Vitamins and Supplements
PRENATAL VITAMINS
We recommend that you take prenatal vitamins throughout the pregnancy and for the duration of breast-feeding, or at least until the six-week postpartum checkup. During the first trimester, vitamins may aggravate pregnancy-related nausea. In this case, take only the folic acid, 1 mg. daily, until the nausea has abated.
We like prescription prenatal vitamins more than over-the-counter. The prescription vitamins contain more folic acid and more iron. Also, many insurance plans will pay for prescription vitamins. Brands we prescribe include: CitraCal Prenatal, Prenate Elite.
CALCIUM
Every pregnant woman needs a minimum of 1000 to 1200 milligrams daily of Calcium, equivalent to about 3 to 4 dairy servings daily. Dairy sources include milk, yogurt, cottage cheese, cheese, tofu, soymilk and ice cream. Supplementation is advised (usually 300 to 600 mg. daily) if this dairy intake is not met.
Most contain calcium carbonate. This is the least expensive form of calcium (Tums, OsCal) and has low absorption by the body, which can lead to GI side effects such as bloating and gas. We prefer CitraCal and Caltrate calcium
IRON
We do not routinely put patients on an iron supplement. There is a lot of iron in the prenatal vitamin, and iron can be constipating. However, if your lab tests show anemia, we may ask you to take extra iron.
Most contain ferrous sulfate. The body does not absorb most of the iron you swallow. Excess iron comes out in the stool, causing it to turn dark. Iron can also cause GI side effects such as heartburn and indigestion. It should be taken with meals, usually dinner. We like Slow-Fe, a slow release form of iron.
There are liquid iron preparations that many people prefer to iron pills. One liquid iron we like is called Floravital. 2 teaspoons contains 10 milligrams, so you should take 1-2 tablespoons a day.
Links
http://www.florahealth.com/flora/home/usa/products/r64775.asp
DHA
Some evidence suggests a benefit from omega-3 and omega-6 vitamins, found in fish oil or flaxseed oil. The fish oil does not have the mercury risk as does certain fish (read the labels). Many prenatal vitamins are incorporating DHA (one of the omega-3 fatty acids), and soon this may become a standard supplement for pregnancy.
Also called omega-3 fatty acids. One product we like is called Lipil, from the makers of Enfamil formula. Most Prenatal Vitamins now contain DHA so an additional supplement may not be necessary.