6 Considerations When Choosing A Prenatal Vitamin 1. Make sure it contains essential nutrients in appropriate amounts. Most prenatal vitamins will adequately cover the needs of your pregnancy. The amounts can vary between brands, but below are some important micronutrients to look for in prenatal vitamins and typical amounts included(1,2): Folate or folic acid (400-800 mcg) Calcium (125 mg) Iron (27 mg) Vitamin D (400-600 IU) Vitamin B12 (6-12 mcg) Iodine (150 mcg) Zinc (15 mg) Copper (2 mg) Omega-3 fatty acids are also important for neurolog- ical development and may not be included in every prenatal (if they are, they are commonly fish-derived). Typically, a daily supplement of 200-300 mg DHA is recommended for pregnant women(3). There are Omega-3 specific supplements available that are derived from algae instead of fish. Very high doses of fat soluble vitamins (like vitamin A, commonly seen as retinoids) should not be included in prenatal supplements(4). 2. Understand the difference between synthetic and naturally-derived nutrients Photo: Natalia Deriabina P renatal vitamins are some of the most commonly used supplements by vegans and non-vegans alike. Multivi- tamin studies have shown overall mixed results as far as effectiveness and safety. However, the general consensus is that pregnant and breastfeeding women should consider taking an appropriate prenatal to support the additional needs of baby and mother during this metabolically de- manding time, especially if there is any concern for dietary inadequacy. Many healthcare professionals recommend taking a prenatal prior to conception, given that some im- portant developmental milestones occur very early on, like the creation of the neural tube, which will later become the baby’s brain and spinal cord. If you’re looking for a prenatal vitamin, chances are you’re overwhelmed with options. Let’s take a look at some of the key considerations when choosing the best option for your plant-powered pregnancy. Lauren Panoff, MPH, RD is a plant-based lifestyle strategist for families and founder of Chronic Planet. www.chronicplanet.net @chronicplanet 42 R a i s e V e g a n NOVEMBER 2018 Most prenatal vitamins contain synthetic nutrients, which are isolated nutrients made artificially, but a growing number of brands are creating products that use naturally-derived sources, which are dehydrated and extracted from whole plant foods. One example is folate (natural) versus folic acid (synthetic). There is controversy over potential safety concerns between the two types as they may not be absorbed in the same way(5). Whole plant foods contain multiple nutrients that work together to enhance absorption, but they may require larger doses than their synthetic counterparts. 3. Do not rely on a prenatal vitamin to meet all of your nutrition requirements Prenatals will often contain 100% of the daily value for various micronutrients, but this does not mean that they provide everything you need. Supplements should never be presumed to be nutritional insurance. That being said, to optimize absorption of supplemental nutrients, take prenatals with a midday meal; or, you may consider choosing a prenatal that breaks up its dosage throughout the day to prevent nutrient compe- tition(4). Regardless, the majority of one’s nutritional needs during pregnancy, as in all stages of life, should be obtained from a whole foods plant-based diet that is rich in variety. This can admittedly be difficult for many women during the first trimester, but this is where your supportive partner, family and friends can be very helpful in preparing nutritious meals for you. 4. Be aware of potential side effects Some prenatal vitamins can cause upset stomach and constipation, usually due to the extra iron that is needed to in- crease blood volume during pregnancy; iron also transports oxygen throughout one’s body. To help combat constipation, increase your fiber intake, drink more water and engage in regular physical ac- tivity as much as possible. If this doesn’t seem to help, ask your healthcare pro- vider about slow release supplements. Prenatals may also contribute to nausea, which can be minimized by taking them with food in the evening rather than on an empty stomach in the morning. 5. Review the ingredient list Look for prenatals that do not contain fillers, artificial sweeteners, color- ings, dyes or herbs. Some popular animal-derived ingredients used in supplements can include magnesium stearate (often from pigs), gelatin (from hooves of pigs and cows), lanolin (from sheep’s wool), bee pollen, carmine (from beetles and often used in red dye #40), and caprylic acid (can be from animal milk)(6). Look for added ingredients that may be beneficial, too, like ginger to ease nausea or probiotics to aid in digestion. 6. Look for third party testing Remember that dietary supplements are not subject to prior approval by the FDA, nor do they go through clinical trials before they are marketed to con- sumers. The best way to ensure you are choosing a safer supplement is to look for independent testing and certifica- tion marks like those from USP, NSF International or Consumer Lab. As with all medical considerations, be sure to speak with your healthcare provider or registered dietitian for personalized pregnancy recommenda- tions, including which prenatal vitamin options are best for you. Sources Prenatal vitamins: Why they matter, how to choose. Mayo Clinic. https://www.mayoclinic.org/ healthy-lifestyle/pregnancy-week-by-week/in-depth/ prenatal-vitamins/art-20046945 Accessed Aug 25, 2018. Aronson, D. Advice for Vegan Mothers-to-Be — Nine Months of Proper Nutrition. Today’s Dietitian. http://www.todaysdietitian.com/newarchives/ tddec2007pg38.shtml. Published Dec 2007. Accessed Aug 24, 2018. Coletta, JM, Bell, SJ, and Roman, AS. Omega-3 Fatty Acids and Pregnancy. Rev Obstet Gynecol. 2010 Fall; 3(4): 163–171.https://www.ncbi.nlm.nih.gov/pmc/ articles/PMC3046737/ Accessed Aug 25, 2018. Schehr, J. Prenatal Vitamins: Benefits, Side Effects & How To Choose One For You. Mindbodygreen. https://www.mindbodygreen.com/articles/prenatal- vitamins-benefits-side-effects-and-how-to-choose. Published March 8, 2018. Accessed Aug 25, 2018. Brown, MJ. Synthetic vs Natural Nutrients: Does It Matter? Healthline.com. https://www.healthline.com/ nutrition/synthetic-vs-natural-nutrients. Published Aug 17, 2016. Accessed Aug 24, 2018. McClees, H. 7 Sneaky Animal Ingredients to Watch out for in Supplements. One Green Plant. https:// www.onegreenplanet.org/natural-health/sneaky-an- imal-ingredients-to-watch-out-for-in-supplements Published Aug 21, 2014. Access Aug 24, 2018.