The 5 Best Prenatal Vitamins, According to a Nutritionist
Maybe you’ve just started your fertility journey or recently found out you’re pregnant, and now you suddenly find yourself browsing the internet or staring at a wall of brightly colored prenatal vitamins at Target, no idea what you have to put your basket.
It’s daunting trying to decipher which of the countless options will work for you. Which will provide the most nutrients for you and your growing baby, without making you nauseous or costing you a small fortune? (Psst: if you have an HSA or FSA, you can use it to cover the cost of prenatal visits!)
As a clinical nutritionist and mother of two, I’ve reviewed the nutrition labels and ingredient lists of *lots* of prenatal vitamins over the years. Below is a list of the ones I recommend to my nutrition clients and friends, but first let’s discuss what goes into a good prenatal and when to start taking one.
Are prenatal vitamins necessary?
These days, the short answer is yes. Because pregnancy is a state marked by heightened nutritional needs (as is breastfeeding, for that matter), prenatal vitamins can offer additional support in a convenient format.
Prenatals can also help protect you against any gaps in your diet, for example, if you are not consuming dairy products and not getting a consistent source of dietary calcium, or if you are in your first trimester and you can only reduce Wheat Thins. right now. A prenatal can help you cover your bases, so it’s good to have one on hand.
When to start taking prenatal vitamins
Ideally, you’ll start taking your prenatal vitamins six to twelve months before you start trying to conceive. If you’re on a faster schedule, even three months before you start trying is best (eggs take three months to mature, so it will take you that long to see results).
You will want these higher levels of nutrients circulating for optimal egg quality and implantation success. It is also essential to have high levels of folic acid in your body before the egg meets the sperm, as folic acid is needed to help close the neural tube in the developing fetus and can prevent neural tube defects. This happens very early in pregnancy, around 4 weeks, before many people even know they are pregnant.
But if you’ve already started trying to conceive or are already pregnant, don’t worry. Just start taking a prenatal vitamin as soon as possible, it’s never too late.
What to Look for in a Good Prenatal Vitamin
This is my must-have list when evaluating any prenatal vitamin.
The number one feature to look for in a good prenatal? One that comes in divided doses. The body can only absorb a certain amount of a certain nutrient in one sitting (for example, the maximum amount of calcium the body can absorb at one time is 600 milligrams [mg]so taking a pill with 1000mg does you little good).
Split doses make it easier for your hard-working digestive system to break down all of these nutrients. For a two-dose formula, take one tablet in the morning and one tablet before bed.
Probably the most important factor that distinguishes prenatal vitamins from standard daily multivitamins is the amount of folic acid present. It is important to take increased amounts of folic acid during pregnancy because it is difficult to obtain the RDA (600 micrograms) from food alone. Make sure the supplement you are considering contains at least 600 mcg, or 400 mcg as a minimum.
A note on forms of folate: You may have heard of the very common genetic variant known as MTHFR, which if you have this variant is widely believed to mean that your body is having trouble converting folic acid into its active form, the L-methylfolate. The Centers for Disease Control and Prevention (CDC) say it’s a myth: People with MTHFR variants can process all types of folate, including folic acid. It doesn’t matter whether the prenatal you choose contains folic acid or 5-MTHF, the methylated form.
“Folic acid is the only type of folate that helps prevent neural tube defects,” states the CDC. “No scientific studies exist that show supplements containing other types of folate (such as 5-MTHF) can help prevent neural tube defects.”
Methylated B vitamins
Finding methylated versions of other B vitamins is your best bet, however, they reduce the load on your digestive system to convert synthetic vitamins into their active forms. Look for formulas with methylcobalamin (B12) and pyridoxal-5-phosphate (B6).
Easy to absorb iron
Because iron can be constipating, some prenatals omit iron altogether or have a lower dose. But pregnancy marks an increased need for iron and pregnant women are often at risk of iron deficiency anemia. However, too much iron can cause oxidative stress in the body, and you probably get some level from the food you eat. It is important to work with your birth attendant to have your blood levels tested to make sure you are getting the extra dose you need.
I’m looking for iron in the form of ferrous bisglycinate, which is more bioavailable (more easily absorbed by the body) than standard ferrous fumarate. As a bonus, it is not constipating.
A good dose of choline
Choline is essential for fetal brain development, and many prenatal formulations contain little or no choline. During pregnancy, choline requirements increase to approximately 450 mg per day. Unless you choose a powder (see my favorite in Essentials below), your prenatal probably won’t have that many, since choline is a large mineral and difficult to put into pill form.
Still, it’s important that the prenatal you choose contains at least some of it – the rest can be found in eggs, beef, and soy, or through a separate choline supplement.
What to Avoid in a Prenatal Vitamin
- One-day formulations, for the reasons stated above
- Dyes or dyes added
- Excessive vitamin A levels: look for vitamin A levels at or below 100% of the recommended dietary intake (RDA), which is 770 micrograms, as excessive levels of retinyl palmitate (the extra form) can cause birth defects congenital.
- Excess packaging. Look for biodegradable pill boxes or recyclable containers to create less waste
These are my 5 favorite prenatal vitamins
trying to get pregnant, fertility, nutrition, health