The early weeks of pregnancy are fragile—and confusing. Here, the answers to your questions.
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Though it won’t replace healthy eating, a prenatal supplement is essential. Here’s expert advice to help you choose a good one.
Q: How early in my pregnancy should I begin taking a prenatal vitamin?
A: Start three months before you begin trying to get pregnant, if possible. “The egg starts maturing about three months before it’s released, and it’s critical that the proper nutrients are present during the earliest stages,” says OB-GYN Robert Greene, M.D., medical director of the Sher Institute for Reproductive Medicine in Sacramento, Calif. “Neural-tube defects [such as spina bifida] happen in the first four to six weeks of pregnancy,” says Sudeep Kukreja, M.D., associate director of the Neonatal Intensive Care Unit at CHOC Children’s in Orange, Calif. If you think you’re pregnant and are not taking a supplement, don’t wait until your first appointment for a prescription because you will have missed this critical developmental period. Start taking an over-the-counter folic acid supplement with 600 micrograms (mcg) right away.
Q: What are the most important vitamins and minerals and why?
A: “The three most important nutrients, based on very good research, are folic acid, iron and calcium,” says Kukreja. Folic acid helps prevent neural-tube defects; iron is important for the delivery of oxygen to the baby and prevents anemia in the mom; and calcium helps build your baby’s bones and prevents bone loss in the mother.
Q: Are all varieties of prenatal vitamins pretty much the same?
A: No. Prescription vitamins are regulated by the Food and Drug Administration, but they are not required to contain certain nutrients. “There are many different formulations available, with different concentrations of each nutrient,” says Kukreja. Some have a little of everything; others contain only a handful of nutrients. If you have special health considerations, your OB may suggest a supplement with added nutrients to meet your needs.
Q: Can I take an over-the-counter or organic prenatal vitamin?
A: There’s nothing wrong with taking over-the-counter vitamins as long as they have a USP (U.S. Pharmacopeia) seal or NSF International certification; these organizations monitor supplement quality. “We do have concerns about pills that contain certain herbs and those that may contain too much of a certain nutrient, like vitamin A, which can adversely affect the fetus’ development,” says Ashlesha Dayal, M.D., an associate professor of obstetrics and gynecology at the Montefiore Medical Center in Bronx, N.Y. “Take the bottle to your obstetrician to make sure that all the ingredients are safe,” Kukreja adds.