Choosing a prenatal is one of the first of many decisions moms-to-be make, and it isn’t an easy one. The ingredient list can be confusing, the pills themselves are large, and they come in a bewildering variety. A search on Amazon yields 507 hits for “prenatal vitamins,” plus there are direct-to-consumer brands. Though there are a core set of nutrients that are the same across all prenatals, some have more of certain ingredients, others have ingredients beyond those that are required, and many have different chemical structures of the nutrients. To make your prenatal vitamin selection go down easier, here are a few factors experts recommend considering.
Who should take a prenatal vitamin?
Ideally, you should begin taking a prenatal vitamin before you become pregnant, says Emily Oken, M.D., a professor of nutrition at the Harvard TH Chan School of Public Health. “Most of the nutrients we require are increased during pregnancy, so it’s helpful for all women to take a prenatal vitamin and mineral supplement to add to the nutrients we get in our diet,” says Marie Caudill, Ph.D., a professor of nutritional sciences at Cornell University.
DHA, iodine, choline, and biotin: not in every prenatal, but worth considering
Fish is an important source of docosahexaenoic acid (more commonly called DHA), says Emily Oken, M.D., a professor of nutrition at the Harvard TH Chan School of Public Health. She advises women to eat two servings per week of high DHA, low-mercury fish like trout, salmon, or sardines. If the thought of fish is turning your stomach, “then there is absolutely no harm from [supplementing with a prenatal containing] DHA,” Dr. Oken says.
Fish also contains iodine, which Dr. Oken says is a common deficiency in the U.S., and can result in thyroid dysfunction and cognitive and developmental delays in kids. She recommends choosing iodized salt, and also taking a prenatal vitamin that contains 150 micrograms of iodine, an ingredient Dr. Oken says is only found in about half of prenatal vitamins.
Choline and biotin are also not found in every prenatal, but Dr. Caudill recommends both. “Choline is noted for its role in brain and eye development,” Dr. Caudill says, and biotin is also required for fetal growth. She says they’re “under the radar” nutrients because there’s a lot of new research about them and they haven’t yet made the prenatal vitamin recommendation lists. Beyond those, Dr. Oken advises women to discuss with their healthcare provider whether they have specific needs, “For example a woman might require more iron based on a blood test that indicates anemia, or more vitamin D if their blood test shows they are insufficient.”
B12 and folate: in every prenatal in different forms
While vitamin B12 is in every prenatal, it’s especially important for women with vegetarian or vegan diets, because it’s naturally found in animal products. Dr. Oken explains that “low B12 levels have been associated with poor fetal…