Contrary to popular belief, the NHS recommends only a small selection of prenatal supplements be taken by pregnant women.
There is ongoing debate as to whether pregnant women require prenatal vitamins. Various multivitamin products have flooded the market in recent years which typically contain up to 20 different types of minerals and vitamins including B1, B2, B3, B6, B12, C, D, E, K, iodine, magnesium, copper, selenium and zinc. These products can prove to be expensive, costing up to £15 a month. In 2016, the NHS stated that maintaining a healthy, nutritious diet during pregnancy would ensure women get the majority of the essential vitamins they need. This advice comes as the result of an evidence-based review that was published in the Drugs and Therapeutics Bulletin—part of the British Medical Journal (BMJ) publishing group—in the same year.
‘For most women who are planning to become pregnant or who are pregnant, complex multivitamin and mineral preparations promoted for use during pregnancy are unlikely to be needed and are an unnecessary expense,’ the study concludes.
The review also states that: ‘The marketing of such products does not appear to be supported by evidence of improvement in child or maternal outcomes. Pregnant women may be vulnerable to messages about giving their baby the best start in life, regardless of cost.’
The only supplements that the NHS currently deem necessary are folic acid and vitamin D. Folic acid is known to reduce the risk of spina bifida—a birth defect of the spine and spinal chord. Spina bifida is often associated with hydrocephalus—an accumulation of fluid around the brain. It can also affect mobility, along with bowel and bladder control. Pregnant women are advised to take 400 micrograms of folic acid per day until the end of the first trimester (12 weeks). Vitamin D is important for regulating the amount of calcium and phosphate in the body, both of which are needed to keep bones, teeth and muscles healthy. All adults, including pregnant and breastfeeding women, need 10 micrograms of vitamin D per day. In the right conditions, our bodies can obtain this vital vitamin from sunlight. It can also be found in a small selection of foods including oily fish (like salmon, mackerel, herring and sardines), red meat and eggs. It's the lack of naturally occurring vitamin D that leads the NHS to recommend taking daily supplements of it.
The National Institute of Health and Care Excellence (NICE) guidelines recommend that pregnant women avoid taking vitamin A supplements. Both NICE and the 2016 review found that consuming too much vitamin A during pregnancy may harm your unborn baby and could cause birth defects in worst-case scenarios.
If for any reason you follow a restricted diet—such as vegan, vegetarian or gluten-free diets—during pregnancy, you may find it more difficult to get sufficient amounts of vitamin B12 and iron. This specific circumstance may call for extra supplement intake. Consult with your midwife or request a consultation with a nutritionist to make sure that you are getting all the nutrients you and your baby require.