Pregnancy and baby

Vitamins and nutrition in pregnancy

Should I take supplements during my pregnancy?

Media last reviewed: 13/04/2012

Next review due: 13/04/2014

Vitamin supplements in pregnancy

Eating a healthy, varied diet in pregnancy will help you to get most of the vitamins and minerals you need. There are some vitamins and minerals that are especially important.

It is best to get vitamins and minerals from the food you eat, but when you are pregnant you will need to take some supplements as well to make sure you get everything you need. It's recommended that you take: 

  • 10 micrograms of vitamin D each day throughout your pregnancy and if you breastfeed
  • 400 micrograms of folic acid each day – you should take this from before you are pregnant until you are 12 weeks pregnant

Do not take vitamin A supplements, or any supplements containing vitamin A (retinol), as too much could harm your baby.

You can get supplements from pharmacies and supermarkets, or your GP may be able to prescribe them for you. If you want to get your folic acid or vitamin D from a multivitamin tablet, make sure that the tablet does not contain vitamin A (or retinol).

Folic acid before and during pregnancy

Folic acid is important for pregnancy as it can help prevent birth defects known as neural tube defects, such as spina bifida. You should take a 400 microgram folic acid tablet every day while you are trying to get pregnant and until you are 12 weeks pregnant. If you didn't take folic acid before you conceived, you should start as soon as you find out that you are pregnant. 

You should also eat foods that contain folate (the natural form of folic acid), such as green leafy vegetables and brown rice. Some breakfast cereals, breads and margarines have folic acid added to them. Find out more about healthy eating in pregnancy.

Higher dose folic acid

Some women have an increased risk of having a pregnancy affected by a neural tube defect, and are advised to take a higher dose of 5 milligrams (5mg) of folic acid each day until they are 12 weeks pregnant. Women have an increased risk if they:

  • or their partner have a neural tube defect 
  • have had a previous pregnancy affected by a neural tube defect
  • or their partner have a family history of neural tube defects
  • have diabetes  

In addition, women who are taking anti-epileptic medication should consult their GP for advice, as they may also need to take a higher dose of folic acid.

If any of the above applies to you, talk to your GP as they can prescribe a higher dose of folic acid. Your GP or midwife may also recommend additional screening tests during your pregnancy.

Vitamin D in pregnancy

Vitamin D regulates the amount of calcium and phosphate in the body, these are needed to keep bones and teeth healthy.

You need to take vitamin D during your pregnancy to provide your baby with enough vitamin D for the first few months of its life. You should take a supplement of 10 micrograms of vitamin D each day when you are pregnant and if you breastfeed. 

In children, not having enough vitamin D can cause their bones to soften and can lead to rickets (a disease that affects bone development in children).

Vitamin D can be found naturally in oily fish (such as salmon, mackerel and sardines), eggs and meat. Some manufacturers add it to some breakfast cereals, soya products, some dairy products, powdered milk, and fat spreads such as margarine.

The best source of vitamin D is summer sunlight on your skin. The amount of time you need in the sun to make enough vitamin D is different for every person, and depends on things such as skin type, the time of day and the time of year. However, you don't need to sunbathe: the amount of sun you need to make enough vitamin D is less than the amount that causes tanning or burning. If you have dark skin or always cover your skin, you may be at particular risk of vitamin D deficiency. Talk to your midwife or doctor if this applies to you.

Iron in pregnancy

If you are short of iron, you’ll probably get very tired and may suffer from anaemia. Lean meat, green leafy vegetables, dried fruit, and nuts contain iron. If you'd like to eat peanuts or foods that contain peanuts (such as peanut butter) during pregnancy, you can do so as part of a healthy balanced diet unless you're allergic to them or your health professional advises you not to. Many breakfast cereals have iron added. If the iron level in your blood becomes low, your GP or midwife will advise you to take iron supplements.

Vitamin C in pregnancy

Vitamin C protects cells and helps keep them healthy.

A balanced diet containing fruit and vegetables, including broccoli, citrus fruits, tomatoes, bell peppers, and blackcurrants, can provide all the vitamin C that you need.

Calcium in pregnancy

Calcium is vital for making your baby's bones and teeth. Dairy products and fish with edible bones – such as sardines – are rich in calcium. Breakfast cereals, dried fruit – such as figs and apricots – bread, almonds, tofu (a vegetable protein made from soya beans) and green leafy vegetables – such as watercress, broccoli and curly kale – are other good sources of calcium. 

You also need to know which foods to avoid.

Vegetarian, vegan and special diets in pregnancy

A varied and balanced vegetarian diet should give enough nutrients for you and your baby during pregnancy. However, you might find it hard to get enough iron and vitamin B12. Talk to your midwife or doctor about how to make sure you are getting enough of these important nutrients.

If you are vegan (you cut out all animal products from your diet), or you follow another type of restricted diet because of food intolerance (for example, a gluten free diet for coeliac disease) or for religious reasons, talk to your midwife or GP. Ask to be referred to a dietitian for advice on how to make sure you are getting all the nutrients you need for you and your baby.

Healthy Start vitamins

The Healthy Start scheme provides vouchers to pregnant women who qualify and families who qualify. The vouchers can be used to buy milk and plain fresh and frozen vegetables at local shops. You'll also get coupons that can be exchanged for free vitamins locally.

Healthy Start vitamin tablets for women are specially designed for pregnant and breastfeeding women, and contain vitamins C and D and folic acid.

Healthy Start children's vitamin drops are for infants aged from six months to five years old, and contain vitamins A, C and D.

If you qualify for the Healthy Start scheme you can swap your coupons for free vitamins locally – just ask your midwife or health visitor where they are accepted in your area. You can also use the Healthy Start postcode search to find where you can use the vouchers. 

If you're not on the Healthy Start scheme, some NHS organisations still offer the vitamins for free or sell them – ask your midwife about local arrangements.

You qualify for Healthy Start if you’re at least 10 weeks pregnant or have a child under four years old, and you or your family get:

  • Income Support
  • Income-based Jobseeker’s Allowance
  • Income-related Employment and Support Allowance
  • Child Tax Credit (but not Working Tax Credit unless your family is receiving Working Tax Credit run-on only*) and has an annual family income of £16,190 or less (2012/13)

If you are pregnant and under 18 years old, you qualify for Healthy Start vouchers regardless of your income.

*Working Tax Credit run-on is the Working Tax Credit you receive in the four weeks immediately after you have stopped working for 16 hours per week (single adults) or 24 hours per week (couples).

You can download a Healthy Start application form at the Healthy Start website, or call the Healthy Start helpline on 0845 607 6823 and order a copy. 

 


Page last reviewed: 31/01/2013

Next review due: 31/01/2015

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Comments

The 13 comments posted are personal views. Any information they give has not been checked and may not be accurate.

Kathryn at NHS Choices said on 06 February 2014

Dear Froggy 1977,

I'm afraid your GP has given you incorrect advice. NICEmaternal and child nutrition guidance (PH11, 2008) states that GPs should prescribe 5mg of folic acid a day for women who are planning a pregnancy, or are in the early stages of pregnancy, if they or their partner have a family history of neural tube defect. Having a brother born with spina bifida, would qualify you as having a family history.

Here's a reference for the advice: http://guidance.nice.org.uk/PH11/Guidance/pdf/English

Best wishes,
Kathryn Bingham, NHS Choices editor

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Ahkihs said on 04 December 2013

Mrs HC, maria_angelina, froggy1977:
do take iron** & folic acid supplements.
Make sure you take only organic fruit & vegetable based supplements (e.g. Nutrilite)

Most of the GPs in UK "assume" you are going to take a healthy diet all the time. And if they recommend anything to you they have to justify to NHS with all the tests. So they avoid the pain, and always say - do not take supplements.

**Be cautious with iron supplements from supermarket - most of them are synthetically made (easy test = crush a tablet and put under a strong magnet, if particle stick to magnet, it means this tablet is not good, just made by adding raw iron), which human body can not absorb and you will get constipation. I personally used iron folic plus which is made from organic spinach.

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Mrs HC said on 16 October 2013

The advice above recommends I take folic acid before preganancy.
I made an appointment with my GP and he said that I need to reduce my alcohol consumption (I don't drink at all anyway), stop smoking (I've never smoked before), but other than that I don't need to do anything until I am pregnant.
So do I buy folic acid supplements or not?

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maria_angelina said on 25 September 2013

Hi! I'm from the Philippines. Is it okay if I take vitamin C and folic acid at the same time ? Does it have any side effects? I'm trying to get pregnant this year. Thanks!

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froggy1977 said on 14 August 2013

I am very confused, we are currently trying for a baby and having read about people with a direct relative with a neural tube defect needing a prescription for a higher dose of folic acid I visited my doctor today. Despite having a brother who was born with spina bifida I was told that I don't need to be taking anything other than the standard dose like everyone else. Is this right?

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uhhquariyes said on 09 April 2013

today I started my Gynefam prenatal vitamins (France) & I'm curious if those are the reason I've been a happy & hyper all day long? I have had less than 200mg of caffeine today. I even feel kind of drunk for a few minutes? It beats feeling sick & tired all day, but this drastic change is unsettling.

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Ellis1980 said on 04 April 2013

Pregnacare is the best. You have to have one folic asid in the morning then one pregnacare tablet after dinner. Good luck :)

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AnushaNalagarla said on 25 March 2013

Hi ,

I am new to this country and I am pregnant(9 weeks). I had a registration of NHS and got the first appointment in 8thApril'13.

My concerns is from which week onwards I have to start having supplements(vitamin tablets) ? Because in our country they will provide from 5 weeks onwards.

your response much appreciated and helpful to me.

Thanks.

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Avalon Gold said on 26 February 2013

I am currently taking a Pregnancy supplement, which naturally, contains calcium. I do not like any of the 'gone-off'dairy foods - cheese, yoghurts, creme fraiche, sour cream etc, and only have milk on my cereals. Should I be taking a calcium supplement on top of the pregnancy supplement I take?

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orielwen said on 27 December 2012

I've seen magnesium supplements recommended as a way to help with morning sickness, leg cramps, poor sleep, and constipation. Is it safe to supplement with magnesium during pregnancy?

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Susie said on 21 December 2012

DNVH - we contacted the nutrition experts to answer this one. Your vegan vitamins should be ok, but you can read their full response as follows.

The chemical name for vitamin A is retinol, which is found, pre-formed, only in foods of animal origin. Beta-carotene is found in most foods of plant origin, and can be converted into vitamin A in the body. The Department of Health (DH) advises women who are pregnant or thinking of having a baby not to take supplements containing vitamin A (retinol) - including fish liver oil - unless advised to by a GP. It also advises them not to eat liver or liver products, such as pâté, as they are very high in vitamin A.

This is because too much vitamin A as retinol may be harmful to a devleoping foetus and cause birth defects. Beta-carotene however does not have the same effect.

You can read the ingredients list of your supplement to find out the source of the vitamin A. If it is not clear, then contact the manufacturer to confirm that the source of vitamin A in your supplement is not retinol. As the supplement is suitable for vegans and pregnant women, it is likely that retinol is not the source of vitamin A and therefore it will not have the same harmful effect.

Remember that eating a healthy balanced diet during pregnancy will help mothers-to-be get the vitamins and minerals they need, but there are some supplements they need to take:
-10 micrograms of vitamin D throughout pregnancy and when breastfeeding
-400 micrograms of folic acid: ideally this should be taken before getting pregnant until the 12th week of pregnancy.
You can find out more about having a health diet in pregnancy via this link: http://www.nhs.uk/conditions/pregnancy-and-baby/pages/healthy-pregnancy-diet.aspx

Hope that helps.
Susie at NHS Choices

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DNVH said on 05 October 2012

My preganancy vitamins have Vitamin A in them. They are vegan pregnancy vitamins. Since receiving this page linked from the weekly NHS email I have visited my doctor about this who has said that it's fine to keep taking the vitamins which has left me very confused and I'd really like some clarification. Thank you

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breehee said on 20 February 2010

An example of a weekly diet plan for all three genres would be very useful

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Media last reviewed: 11/03/2013

Next review due: 11/03/2015