A frequently asked question is “do I need to take supplements?” It is often suggested that many women of childbearing age are not meeting the recommended guidelines for healthy eating. Long working hours, eating on the run or dining out can be a common theme in many people’s lives.
In pregnancy, there is an increased need for many vitamins and minerals. The increase for some vitamins is minimal. Vitamin C, B12 & Magnesium requirements increase between 13-18 % above RDI (Recommended Daily Intake). Others, like Iron and Folate, which you will be more familiar with, require up to a 50% increase. Iodine and B Vitamins are close behind.
The World Health Organisation (WHO) recommendations
The WHO recommends that women have daily iron and folic acid supplementation. This is in contrast to clinical practice where folic acid is always recommended preconceptually and in the first trimester, but not iron. Women who have a history of anaemia, are vegetarian or who have poor absorption due to a health disorder, are encouraged to have iron supplementation throughout the pregnancy. Other factors that may impact whether you need extra vitamins will be where you live and if you have access to fresh fruit and vegetables, meat etc. All of this means that in pregnancy, vitamin and mineral supplementation is recommended.
Some nutrients are lacking in our diet, as the source is limited. This is the case with Iodine. Iodine is important for thyroid function and baby brain development. Oysters and Iodised salt are the main food-based sources of iodine, making getting enough difficult. There is some fortification of foods like bread and cereals, which may help also to increase Iodine levels. Iodine levels are tested via a urine sample. However, this is not a routine test in the antenatal bloods, so you should ask if you would like your levels tested.
How to Take Vitamins
If you are taking a multivitamin and then need to take extra vitamins like iron, it is best to try and take them at different times of the day. This will enable you to absorb the vitamins, without your body competing for the nutrients all at one time. Most vitamins are best taken with food or they may cause nausea and vomiting and or a sense of bloating, due to the effect on the gut. Avoid taking supplements with caffeine containing drinks and bran-based cereals as they interfere with absorption.
Iron tablets are best taken with food, avoiding dairy products, as they can delay absorption. Iron is often constipating in tablet form so it is best to increase fluids and maintain exercise if you introduce an iron supplement to your system. Iron in liquid form tends to have fewer side effects.
Folic acid Please see the August newsletter here
Calcium supplements are recommended when dairy intake is below 1000-1200mg/day. This is equivalent to a 250 ml glass of milk, plus a tub of yoghurt and a small wedge of cheese per day. They are best taken in the evening.
Vitamin D does not cause side effects and can be taken at anytime of the day. Like all vitamins, our body, in most cases, absorbs best from natural sources. In the case of Vitamin D, it is the sun! In winter 20 minutes of exposure to the sun is recommended so try and get outside for lunch on the warmer winter days and go for a quick walk. In summer, the recommendation is 10 minutes in the sun before 11am or after 4pm.
Omega 3 Omega-3 fatty acids are considered essential, as the body is not able to produce them and so we must get them from our diet or supplement with fish oil. Eating 150g of red flesh fish like salmon or slightly bigger fillets of white fish like barramundi 2-3 times per week will help to give you the recommended requirements. If dietary intake is inadequate, 1-2 capsules of fish oil daily are recommended.
B12 B12 is found in foods from animals. Vegans and strict vegetarians need to have B12 supplementation in pregnancy and should have a blood test to check levels early in pregnancy. Some Soy Milks are fortified with B12. Mushrooms and tempeh, do not meet the requirements in pregnancy.
Pregnancy is a good time to improve eating habits along with regular exercise. Everyone is busy – and when life involves children it becomes busier. It is important to take time for your self now and instill good habits that will carry you into parenthood and provide you with energy and wellbeing. Many of you tell me that you are too busy to exercise regularly or take some time out for Yoga classes, but try to make the time. Regular exercise of some form will help you sleep better, reduce your stress levels, leaving you feeling better and more energised. I also find many struggling with what to buy for lunch, as food halls seem to be full of the foods that are restricted in pregnancy. Try some days to take lunch from home, pack healthy snacks too like fresh fruit, yoghurt, nuts, and dried fruits. Water is also another essential and pregnant women should drink 2.5-3litres a day. Good hydration improves energy and will also reduce the risk of urinary tract infections in pregnancy.
If you have any questions regarding the information here, please don’t hesitate to contact us, or ask me during your next visit.
By Belinda Brodrick
Midwife – Dr Morris | Sydney Mother & Baby