Vitamins and supplements in pregnancy

This article covers:

Folic acid

Vitamin D

Iron

Vegetarian and vegan diets

Healthy start vouchers for pregnant women

Further information

Folic acid

The government recommends all women who are considering pregnancy take a 400 microgram folic acid tablet every day until the 12th week of pregnancy. It’s also a good idea to eat more foods containing folic acid, such as green leafy vegetables, fortified breakfast cereals, wholemeal bread and brown rice. Some breakfast cereals, breads and margarines have had folic acid added to them, so it’s worth looking at the labels.

Taking extra folic acid  before you become pregnant and in the first three months can help prevent birth defects, such as spina bifida (a neural tube defect). 

Even if you didn’t take folic acid beforehand, it is worth starting as soon as you find out that you are pregnant, and continuing to do so until you are 12 weeks pregnant. Supplements are available from pharmacies and supermarkets, or your GP may be able to prescribe them for you.

You will need to take a higher dose of folic acid if:

• you have had a baby with spina bifida before,
• you take medicine for epilepsy,
• you have diabetes and/or
• you have coeliac disease.

See your doctor if any of these apply to you.

Vitamin D

The government recommends that pregnant women and women who are breastfeeding all take vitamin D supplements of 10 micrograms a day. Vitamin D is important for many purposes in the body; it is needed to help absorb calcium from foods and build bones and is needed in the immune system. 

Vitamin D is naturally found in only a few foods including oily fish and eggs, with small amounts in butter and margarine. It is also found in liver, but pregnant women are recommended not to eat liver as it can contain too much vitamin A.  Most of our vitamin D is made in the skin when we’re out in the sunshine. However, in the UK the sunshine is only strong enough in the summer between about 11am to 3pm. This is exactly when we are often covering up or putting on sun block, so many of us do not have enough vitamin D in our bodies. 

Iron

Many women start pregnancy with low iron stores or slightly anaemic. Your blood will be tested at your first appointment, and you will be advised to take iron supplements if you need them. Increasing the amount of iron in your diet may help you to avoid having supplements, which can cause constipation and interfere with the absorption of other nutrients. Good sources of iron include red meat, kidneys, fortified breakfast cereals, bread, pulses such as baked beans and kidney beans, eggs and green vegetables.

We need iron in our diets to make healthy red blood cells, which carry oxygen around the body and to the baby. If you are not getting enough iron, you may have symptoms of anaemia, appearing pale and feeling:

• tired
• headachy
• breathless 
• weak 
• dizzy.

Tell your doctor or midwife if you feel like this.

Vegetarian and vegan diets

Some women may need to take extra care to meet all their nutritional needs during pregnancy, including:

• those who don’t eat many foods from animals, or who follow a vegetarian or vegan diet
• others with restricted or limited diets.

If you don’t eat dairy products you can get calcium from:

• dark green leafy vegetables
• tofu made with calcium
• tahini
• molasses
• fortified soya milk. 

A vitamin B12 supplement or fortified foods will also be important for anyone not eating animal products.

Healthy Start vouchers for pregnant women

If you are on benefits, have a very low income or are under 18, you can receive Healthy Start vouchers to buy fruit, milk and vegetables. You can also receive free vitamin supplements, which include folic acid and vitamin D and vitamin C. Your midwife should give you a form to claim the vouchers.

Further information

NCT's helpline offers practical and emotional support in all areas of pregnancy, birth and early parenthood: 0300 330 0700. We also offer antenatal courses which are a great way to find out more about birth, labour and life with a new baby.

NHS Choices website has information on healthy eating in pregnancy and vitamins and nutrition in pregnancy. 

The Food Standards Agency publishes the booket Eating while pregnant. 

The Eating for Pregnancy website provides information for women on healthy eating and food safety before and during pregnancy. 

The Vegetarian Society produces a pregnancy and baby guide Vegetarian pregnancy, vegetarian babies. 

The Healthy Start website gives information on the voucher scheme, plus food and health tips for before and after your baby is born.