As expected, there are several nutrients you need more of during pregnancy for both you and your baby. In most cases the best source of these extra vitamins and minerals is a good balanced diet. The reason you need to eat a variety of foods each day from the five food groups, is to make sure you are getting the full spectrum of nutrients required. Each food group provides its own unique array of vitamins, minerals, protein, fats and carbohydrates.
Other than folic acid and iodine, other supplements or multivitamins are not recommended during pregnancy unless on the advice of your doctor or midwife.
Folic Acid
There’s one particular nutrient that’s vital to take as a supplement from even before you get pregnant: folic acid. In a nutshell, folate is an essential B vitamin that helps with the formation of red blood cells and the growth of new tissues. It acts as an important building block during the rapid growth and development stages of your baby.
In New Zealand it’s recommended that a daily 800 microgram folic acid-only tablet is started at least 4 weeks before pregnancy, and until the end of the first 12 weeks of pregnancy.
Low folate levels in early pregnancy are associated with a higher risk of neural tube defects (NTD’s) like spina bifida in babies. Research has shown that folic acid supplementation can help to prevent NTD’s.
Talk to your doctor if you've already had a pregnancy that was affected by a neural tube defect, or if you’re at a higher risk of having a pregnancy affected by an NTD. You may be prescribed a higher dose folic acid tablet for the same period.
As well as taking a folic acid-only tablet every day, it’s also important to eat a healthy diet including folate containing foods. Folate is found in green leafy vegetables (such as spinach and broccoli), oranges, lemons, legumes and fortified breads and cereals. Diet alone will not provide you with all of the folate you need during pregnancy, and this is why you need to take a daily folic acid tablet.
Talk to your midwife or doctor for further information about a folic acid-only tablet.
Iodine
Iodine is an essential mineral that is important for your baby's growth and in particular, brain development. It can be difficult to get enough iodine from foods and most New Zealand soils are low in iodine, so locally grown foods can also be low in iodine. To meet pregnancy and breastfeeding needs, it is recommended to take a 150 microgram iodine-only tablet right from the start of pregnancy, through until the end of breastfeeding.
It is also important to regularly eat foods which contain iodine such as bread (as iodised salt is used in most breads except organic and unleavened breads), milk products, eggs and cooked fish. If using salt in cooking, choose iodised salt.
Your doctor or midwife can give you a script for both iodine-only and folic acid-only tablets so you can purchase them at a lower cost at the pharmacy. Otherwise talk to a pharmacist about which folic acid and iodine tablets you can buy over the counter for pregnancy and breast feeding.
Vitamin D
Vitamin D is essential for good health and helping your body absorb calcium from food for strong bones and teeth and muscle function. The main source of Vitamin D is through skin exposure to ultraviolet B (UVB) rays from the sun - remember to always follow the recommendations for safe sun exposure. It can be difficult to get enough Vitamin D from diet alone because few foods contain or are fortified with Vitamin D. The best food sources include oily fish (freshly cooked or canned), fortified foods (margarines, milk, yoghurt), full-fat milk, egg yolks (well cooked).
If you are concerned you are at high risk of Vitamin D deficiency consult your doctor, midwife or dietitian for Vitamin D supplement advice.
Iron
Iron is a mineral that helps you produce red blood cells which carry oxygen and nutrients through your body and is critical to support your baby’s growth and development. During pregnancy, you need more iron in your diet to support your higher blood volume and your growing baby’s needs.
Make sure you eat plenty of iron-rich foods every day. Iron is found in a wide range of foods like meat, chicken, fish, legumes, green leafy vegetables and fortified breakfast cereals.
The best sources of iron are animal meats such as lean red meat, chicken and fish, because the ‘haem-iron’ found in these foods is more easily absorbed by your body. In fact, the redder the meat, the better the iron content.
Legumes, vegetables, nuts, wholegrain breads and fortified breakfast cereals contain a type of iron called 'non-haem' iron which your body doesn’t absorb as easily. Eating fruits and vegetables which are high in vitamin C (like oranges, broccoli, tomatoes or capsicums) as part of your meal can help you better absorb the non-haem iron from plant sources. The protein in meat, fish and poultry can also help the absorption of non-haem iron from plant foods, so eating mixed meals of meat, vegetables and grains is another great way to help the body absorb as much iron as possible.
Avoid drinking tea and coffee with your meals as the tannins present can reduce your iron absorption.
If you follow a vegetarian or vegan diet, eat a range of foods from each food group, including iron-fortified foods. You may want to ask your health professional for extra information and support to ensure you are getting enough iron.
If you are concerned you are low in iron, have a chat with your midwife or doctor. They may advise a blood test to check if your iron levels are low, to diagnose if an iron supplement is required.
Other supplements are not recommended
Other than folic acid and iodine, the New Zealand Ministry of Health does not recommend taking any other supplements or multivitamins during pregnancy unless they have been prescribed by your doctor because you are at risk of a deficiency. Eating a wide variety of fruits, vegetables, wholegrain breads and cereals, milk and milk products and protein rich meat and meat alternatives will usually ensure you get all of the vitamins and minerals you need for pregnancy and breastfeeding.
References:
Ministry of Health. 2020. Eating and Activity Guidelines for New Zealand Adults. Updated 2020. Wellington: Ministry of Health.
www.healthed.govt.nz/resource/folic-acid-and-spina-bifidaiodine-and-iodine-deficiency
The materials published on this website are of a general nature and have been provided for informational purposes only. Always consult your medical practitioner or a qualified health provider for any further advice in relation to the topics discussed.
