.6 mcg in pregnancy. Methylcobalamin is a preferred form of supplement when indicated. 

Inadequate intake of B12 in babies is associated with failure to thrive and irritability while deficiency is shown to increase the risk of preterm birth, miscarriage, and neural tube defects. 

Babies are born with enough B12 reserve to last about four months postpartum. How neat is that?!

Suggested daily vitamin B12 intake during pregnancy = 2.6 mcg (RDA)
Suggested daily vitamin B12 intake during lactation = 2.8 mcg (RDA)
RDA (Recommended Dietary Allowance)

Real food portion size examples to achieve 2.6 mcg vitamin B12 intake
6 oz. beef  or  2 cups milk  or  4-5 oz. lamb

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While Vitamin D is synthesized largely by sun exposure, it’s also found in foods from fatty fish (salmon, anchovies) to cod liver oil, and eggs. In the absence of daily vibrant sun exposure, supplements are recommended. 

Adequate Vitamin D levels are associated with lower risk of colorectal and breast cancer, cardiovascular disease, autoimmune disease, and have been shown to improve pregnancy outcomes.

During pregnancy, healthy levels of vitamin D are also associated with lower prevalence of preeclampsia (a disorder of pregnancy characterized by the onset of high blood pressure), low birth weight, and gestational diabetes—as well as a decreased risk of asthma for newborns in later life. 

Phosphorus, calcium and vitamin D are intricately interwoven in the physiology of the human body. Your body needs all three synergistic nutrients to support the formation and maintenance of the musculoskeletal system.

Suggested daily vitamin D3 intake during pregnancy = 15 mcg (600 IU) – 100 mcg (4,000 IU) (RDA-UL)
Suggested daily vitamin D3 intake during lactation = 15 mcg (600 IU) – 100 mcg (4,000 IU) (RDA-UL)
RDA = Recommended Dietary Allowance
UL = Tolerable Upper Intake Level

Real food portion size examples to achieve 15 mcg (600 IU) vitamin D3 intake
3 oz. salmon  or  5 cups milk  or  4 filets tilapia  or  1 cup white (exposed to UV light) mushrooms  

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Zinc is an essential mineral responsible for healthy immune functioning, nucleic acid metabolism, cellular growth, and protein synthesis. Healthy levels of zinc are associated with a decrease in preterm birth. General guidelines suggest about 12 mg of zinc, although 15-30 mg is considered safe in pregnancy. 

Supplements of zinc are best taken as gluconate or acetate and are often consumed as lozenges. Zinc should not be consumed as a nasal spray as it is linked to damage to the sense of smell. 

Oysters, by far, have the highest level of zinc of any food! Zinc can also be found in beef, legumes, whole grains, nuts, and seeds. Plant sources of zinc are high in components such as phytic acid that actually inhibit the absorption of zinc. For this reason, it’s recommended to soak legumes, whole grains, nuts, and seeds in order to help break down the phytic acid and increase absorption rates. It’s further recommended that women who follow a vegetarian diet consume additional high zinc foods to offset this inefficient assimilation. 

While exceedingly rare to suffer from zinc deficiency in the developed world, current daily intake of zinc is inadequate in roughly 80% of pregnant women. True zinc deficiency is known associated with increased rates of miscarriage and congenital defects.

Suggested daily zinc intake during pregnancy = 11-40 mg (RDA-UL)
Suggested daily zinc intake during lactation = 12-40 mg (RDA-UL)
RDA = Recommended Dietary Allowance
UL = Tolerable Upper Intake Level

Real food portion size examples to achieve 11 mg zinc intake
5 oz. beef  or  1 cup pepitas  or  1 cup peanuts  or  2 cups pine nuts

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