Good nutrition is important for everyone because it supports good health. It is especially important for any woman who is planning to become pregnant, is currently pregnant, or is breastfeeding. When a woman is pregnant her body needs additional calories and nutrients to support proper growth and development of her baby. Breastfeeding also increases the nutritional burden on a woman’s body. In both cases, if good nutrition is not maintained, the woman’s body will favor directing nutrients to the baby and to milk production at the expense of its own health.
Using available scientific evidence, the Institute of Medicine’s Food and Nutrition Board sets standards for nutritional requirements of healthy individuals across all age groups including during pregnancy and breastfeeding. These standards are referred to as dietary reference intakes (DRIs) but you may know them as recommended dietary allowances (RDA). Pregnancy and breastfeeding increase the body’s need for energy (calories) and for some but not all vitamins and minerals.
Several organizations make recommendations about nutritional needs during pregnancy and breastfeeding including:
- The World Health Organization
- The American College of Obstetrics and Gynecology
- Institute of Medicine
Although the recommendations vary slightly among the organizations, all promote eating a healthy well-balanced diet while a woman is pregnant or breastfeeding. They also agree that the 2 nutrients with the greatest importance and greatest increased need during pregnancy are folic acid and iron. Adequate folic acid intake decreases the risk of a birth defect of the spinal cord called a neural tube defect and therefore it is recommended that women even planning to become pregnant start a folic acid supplement. Iron needs increase during pregnancy because the mother’s body must produce more blood in order to deliver oxygen to the baby. Oxygen is carried by a form of iron within red blood cells. Without enough iron the mother may develop iron deficiency anemia.
Most RDAs, with the exception of folic acid and iron, are able to be met by eating a healthy well-balanced diet even for pregnant and lactating women. However, it is not always easy to eat a healthy diet especially for women who struggle with morning sickness or heartburn. To assure a pregnant woman gets enough vitamins, obstetricians will often recommend a prenatal vitamin be taken every day. A prenatal vitamin is meant to add to NOT replace a healthy diet.
Prenatal vitamins are available by prescription from a doctor or may be purchased without a prescription (also referred to as over-the-counter or OTC). There are many products to choose from and formulations vary among manufacturers but generally all contain the greater amounts of folic acid and iron important during pregnancy.
Although there is general agreement about which vitamins and how much of each need to be supplemented during pregnancy there is no consensus about how long a woman should continue to take a prenatal vitamin after the baby is born. None of the organizations mentioned above comment on when to stop taking them. Because breastfeeding does place a nutritional burden on the mother’s body it seems reasonable to continue vitamin supplementation for the duration of breastfeeding however there is nothing to support that this supplementation must be in the form of a prenatal vitamin. Some other multiple vitamin may be enough.
What You Can Do
Discuss with your obstetrician what is best for your situation. Your nutritional needs may be affected by how many babies you are carrying, by other conditions or intolerances you have, by medicines you take, or even by your lifestyle choices such as opting for a vegan diet. Your vitamin options may be influenced by whether you have health insurance and if so by the particular plan you have. If you are buying over-the-counter vitamin supplements, ask your pharmacist for help selecting a product from a reputable manufacturer.
For help with making healthy food choices during pregnancy and breastfeeding check out MyPlate.gov where you can personalize a food plan, available in English and Spanish. The U.S. Department of Agriculture also offers additional resources for pregnant and breastfeeding women.