Making a Healthy Baby
Even with the best intensions it can be hard to meet the body’s needs with diet alone.
Taking a natal supplement can ensure that you are getting all of the essential nutrients.
Emed’s Best Preconception and Pregnancy Multivitamins:
The most important nutrients in pregnancy and preconception:
Below is a run through of the basic nutrients required inpreconception and pregnancy, the reasons why you need them, as well as the recommended daily dose.
See how your current multi stacks up – a word to the wise, if it’s a retail supplement such as ‘Elevit’ – it doesn’t.
Elevit prides itself on having 800mcg folic acid per tablet, however it contains such low doses of the other B vitamins that it may cause imbalances in the body.
Excess folate can mask B12 deficiencies so it is important to have good levels of both vitamins in your multi.
What to look for in Your Pregnancy Multivitamin?
1. B Vitamins
Supplementation with B vitamins is especially important during preconception and 1st trimester.
* DOSE: Always give in a complex, around 50mg of most, 400mcg of B12 and 500mcg of folic acid
Vitamin B1 (Thiamine): The requirement for thiamine is increased by approximately 30 per cent during pregnancy. It is extremely important for energy production, transmission of nerve impulses and for the production of collagen which is the major structural protein in the body.
It is an important nutrient during pregnancy, especially to help women maintain healthy blood sugar, because it is necessary for normal glucose metabolism and insulin production. Low thiamine levels have been associated with low birth weight infants.
Vitamin B2 (Riboflavin): Due to high growth and energy demands on the body, the need for riboflavin is increased in pregnancy. Low birth weight infants can be significantly low in riboflavin (also vitamin A, E and folate).
Riboflavin is necessary for energy production and metabolism of carbohydrates, fats and proteins.
Vitamin B3 (Niacin): Niacin is necessary for energy production, normal blood sugar regulation and DNA health and repair. It helps to lower cholesterol levels and is important for a healthy nervous system, skin and digestive system.
Vitamin B5 (Pantothenic acid): The biologically active form of vitamin B5 is coenzyme A (CoA) which is involved in energy production and the synthesis of proteins and fatty acids.
Vitamin B6 (Pyridoxine): Vitamin B6 may improve fertility in women because it supports the luteal phase of the menstrual cycle and can help to lower prolactin levels if they are high (high prolactin significantly reduces fertility).
It also relieves the symptoms of PMS, helps maintain healthy blood sugar levels, improves immunity and is essential for the production of red blood cells.
There are often decreased levels of B6 after taking the Oral Contraceptive Pill (OCP) for a period of time.
In pregnancy, vitamin B6 is effective for morning sickness. If you have adequate levels of this vitamin when you conceive you are much less likely to experience morning sickness.
In conjunction with vitamins B12 and folic acid, pyridoxine helps to reduce elevated homocysteine. Healthy levels of homocysteine are associated with a normal full term pregnancy.
Vitamin B12 (Cyanocobalamin): Vitamin B12 is necessary for the activation of folic acid. Together with folic acid it is necessary for the formation of healthy DNA and nervous system tissue.
It also is a natural antioxidant and together with vitamin B6 and folic acid it reduces elevated homocysteine.
Folic/folinic Acid: Folate deficiency is one of the most common vitamin deficiencies and the need for this vitamin doubles during pregnancy; there are particularly high requirements in the early stages of pregnancy especially in the first 3-7 weeks
It is necessary for healthy foetal development and reduces the incidence of neural tube defects by 80 per cent when taken at 400-500 mcg a day.
The neural tube is the structure from which the baby’s central nervous system develops. Neural tube defects are a group of abnormalities that occur in the spine and brain of the developing foetus, causing mental and physical disabilities. Spina bifida is one of the most common neural tube defects.
Ideally supplementation with folic acid should be started approximately three months prior to conception because neural tube defects occur within the first 22 to 28 days of pregnancy.
This is particularly important for women who have taken the oral contraceptive pill (OCP), which reduces folate levels. Deficiency can lead to decreased fertility.
Folate supplementation is essential for women coming off OCP.
Folic acid improves birth weight and is essential for new tissue to differentiate into organs. It’s also needed for the formation of DNA and RNA.
* DOSE: 500µg – 1000µg – the higher dose if there is a history of miscarriage or neural tube defects in the family
2. Other Vitamins & Contingent Nutrient Factors
Vitamin A: Vitamin A is importantfor cellular differentiation and proliferation, particularly for the development of the vertebrae and spinal cord, ears, eyes, heart and limbs. There is an increased demand during pregnancy.
In men, optimum levels of vitamin A are important to maintain sperm count and motility. Deficiency of vitamin A is associated with male and female infertility.
Low levels are associated with abnormality of mucus membranes in the reproductive tract, abnormality of sperm and perhaps ovum.
Decreased levels of vitamin A are associated with the development of a cleft palate in the infant.
Supplementing with vitamin A results in a lower tendency to miscarry.
* DOSE: 5,000 IU – 10,000 IU (take 6mg beta carotene).
Vitamin A is toxic in pregnancy at doses of of >25,000 IU, but youwouldn’t go higher than 10,000 IU to allow for safety margin – Can’t go over 2,500 IU Vitamin A in most over the counter products, which is not enough on it’s own
Betacarotene: Betacarotene is a powerful antioxidant and isconverted to vitamin A in the body. It is found predominantly in yellow vegetables as well as spinach and some fruits such as apricots and peaches.
Vitamin C: Vitamin C is an important antioxidant and is necessary for healthy immunity. It should be taken as part of preconception care.
Vitamin C helps support normal sperm and healthy cell membranes,including those of the ovaries.
Vitamin C improves all sperm parameters; reduces agglutination of sperm and helps improve a decreased sperm count.
Vitamin C may assist in maintaining normal blood pressure in pregnancy and reducing the risk of pre-eclampsia along with vitamin E.
Vitamin C is absolutely essential for iron absorption. Low levels of iron are common during pregnancy.
Supplementing with vitamin C protects against free radical damage to a developing foetus and a higher concentration of vitamin C in breast milk is associated with reduced risk of allergy in infants.
* DOSE: 2-3gms and 300mg bioflavanoids
Bioflavonoids: Bioflavonoids including rutin and hesperidinare often found in vitamin C rich foods and they work with vitamin C to enhance its activity. Bioflavonoids are important for vascular health.
Vitamin D3: Vitamin D3 is essential for calcium absorption and increases calcium and mineral deposition in bone.
Vitamin D deficiency can lead to hypocalcaemia in the foetus and osteomalacia in the mother. Studies have shown that insufficient vitamin D during pregnancy can lead to reduced childhood bone mass and decreased body size.
Vitamin D is also important for cell growth and development, and a healthy immune system.
* DOSE: 1000 IU (can increase dose if blood test shows low levels)
Vitamin E: Vitamin E is an important antioxidant reducing free radical damage in the body and adequate levels are essential for the developing nervous system.
Children who have a vitamin E deficiency and who are not treated with vitamin E rapidly develop neurological problems. Newborn infants, especially premature infants, are vulnerable to vitamin E deficiency because they have low tissue reserves.
Vitamin E is important for healthy sperm production and adequate levels may help a normal pregnancy.
Vitamin E also improves circulation, reducing oxygen requirements (good for varicose veins, haemorrhoids).
* DOSE: 500 IU (increase to 1000 IU in last trimester)
Biotin: Biotin requirements are increased during pregnancyand lactation. It is important for cell division and growth, DNA synthesis and for the metabolism of fats and proteins.
Choline: Choline is necessary for the formation of cell membranes and the myelin sheath surrounding nerves. It is also important for healthy liver function and for proper functioning of thenervous system.
Inositol: Inositol is closely associated with biotin and choline and it has a close working relationship with vitamin B6, folicacid and pantothenic acid. Inositol is involved with signal control in cells within the nervous system.
Zinc: Zinc is commonly deficient in both men and women. Zinc status is disrupted by use of oral contraceptives, copper IUD, inorganic iron supplements as well as stress.
An estimated 82 per cent of pregnant women worldwide may have inadequate zinc intakes. Low zinc status in pregnant women has been associated with labour complications, low birth weight and premature delivery.
According to a 2008 Cochrane Review zinc supplementation during pregnancy helps to reduce the incidence of preterm births.
Zinc is also extremely important for male fertility. Deficiency results in low testosterone levels and low sperm count.
There are increased zinc levels in placenta and in semen.
Zinc is important for correct formation and functioning of the brain and immune system. It is also utilised in excretion of certain heavy metals.
Postnatal depression is linked with zinc deficiency and cravings for salt can be a sign of that you are low in this important mineral.
Women deficient in zinc often develop stretch marks and have perineums that tear more easily.
* DOSE: 20-60mg of elemental zinc daily – Particularly important for men
Magnesium: Along with calcium and vitamin D, magnesium is essential for the development of healthy bones, teeth, muscles and nervous system, and for maintaining the health of these tissues in the mother.
Adequate magnesium will help prevent muscle cramps and keep blood pressure normal.
It also plays an important role in regulating normal blood sugar and insulin levels, nourishing the nervous system and alleviating symptoms of PMS.
Low magnesium is common and may lead to high blood pressure, premature labour, low birth weight, or retarded development.
Magnesium is essential for healthy sperm production and for good muscular contraction of the fallopian tubes – decreased levels may lead to miscarriage.
Magnesium is used especially in the last trimester of pregnancy for leg cramps. You will most likely need an extra magnesium supplement such as Bioceuticals UltraMuscleze.
* DOSE: 400mg
Calcium: Calcium is an extremely important nutrient leading up to and during pregnancy. It is necessary for the development of bones and teeth in the foetus.
Approximately 30 to 40 grams of calcium are transferred to the foetus throughout the pregnancy, the majority in the third trimester.
It is important for the mother to have good stores of calcium before becoming pregnant so that the health of her own teeth, bones, nervous system and muscular function is not at risk.
Adequate maternal calcium levels can also help to maintain normal blood pressure during pregnancy.
Neonatal mortality is found to be lower in women supplemented with calcium.
Interestingly, supplements may provide an important secondary prevention strategy to reduce circulating levels of lead in the mother and hence reduce lead levels in the infant.
* DOSE: 800mg is needed daily for foetal skeletal development
Iodine: Iodine is essential for healthy thyroid function and is important for developing nervous tissue and the brain in the foetus.
It is estimated that 80% of Australians and New Zealanders do not get adequate amounts of iodine in their diet, and iodine requirements for pregnant and lactating women are approximately double that ofnon-pregnant women.
Lack of iodine can be damaging to the development of the brain. Iodine is essential for normal healthy cognitive development and growth of foetus and newborn baby.
Iodine is required during pregnancy to ensure thyroid hormone (T4) production is maintained at adequate levels. During the first and second trimester the foetus is entirely dependent on T4 from the mother, and during the last trimester requires a regular supply of iodine for its own T4 synthesis.
Thyroid hormones play a role in early growth and development of many foetal organs including the brain. Iodine deficiency during pregnancy is the most common worldwide cause of preventable intellectual impairment. Deficiency has been related to: low development quotients, low intellectual quotients, low visual-motor performances, poor perceptual and neuromotor abilities.
Lowered thyroid function in adults is associated with lower fertility.
* DOSE: 175µg-220µg
Iron: Iron requirements increase substantially during pregnancy.
This increased need cannot always be met by diet alone so supplementation may be beneficial. Ask your GP for a blood test to check your levels.
Menstruating women lose iron with each period; the heavier and longer the menstrual flow the more iron is lost, causing many women to be iron deficient before they become pregnant.
Along with fatigue, impaired learning, memory and concentration, iron deficiency also increases the vulnerability to environmental lead and cadmium. Vitamin C is essential for the absorption of iron.
Iron is essential for a healthy growth rate of the foetus and to ensure correct immune function.
During pregnancy there is increased blood volume; the mother is providing for foetal and placental requirements. The number of red blood cells in the mothers blood increases by 20 to 30%, and during the last three months of pregnancy up to 3-4mg of iron is transferred to the baby each day.
Iron supplementation is also important if there has been blood-loss during the delivery.
Low iron stores in the mother have been linked to iron deficiency anemia, low birth weight and increased risk of prematurity.
It is important to watch for deficiency symptoms especially in women with aprevious history of anaemia – may need to supplement after around 20 weeks. If iron is low, it is best to supplement with InNatal Plus Iron that contains a big dose of easy to absorb iron or a specific iron formula such as Iron Excel.
* DOSE: 30mg – Best to have your iron stores (Ferritin) at around 50
Selenium: Selenium is a major natural antioxidant present in all tissues in the body. Selenium is important for the activity of vitamin E.
It also supports healthy thyroid and immune function and has a role in preventing miscarriage.
Australian soils are very deficient in selenium, so it is easy for us to become deficient without supplementation.
Deficiency during pregnancy has been linked to SIDs, Downs Syndrome and Asthma.
In pregnancy, adequate levels of selenium may help maintain healthy blood pressure.
Although this is an essential nutrient it can be toxic in large amounts, so always read product labels for any supplements, or check with your practitioner.
Men need adequate selenium during preconception as this mineral is required for testosterone biosynthesis and formation and development ofsperm. Decreased selenium is associated with decreased production andmotility of sperm.
* DOSE: 65µg
Chromium: Chromium is essential for healthy blood sugar levels and to reduce cravings for sugar. It works together with B complex vitamins and magnesium for blood sugar regulation.
Chromium also plays an important role in cell division and growth, protein and lipid metabolism, and may assist with maintaining healthy cholesterol.
* DOSE: 100µg – 300µg
Other Minerals: Manganese and boron are essential for bone formation, and manganese aids cholesterol and carbohydrate metabolism. Manganese and molybdenum are important for amino acid metabolism.
Molybdenum and copper are important for iron metabolism. Copper is also necessary for energy production and the metabolism of hormones and neurotransmitters.
Silica is essential for healthy connective tissue including bone, cartilage, skin and nails.
What to Combine with Your Multivitamin?
Multi + Omega 3’s
They are necessary for healthy brain and liver development and for placental growth.
In technical speak – polyunsaturated fatty acids have been shown to increase the number andsize of ovarian follicles, the ovulation rate, progesterone productionby the corpus luteum, the timing of luteolysis and gestational length.
Fatty acids are necessary for the mother to support mammary gland and uterine growth. The omega 6 fatty acids are readily sourced from the diet in the form of vegetable oils. However, omega 3 fatty acids (DHA, EPA) are often lacking.
Mothers who supplement with omega 3 oils have been found to have a lower incidence of allergy in their children and higher intelligence levels.
These omega 3 fats, particularly DHA, are critical for central nervous system development which begins 21 to 28 days after conception. At 40 days after conception brain waves are recordable. Therefore, it is essential that women ingest adequate amounts of essential fatty acids prior to conception. Increased intake is also extremely important during lactation.
Currently, the proposed Adequate Intake of DHA for pregnant and lactating women is 300 mg per day.
Multi + Omega 3’s + Good Bacteria
During pregnancy many women experience bloating, gas, heartburn and constipation. This is caused by a variety of reasons including hormonal changes, crowding in the abdominal cavity, changes in eating habits and disruption to the balance of normal gut flora.
A high strength probiotic may assist in alleviating the discomfort associated with these symptoms by aiding in the degradation of food and allowing faster and better absorption.
Recent studies have also shown that infants of mothers who suffer allergies had a reduced risk of developing sensitisation if the mother took probiotics during pregnancy and lactation. It is believed that these results were due in part, to the beneficial composition of the breast milk.
A particular probiotic strain called Lactobacillus rhamnosus GG (LGG) when taken during pregnancy and breastfeeding, was shown to reduce the incidence of eczema and food allergy in infants.
This probiotic strain can be found in MedLab Biotic Natal. Mothers, take 2 capsules daily (especially during the last two months of pregnancy and during breastfeeding) to reduce the incidence of eczema and allergy in your child.
NOTE: Men often get overlooked in the preconception stages, but their contribution is extremely important.
Sperm production requires adequate nutritional levels and an absence of chemicals – since sperm are so tiny they are very easily damaged by oxidants, chemicals and radiation, so including both partners in a preconception care program is vital.
The following products can be used as a basic preconception program for men: