Newly expectant mothers often want to get started on vitamin supplements right away. Many worry that it will hurt the baby if they are too nauseated to take a vitamin, or if they didn't find out about their pregnancies until they were a few months along. But what do prenatal vitamins really accomplish? And which of their components are the most important?
Early in pregnancy, the only component of a multi- or prenatal vitamin that most mothers-to-be really need is folic acid (or folate). Women who are taking extra folic acid when they conceive lower their chances of having a baby with an incomplete spinal column (also known as a neural tube defect or spina bifida). For this protection to take effect, the folic acid has to be present in the first four weeks of fetal development, two of which happen before a woman even realizes that she is pregnant (you don't know until after you miss your first period, which usually occurs about two weeks after conception). That's why it is recommended that all women of childbearing age take either an over-the-counter vitamin containing folic acid or a plain folic acid supplement every day. This is true even if they're not planning on getting pregnant. About half of all pregnancies aren't planned, so being ready at all times is a good idea.
Folic acid is added to many breads and pastas, and is naturally found in many dark green or orange fruits and vegetables. Studies have found that taking a daily supplement offers more of the protective effect than getting the same amount in the form of food. Therefore, even women who eat a healthy diet may benefit from a supplement. The protective dose of folate is found in most regular vitamins (such as One-a-Day or Centrum) or in two chewable children's vitamins. The dose may be written 0.4 mg, 400 ug, or 400 mcg.
Mothers at extra risk for having a baby with a spinal defect usually will be told to take 10 times the recommended dose of folic acid. This 4 mg dose is only recommended for women who have had family members with spina bifida or are on drugs that increase their risk, such as some epilepsy medicines. This high dose of folate has not been shown to benefit those at average risk.
Other vitamins and minerals
Babies are excellent nutrition magnets! Drawing upon their mothers' bodies, they usually help themselves to everything that they need. Therefore, for most babies, extra vitamins are a bonus, not a necessity. Most mothers, however, do benefit from extra iron and calcium, which can be started later in the pregnancy.