Overview

You probably know that taking a prenatal vitamin during pregnancy is important, but there’s more to it than just that simple advice. I’ve received a lot of questions recently, including: When should you start taking a prenatal vitamin? Is a prenatal really that different from a multivitamin? What can you do if you have trouble swallowing pills or experience nausea? And how long should you continue taking one after having your baby? Tune in to this episode to get answers to these essential questions and more, and ensure you and your baby are getting the right nutrients at the right time.

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Transcript and Resources

When to Start Taking a Prenatal Vitamin

Hi Vanessa, thank you for all of the amazing podcast episodes. I have a question about prenatal vitamins. My husband and I are TTC and I don’t know when I should start taking a prenatal vitamin. I have a multi vitamin that I really like, is it okay to continue taking that until I am pregnant or should I start taking a prenatal now? Is there a big difference between them?

-Kim

Prenatal Vitamins vs. Multi-Vitamins

You have increased nutrient requirements during pregnancy, and prenatal vitamins are formulated differently from multivitamins. Prenatals contain ingredients that you need more of during pregnancy, like higher levels of iron and folic acid or folate.

Iron

Iron is essential for everyone, but it is critical during pregnancy. Iron is a component of hemoglobin, a substance in your red blood cells that carries oxygen from your lungs throughout your body. During pregnancy, your blood volume increases by 50%, which requires a lot of additional iron. If you are deficient in iron during pregnancy, it can cause premature labor or your baby to have a low birth weight and impaired cognitive and behavioral development.

Folic Acid and Folate

Folic acid or folate helps prevent neural tube defects. Folate is water-soluble, so it does not remain in your system for long, so you need to replenish your supply through your diet constantly. Folate deficiencies are rare, but folate is essential when pregnant because it helps prevent neural tube defects, which are serious abnormalities of the brain and spinal cord.

Folate and folic acid are often used interchangeably, but they are not identical. Folate is also known as vitamin B9, and this is found naturally in foods like green veggies, fruits, eggs, liver, dairy products, and beans. Folic acid is a synthetic folate often used in supplements, vitamins, and fortified foods. The main difference is that folic acid does not occur naturally. While it is easy to generalize that natural is always better than artificial, that does not mean that artificial or synthetic has no practical application because, in many cases, it does.

There is overwhelming evidence for the protective effect of folic acid supplementation, both pre-conception and during early pregnancy, on the development of neural tube defects in newborns. As a result, folic acid was introduced as a mandatory food fortification in the U.S. in 1998. Most prenatal vitamins include folic acid rather than folate. One reason is that synthetically produced folic acid is a lot cheaper than naturally occurring folate. Also, folic acid is absorbed two-fold better than folates, assuming your body metabolizes folate well.

MTHFR is short for methylenetetrahydrofolate reductase, a critical enzyme in folate metabolism involved in DNA methylation, DNA synthesis, and DNA repair. About half of the population is estimated to be carriers of certain polymorphisms in genes related to folate metabolism. Those with the polymorphisms do not process folic acid into methylfolate well. Methylfolate is the biologically active form needed at the cellular level. You do not need to go get a genetic test to see if you have this mutation, but this is why I prefer the active forms of folate over folic acid in a prenatal vitamin.

Other Nutrients

In addition to iron and folate, you are supplying your growing baby with every nutrient they need. This is why prenatal vitamins include other vitamins and nutrients like choline or DHA. All vitamins are soluble in either fat or water. You can store fat-soluble vitamins, like vitamin D, but water-soluble vitamins need to be replenished regularly. This is why it is important to take a daily prenatal vitamin.

When to Start Taking a Prenatal Vitamin

Ideally, you start taking a prenatal vitamin before you get pregnant. This ensures your body is prepared to support your health and your baby’s development from the very start. Starting a prenatal early also gives your body time to adjust to the extra vitamins and minerals. If you are trying to conceive, I would start taking a prenatal vitamin now. The next best time is as soon as you realize you are pregnant.

When to Stop Taking a Prenatal Vitamin

I would like to know if you have a recommendation for POST-natal vitamins. Maybe the same for prenatal? My baby is 22 days.
-Jocelyn

After having your baby, your body is in recovery mode from birth, and you are likely breastfeeding. You still require additional nutrients to support your health and healing and to supply your baby with all the nutrients they need through breastmilk.

If you are taking a high-quality prenatal, I do not see a downside to continuing that in the postpartum period. Some people have issues with a prenatal, causing constipation due to the additional iron. Hopefully, you are taking a high-quality prenatal that uses a form of iron that doesn’t cause constipation. The only other downside is that prenatal vitamins tend to be more expensive than typical multivitamins. You can switch your prenatal for a multivitamin anytime after you have your baby. In the future, if you plan on having more children, you can switch back to a prenatal. I took a prenatal for years while I was having kids. I started before getting pregnant for the first time and continued taking a prenatal vitamin after I had my son through having my daughter.

Difficulty Swallowing Pills

First off, I love your podcast! I am having an issue I hope you can help with. I have always had a very hard time swallowing pills, and I have issues with taking a prenatal vitamin. It doesn’t help that I have also been really nauseous. I want to take the best vitamin possible, but I can’t bring myself to swallow a huge pill multiple times a day.

-Ionna

You are definitely not the only one who has an issue swallowing pills, and I know morning sickness can make that even worse. You need to find a prenatal vitamin that works for you. I would suggest trying an alternative that is either a smaller pill or in a different form. Zahler does have a significantly smaller prenatal vitamin called the Mighty Mini. It also includes DHA and the high-quality level of ingredients that Zahler is known for.

You could also try alternatives like gummy vitamins, chewable tablets, or a powder formula you mix with water. One resource I use for vitamins and supplements is Labdoor.com. This third party ranks vitamins and supplements based on label accuracy, product purity, nutritional value, ingredient safety, and projected efficacy. You can see their prenatal vitamin rankings here. Most of the ranked prenatal vitamins are pills, so I suggest only looking at brands and avoiding brands rated poorly.

Gummy Vitamins

Many gummy prenatal vitamins will not include iron since that poses a challenge with the texture and taste. If you opt for a prenatal that does not include iron, you may consider taking a separate iron supplement. You can always ask your doctor or midwife if they have a recommendation or if you should add an additional supplement, like iron if your prenatal does not include that nutrient.

Your Prenatal Vitamin and Morning Sickness

Morning sickness is terrible and there are some suggestions if your prenatal vitamin is contributing to nausea. You can try taking it with a snack or small meal so you are not taking it on an empty stomach. You may also consider taking it during a time of the day when you feel less nauseous or taking it in the evening before bed.

Remember that your prenatal vitamin should help to fill any nutrient gaps and the majority of the vitamins and nutrients you need should come from your diet. If you want to ensure you are getting something your prenatal may be lacking, like iron or DHA, you can increase foods in your diet high in those nutrients.

Thank you to the amazing companies that have supported this episode.

Save 40% off the Zahler Prenatal +DHA on Amazon with the code PREPOD40. (Valid through October 31, 2024, code must be used with Apex Nutrition as the seller.) You can always see the current promo code for the Zahler prenatal vitamin here.

It is challenging to meet your increased nutrient requirements during pregnancy with your diet alone. Taking a high-quality prenatal vitamin is one of the easiest things to ensure you have all the vitamins and nutrients you and your baby need. Zahler goes above and beyond to use high-quality bioavailable ingredients like the active form of folate, bioavailable iron, and omega 3s.