The early weeks of pregnancy are fragile—and confusing. Here, the answers to your questions.
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If you’re considering forgoing prenatal multis in favor of cafeteria-style supplementation, make sure you’re eating a nutrient-packed prenatal diet and taking supplements of the following indispensable nutrients.
You must get no less than 400 micrograms daily of folic acid, or folate—found in spinach, orange juice, black beans and oatmeal—starting prior to conception if possible. It is critical to the rapidly developing fetus in the first few weeks of pregnancy, often before a woman knows she’s pregnant, says Niebyl. Thus, “the U.S. Public Health Service recommends that all women of childbearing potential consume this amount.”
Getting sufficient folic acid preconceptionally and in the very earliest days of pregnancy can slash the rate of spina bifida and other neural tube defects by an astonishing 50 to 70 percent and may reduce the risk of premature birth, one of the leading causes of infant illness and death. (In one study, women who consumed less than 240 micrograms were twice as likely to give birth too early.) A deficiency of folate can also cause cleft palate.
Another must-have nutrient is iron, at least 30 milligrams daily, beginning in the second trimester or 13th week of pregnancy. Iron—found in meat, fish, poultry, dark-green leafy vegetables, eggs and whole grains—helps build red blood cells, energy-regulating enzymes and the immune system. If you’re advised to take 60 milligrams or more because of anemia, ask your obstetrician about also taking zinc (15 milligrams) and copper (1.5 to 3 milligrams) supplements. (That much iron may interfere with zinc absorption, and taking extra zinc, in turn, may interfere with copper absorption.)
You also need 1,200 milligrams of calcium each day. While it’s easy to get this amount from milk, yogurt and cheese (eight ounces of milk has 300 milligrams, a cup of low-fat yogurt, 370, and one ounce of hard cheese, about 200), if you are lactose intolerant or choose not to eat these foods, you must supplement (calcium carbonate is absorbed best). Also supplement 10 micrograms of vitamin D to help absorb and use the calcium. Calcium is critical to the baby’s developing bones. “If a woman isn’t getting enough calcium, the baby will draw it from the mother’s bones, leaving her at risk for [later] developing osteoporosis,” adds Niebyl.
A Healthy Balance
The best solution is to cover all your bases without overdoing it. First, eat a nutritionally sound diet. Then take a prenatal multisupplement as a safety net. “Practically speaking, the easiest way to get iron and folate is to take a multivitamin/mineral supplement,” Niebyl explains. “This boosts nutrient intake to give pregnant women added insurance for the days they don’t have a nutritionally balanced diet.”