May is all about celebrating moms! From pre-pregnancy, through pregnancy, to post-pregnancy, in this two-part blog series we’re going to start by answering the top 10 questions we hear when it comes to nutrition for moms-to-be and new moms—with a special emphasis on omega-3s and vitamin D.
We know you have questions like “is omega-3 good for pregnancy?” and “will vitamin D help with pregnancy?” And, as importantly, “is it ok to take omega-3 when pregnant?” and “are vitamin D supplements safe during pregnancy?”
This week we’ll focus on the prenatal (before and during pregnancy) timeframe and next week we’ll address the postpartum (after childbirth) period.
So, let’s get started.
Question 1. If I’m pregnant when I should start taking vitamins?
Ideally, you would already be taking vitamins, especially if you’re not getting enough of the essential nutrients your body needs from diet alone. And according to the government, most of us aren’t—especially when it comes to these four nutrients: potassium, vitamin D, calcium and dietary fiber. The Dietary Guidelines, considered the cornerstone for nutrition policy in the U.S., has identified the lack of these four nutrients in the typical American diet as a public health concern.
But there’s another nutrient that is essential, especially for the health of unborn babies. And that nutrient is folate, the natural form of vitamin B9 in food, also known as folic acid, which is the synthetic form found in vitamin supplements. Folic acid can help prevent neural tube defects such as spina bifida, a serious birth defect in which a baby’s spine does not develop correctly, and anencephaly, a fatal birth defect.
Therefore, it’s recommended, by the government and in scientific circles, that all women of child-bearing age get at least 400 mcg of folate/folic acid every day because neural tube defects happen in the first few weeks of pregnancy, a time when many women aren’t even aware that they’re pregnant.
Most multivitamins contain that amount, but be sure to check the label. Once you start your doctor visits, your doctor will likely switch you to prenatal vitamins with your specific pregnancy needs in mind.
Question 2. Is it safe to take omega-3 while pregnant? What about vitamin D?
The answer is to both questions is yes. Omega-3s are essential fatty acids and vitamin D is an essential nutrient. The bigger concern for pregnant women is not getting enough DHA (a type of omega-3 fat) or vitamin D.
Question 3. Is vitamin D beneficial to take during pregnancy?
Vitamin D is essential for life. Research shows that people with higher blood levels of vitamin D live better for longer, with immune and cardiovascular systems that function better.
Vitamin D is especially important during pregnancy to help your baby’s bones, teeth, kidneys, heart and nervous system develop. It’s also thought that vitamin D can reduce the risk of pre-eclampsia and low birthweight.
Government recommendations suggest that pregnant women need 15 mcg (600 IU) daily.
Some research recommends much higher amounts. For example, one older study found that higher doses of vitamin D might reduce the risk of pregnancy complications, including gestational diabetes and preterm birth. That study recommended 4,000 IU of vitamin D daily for pregnant women. According to the researchers, women in the study who took that amount during their second and third trimesters showed no evidence of harm but had half the rate of pregnancy-related complications compared to those women who took 400 IU. The researchers noted that could be a controversial recommendation, but further advised that there is no evidence that vitamin D supplementation is toxic, even at levels above 10,000 IU.
It’s best to have that discussion with your doctor to determine how much vitamin D you should be taking during your pregnancy. A good place to start is by determining your current vitamin D blood levels. OmegaQuant offers a simple at-home blood test to help you begin the discussion. More information is available here and here.
Question 4. Is Omega-3 EPA and DHA beneficial during pregnancy?
Omega-3 fatty acids, particularly DHA, have been the subject of several research studies during the last 30 years with results pointing to their benefits in pregnancy, particularly for helping prevent preterm and early preterm birth—i.e., having a baby before 37 and 34 weeks, respectively. Having a baby prematurely is a major concern for pregnant women and their doctors.
One study showed that taking DHA could reduce early preterm birth risk by 42%, while another study suggested that women with low blood levels of DHA are 10x more likely to deliver a baby prematurely than women with healthy DHA levels. And yet another study showed that taking a DHA supplement could save the US healthcare system $6 billion in costs associated with preterm births.
Consuming enough omega-3 during pregnancy is also important to support the development of a baby’s brain and nervous system. Other research has confirmed that adding EPA and DHA to a pregnant woman’s diet has a positive effect on visual and cognitive development of the baby. It’s also thought that omega-3 fatty acids may play a role in preventing perinatal (the time before and after the birth of a child) depression.
During pregnancy, women need at least 200 mg of omega-3 DHA daily to access these benefits.
Question 5: What fish can pregnant women eat and how much is recommended?
Fish is an excellent source of nutrition for a developing baby because it is low in calories and saturated fat, and high in protein, vitamin D and omega-3s. Plus, it is highly beneficial for the health of expectant mothers. The U.S. Food and Drug Administration (FDA) recommends eating 8 to 12 ounces a week of a variety of seafood that’s low in methylmercury while you’re pregnant or nursing a baby.
Consistently safe options like salmon, trout and herring can be eaten 2-3 times per week and are not only low in mercury but also high in omega-3s, which are shown to be especially important for a baby’s cognitive development. White or albacore canned tuna is also a good source of DHA but should only be eaten once per week due to a slightly higher mercury content.
But not all fish are considered equal, especially when it comes to pregnant women. While many fish prove to be an excellent source of DHA, the FDA advises women of childbearing age to steer clear of high-mercury species like swordfish, shark, king mackerel, and tilefish, which, according to the Environmental Protection Agency (EPA), can be detrimental to a baby’s brain development, vision, cognition and motor skills.
The FDA has released a helpful guide to choosing low mercury fish but be aware that not all the fish are rich in DHA. A list of fish that are high in DHA and low in mercury is included in your personalized report received after taking OmegaQuant’s Prenatal DHA Test.
Question 6. Are Omega-3 supplements an option?
While fish should be your first option, omega-3 EPA and DHA supplements are also a fine (and safe) option, particularly if you don’t like the taste of fish, or have concerns about high mercury found in some fish. Be sure to check the label to confirm the brand you choose includes at least 200 mg of DHA, as that’s where most of the benefits from omega-3s specifically during pregnancy are found. And if you are a vegetarian or vegan, you can get your omega-3 EPA and DHA from plant-based algae oil supplements.
We recommend getting an adequate amount of omega-3 EPA and DHA throughout your pregnancy—actually throughout your life. But for pregnant women and the child-to-be, it’s especially important during the second half of pregnancy, mainly the third trimester, when the most rapid neural and retinal development happens in the fetus and omega-3s have their greatest impact.
Question 7. What happens if you don’t get enough DHA during pregnancy?
You’ll be losing a lot beneficial nutrients that, were you consuming DHA, could potentially positively impact you and your child. There is some research that has suggested that an inadequate amount of DHA while you’re pregnant may compromise fetal development, but most of the research is focused on the benefits of adding DHA to your diet, rather than looking at the negative consequences of not doing so.
And here’s a heads up. Not all prenatal vitamins contain DHA, so you’ll want to ask your doctor (or other healthcare practitioner) if you’ll need a separate DHA nutritional supplement.
Question 8. Are there other nutritional supplements to consider taking during pregnancy?
Now isn’t the time to drastically shift your supplement routine—either by eliminating supplements you’ve been using regularly that are contributing to your health or by adding the latest trendy supplement making the rounds on social media. And certainly not without discussing it with your healthcare advisor.
In addition to folic acid, vitamin D, and omega-3 EPA and DHA, here are a few other supplements to consider during pregnancy.
Your body uses iron to make hemoglobin, a protein in the red blood cells that carries oxygen to your tissues. When you’re pregnant, you need twice as much iron because your body is also responsible for supplying your baby with oxygen. Without enough iron, your mild anemia, which is common during pregnancy, could turn into severe anemia, increasing your risk of premature birth, having a low birth-weight baby, and postpartum depression. Food sources include dark leafy greens, poultry, fish, and beans.
It goes without saying that calcium is important for building a baby’s bones and teeth, especially along with vitamin D, and other bone-building nutrients like magnesium and vitamin K. Food sources for calcium include dairy products and dark leafy greens.
And there is one other supplement in particular that is gaining traction among scientific researchers and that’s choline, another essential nutrient.
For example, one review article noted that maternal choline intake during pregnancy was shown to influence numerous metabolic and physiologic processes such as placental function, fetal growth and neural development in the fetus. The same article advised that in 2018
the American Academy of Pediatrics recognized choline as a “brain-building nutrient and called upon pediatricians to ensure pregnant women and young children have adequate intakes.
Eggs, fish, and beef are some of the food sources rich in choline.
Question 9. How important Is your diet during pregnancy?
Two words: super important. We can’t stress this enough.
While it’s always important to eat a healthful diet, you’re now eating for you and your future child. What you eat during this time not only impacts your own health, but also your baby’s health. During pregnancy, your hormones are fluctuating, your body is changing, you may feel like you’re walking around with an alien in your body, and there will come a time when you may not be able to see—let alone reach—your toes.
It’s vital that you and your baby are getting the nutrients you need—in the right amounts—throughout the pregnancy. While you’ll want to work with your doctor (and possibly a dietitian) to understand how many extra calories you’ll need to eat daily to gain the amount of weight that’s right for your particular circumstances, don’t use pregnancy as an excuse to go hog-wild on your food choices.
The best recommendations are still a balance of nutrient-dense foods. In other words, the usual suspects. In addition to fatty (low mercury) fish, you should be eating leafy greens, whole grains, proteins (lean meats, if you eat meat), eggs, oatmeal, avocados and berries. And don’t forget the dairy products like milk, yogurts, and low-fat cheese.
An occasional ice cream as a treat should be fine. But this time of your life isn’t your free pass to doubling up on sweets. Yes, you’re eating for two. But neither of you need to overindulge. Your body is your future baby’s home for now—make sure you make it a healthy environment for growth.
Question 10. What foods should be avoided during pregnancy?
Sorry to say, but there’s a long list. If you’re sushi fan, the cooked rolls are okay; the raw fish, not so much. If like your poached eggs covered in hollandaise sauce, make sure the whites of the eggs are set and the yolk has at least started to thicken, but lay off the sauce. Hollandaise is made with raw eggs.
And if you can’t get through a day without five cups of coffee or a nightly glass of wine, you’re going to want to take a nine-month timeout. Talk to your doctor about how much coffee or alcohol, if any, you should drink while pregnant. Don’t be surprised or upset if the answer comes back as none. Especially with the alcohol.
Here are a few more foods you’ll want to avoid:
- Undercooked or raw meats, eggs, seafood
- Cold or unheated cold cuts and hot dogs
- Unpasteurized milk and other dairy products
- Soft cheeses made with mold (e.g., goat cheese, camembert)
- Cheeses with blue veins (e.g., blue cheese)
Here’s to your healthy pregnancy followed by a healthy baby. We’ll be back next week to celebrate our new moms with some tips on how to navigate the twists and turns of this transformative period in your life.