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
- are very overweight, with a body mass index (BMI) over 30
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 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.