Multivitamins during Pregnancy

I had a friend ask me the other day what I did about taking a multivitamin/mineral (MVI) during my pregnancy, and I thought some other people might be interested.

The friend who asked is also a registered dietitian, and as RDs, we believe that people eating a healthy diet should not need any dietary supplements. After all, what is there to supplement if your diet is adequate? But, the wisdom of today is that every woman needs to be taking supplements while pregnant, regardless of diet. Nevermind the fact that all foods made with white flour and rice have been fortified with folate (the main nutrient that doctors are worried about us getting), and since this practice was begun spina bifida and other neural tube defects have become much more rare.  So, even if you’re eating an unhealthy refined-flour based diet, you’re pretty much covered.  Not only that, but whole grains and vegetables are naturally good sources of folic acid (another form of folate), so if you’re actually trying to do your body good with your diet, you’re still covered.

So what’s the point?

When I was deliberating this prior to becoming pregnant, I talked it over with another RD friend of mine who happens to work at a high-risk OB practice, and who was a running partner of mine at the time (running partners can become pretty intimate friends!) Her response to the question was “Why risk it? Just take the multivitamin.” I thought that was fair enough, because there isn’t too much risk from taking an MVI, at least not for a short amount of time.  But, which one to choose?

I got some samples of prescription MVIs from my OB/GYN (I later changed to a midwife), and looked at all my options. There were MVIs high in iron. There were MVIs higher in iron. There were MVIs with DHA. I don’t even remember all the options, but I knew what I wanted: a MVI with about 100% of each nutrient I need, no artificial color (CSPI has been warning the public about the health risks), and DHA in an included but separate pill.  Believe it or not, this was very hard to find! I did find one MVI that fit the bill, but when I contacted my health insurance company, they let me know that my copay each month would be $50. Fifty dollars a month!! For something I wasn’t convinced that I needed!  I decided to look at non-prescription vitamins.

These were just as bad. Almost all the “prenatal” MVIs had food coloring. Why should a pill have food coloring? That is the height of pointless ingredient additions, in my view. They also generally lacked iodine, which is important for healthy fetal brain development, as well as proper thyroid function. The RDA for iodine for pregnant women is 220 micrograms from all sources, or a supplement of 150 micrograms.

http://www.naturemade.com/Products/Multivitamins/Multi-For-Her

What did I finally decide on? NaureMade Multi for Her. It had no coloring, 150 micrograms of iodine, 1000 IU of vitamin D, 18 mg iron, and 600 micrograms of folic acid. And Kroger often had it on sale for half price, so it was really cheap.  I also took fish oil supplements from either Spectrum or Nordic Naturals, which I bought at EarthFare, the local health food store.

So, there it is- more than you ever really wanted to know about how an RD picks a multivitamin.