Vitamins in pregnancy

The choice of supplements you need to stay healthy and keep your baby healthy can be confusing.Read our guide for what you do and don’t need and why.

Eating a healthy, varied diet in pregnancy will help you get most of the vitamins and minerals you need (NHS Choices, 2017a). But as well as munching on those blueberries and grabbing some avocado toast for lunch, you might be thinking about getting some supplements.

Where can I get pregnancy vitamins?

You might be eligible for free vitamins through the Healthy Start scheme (Healthy Start, 2018). If not, folic acid or pregnancy multivitamin tablets are available from pharmacies and supermarkets. Your GP might also be able to prescribe them.

What vitamins do I need in pregnancy?

When you’re pregnant, it’s recommended that you take additional vitamin D and folic acid, and avoid taking vitamin A (retinol) (BDA, 2016; NHS Choices, 2017a). Aim for 400mg of folic acid and 10mcg of vitamin D from your supplements (BDA, 2016; NHS Choices, 2017a).

Why do I need folic acid in pregnancy?

Folic acid (also known as vitamin B9), plus vitamin B12, is needed to form red blood cells (BDA, 2016).

"Folic acid is important for pregnancy because it can help to prevent neural tube defects, including spina bifida (NHS Choices, 2017b)."

The neural tube is a structure in the embryo that later develops into the baby’s brain and spinal cord. Taking folic acid before you conceive and while you're pregnant might prevent up to seven out of 10 cases of neural tube defects (NHS Choices, 2017b).

Can I get enough folic acid from food instead?

The recommended dose of folic acid for adults and children over 11 years old is 200 mcg (BDA, 2016; NHS Choices, 2017). You can get this from eating a healthy, varied diet. Pregnant women, however, should take an additional 400mcg of folic acid, which is where the supplements come in. Eating foods that are rich in folic acid is encouraged as well (BDA, 2016; NHS Choices, 2017).

Which foods are high in folic acid?

You can get folic acid in broccoli, peas, kale, brussel sprouts, oranges and brown rice (BDA, 2016). It’s also added to some breakfast cereals.

Watch out for folic acid being lost when you cook vegetables. Boil for as little time as possible or steam or microwave instead (BDA, 2016).

The Association of UK Dieticians have published an overview of all of the natural sources of folic acid (BDA, 2016).

Can I overdose on folic acid?

Most women shouldn’t take more than 1mg of folic acid a day. Some women who are at a higher risk of having babies with neural tube defects might benefit from up to 5mg a day (Kennedy and Koren, 2012; NHS Choices, 2017a).

Family history of or previous pregnancies with neural tube defects, diabetes, and taking anti-epileptic medication raise your risk of having babies with neural tube defects. If you are at higher risk, talk to your GP or midwife as they can prescribe a higher dose and/or recommend additional screening tests (NHS Choices, 2017a).

What is vitamin D and why is it important in pregnancy?

Vitamin D regulates the amount of calcium and phosphate in the body (NHS Choices, 2017c). These nutrients keep your bones, teeth and muscles healthy.

All adults need 10mcg of vitamin D a day (NHS Choices, 2017c). Vitamin D is especially important in pregnancy so you should consider taking a supplement to make sure you’re getting enough.

Which are the best vitamin D foods and sources?

Our bodies make vitamin D when our skin is exposed to sunlight between March and September (NHS Choices, 2017a). If you have dark skin or always cover your skin when outside, talk to your midwife or doctor as you may not get enough.

You can find vitamin D in foods like oily fish (salmon, mackerel, herring and sardines), eggs and red meat. As vitamin D is only present in a few foods, supplements can be useful (NHS Choices, 2017a).  

Can you overdose on vitamin D?

Vitamin D is unlikely to be harmful even in large doses. The recommended upper limit of daily vitamin D intake for adults is 1 mg (American Pregnancy Association, 2015).

What is vitamin A and why is it so bad for pregnant women?

Vitamin A, also known as retinol, helps your body’s natural defence against illness, as well as your vision and your skin. When you are pregnant, do not take vitamin A supplements or supplements containing vitamin A (British Nutrition Foundation, 2018). Too much could cause birth defects (NHS Choices, 2017d; British Nutrition Foundation, 2018).

If you decide to take a multivitamin tablet during pregnancy, make sure the tablet doesn’t contain vitamin A. You also need to avoid choosing liver or liver paté because these are very high in vitamin A (NHS Choices, 2017d).

Vitamin A your body produces from beta-carotine does not increase the risk of birth defects (Tetralogy Society, 1987; Strobel et al, 2007).

Do I need an iron supplement in pregnancy?

Right now, iron supplements are recommended if pregnancy blood tests show that the mother is anaemic. They’re not routinely offered to pregnant women because of potential side effects (NHS Choices, 2013).

You should be able to get all the iron you need from your diet, in things like leafy vegetables or red meat (NHS Choices, 2013). Check out the BDA’s food fact sheet about iron to see how you can get enough of it (BDA, 2017).

This page was last reviewed in March 2018

Further information

Our support line offers practical and emotional support with feeding your baby and general enquiries for parents, members and volunteers: 0300 330 0700.

You might find attending one of NCT's Early Days groups helpful as they give you the opportunity to explore different approaches to important parenting issues with a qualified group leader and other new parents in your area.

Make friends with other parents-to-be and new parents in your local area for support and friendship by seeing what NCT activities are happening nearby.

 

American Pregnancy Association. (2015) Vitamin overdose. Available from: http://americanpregnancy.org/pregnancy-health/vitamin-overdose/ [Accessed 18th March 2018].

BDA (The Association of UK Dietitians). (2016) Folic acid. Available from: https://www.bda.uk.com/foodfacts/FolicAcid.pdf [Accessed 18th March 2018].

BDA (The Association of UK Dietitians). (2017) Iron. Available from: https://www.bda.uk.com/foodfacts/iron_food_fact_sheet.pdf [Accessed 18th March 2018].

Healthy Start. (2018) Healthy start. https://www.healthystart.nhs.uk [Accessed: 18th March 2018].

Kennedy D, Koren G. (2012). Identifying women who might benefit from higher doses of folic acid in pregnancy. Canadian Family Physician. 58(4):394-397 [Accessed 18th March 2018].

NHS choices (2017a) Vitamins, supplements and nutrition in pregnancy. Available from: https://www.nhs.uk/conditions/pregnancy-and-baby/vitamins-minerals-supplements-pregnant/ [Accessed 18th March 2018].

NHS choices. (2017b) Spina bifida. Available from:  https://www.nhs.uk/conditions/spina-bifida/ [Accessed 18th March 2018].

NHS choices. (2017c) Vitamin D. https://www.nhs.uk/conditions/vitamins-and-minerals/vitamin-d/ [Accessed 18th March 2018].

NHS choices (2017d) Vitamin A. Available from:   https://www.nhs.uk/conditions/vitamins-and-minerals/vitamin-a/ [Accessed: 18th March 2018].

NHS Choices. (2013) Iron pills in pregnancy ‘make babies healthier’. Available from:   https://www.nhs.uk/news/pregnancy-and-child/iron-pills-in-pregnancy-make-babies-healthier/ [Accessed: 18th March 2018].

Strobel M, Tinz J, Biesalski HK. (2007) The importance of β-carotene as a source of vitamin A with special regard to pregnant and breastfeeding women. European journal of nutrition. 46(9):1-20. [Accessed 18th March 2018].

Teratology Society. (1987) Teratology Society position paper: recommendations for vitamin A use during pregnancy. Teratology. 35(2):269-275. Available from: http://teratology.org/pubs/vitamina.htm [Accessed 18th March 2018].

Further reading

British Nutrition Foundation (2018) Vitamin A. Available from: https://www.nutrition.org.uk/nutritionscience/nutrients-food-and-ingredients/vitamins.html?limit=1&start=2 [Accessed 18th March 2018].

Mitchell LE, Adzick NS, Melchionne J, Pasquariello PS, Sutton LN, Whitehead AS. (2004). Spina bifida. The Lancet. 364(9448):1885-1895. Available from: https://www.ncbi.nlm.nih.gov/pubmed/15555669 [Accessed 18th March 2018].

National Institute of Health, Office of Dietary Supplements (2018) Vitamin A. Available from: https://ods.od.nih.gov/factsheets/VitaminA-HealthProfessional/ [Accessed 18th March 2018].

NHS choices (2017) Have a healthy diet in pregnancy. Available from: https://www.nhs.uk/conditions/pregnancy-and-baby/healthy-pregnancy-diet/ [Accessed 18th March 2018].

Rothman KJ, Moore LL, Singer MR, Nguyen US, Mannino S, Milunsky A. (1995). Teratogenicity of high vitamin A intake. New England Journal of Medicine. 333(21):1369-1373. Available from: https://www.nejm.org/doi/10.1056/NEJM199511233332101 [Accessed 18th March 2018].

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