HealthInfo Canterbury

Nutrients and supplements during pregnancy and breastfeeding

 

Eating a wide variety of foods in pregnancy will help you get most of the vitamins and minerals you and your pēpi (baby) need. But there are some supplements such as folic acid and iodine that you should take to give your pēpi the best chance of being healthy.

Folic Acid

Doctors and midwives recommend that you take folic acid for at least a month before becoming pregnant and until you're 12 weeks pregnant. This reduces the risk of your pēpi having brain and spinal problems.

If you find out that you're pregnant and you have not been taking folic acid, start taking it as soon as possible.

If you're having one pēpi, you'll need to keep taking it until you're 12 weeks pregnant. But if you're pregnant with more than one pēpi, you may need to keep taking it throughout your pregnancy.

Iodine

Doctors and midwives also recommend that you take an iodine supplement containing 150 mcg (micrograms) while you're pregnant and breastfeeding, as your needs increase during this time. Your pēpi baby also needs iodine to grow and develop normally.

Vitamin D

You need enough vitamin D to maintain healthy levels of calcium and phosphorus in your body. These are the chemicals that help build your baby's bones. If you do not get enough vitamin D when you're pregnant, your pēpi may be at risk of having serious bone problems.

Food sources of vitamin D include eggs, oily fish and vitamin-D-enriched foods such as some types of milk, yoghurt and margarine.

It's very difficult to get enough vitamin D from food alone and the best source of vitamin D is sunshine directly on your skin (not through glass or with sunscreen on). You should get 20 minutes of sun a day but in summer, limit this to before 10 am and after 4 pm to avoid sunburn.

If you have dark skin or if you cannot get enough vitamin D from sunshine and food, you may need to take a vitamin D supplement.

If you're pregnant with more than one pēpi, you may also benefit from a Vitamin D supplement to reduce the risk of high blood pressure and pre-eclampsia.

The Ministry of Health has some easy-to-read advice about vitamin D and sun exposure for when you're pregnant and after your pēpi is born.

Iron

During pregnancy, your iron needs almost double. Lack of iron can result in anaemia making you feel more tired than usual.

Red meat such as lean beef and lamb are the best sources of iron. Other good sources include:

• chicken and fish
• legumes, such as chickpeas, lentils, kidney beans and baked beans
• nuts and seeds
• wholegrain breads
• iron-enriched breakfast cereals – choose a cereal with at least 3 mg of iron per serving
• dried fruit, such as apricots, raisins and figs
• green leafy vegetables such as silverbeet, spinach and watercress
• tofu and tempeh (fermented soybeans)
• spreads such as Marmite, Vegemite and peanut butter.

Although liver is a rich source of iron, you should only eat small amounts (no more than 100 g each week). This is because liver contains very large amounts of vitamin A, which can harm growing pēpi babies .

Vitamin C helps us absorb up to four times as much iron from our food. You can get vitamin C from many fruits (berries, feijoas, kiwifruit, mandarins, oranges, rock melons and tamarillos) and vegetables (broccoli, capsicums, cauliflowers and tomatoes). Try to include fruit or vegetables with every meal, especially if you're vegetarian.

For more tips to improve your iron intake, especially if you're vegetarian, see How to get your daily iron.

If you cannot get enough iron from your diet, you may need to take an iron supplement. Your LMC or GP will advise what is most appropriate for you.

Some drinks, foods and medications make it harder for your body to absorb iron. Take iron supplements one hour before or two hours after having:

• tea or coffee
• milk, yoghurt or cheese
• calcium supplements
• antacids, such as Mylanta and Quick-Ez.

Essential fatty acids

Essential fatty acids help form your baby's nervous system and other tissues.

To increase your essential fatty acid intake:

• eat oily fish such as salmon, tuna, sardines, either fresh, canned or frozen, once or twice per week (30 g)
• eat a small handful of raw nuts and seeds every day, such as walnuts, almonds, peanuts and sunflower seeds
• use sunflower, canola or olive oils
• choose margarine over butter
• regularly choose eggs as a convenient cheap meal or snack
• eat plenty of vegetables every day, particularly dark green types, such as spinach, broccoli, green peas and green beans.

Calcium

Calcium is important for the formation of your baby's bones, particularly in the last months of pregnancy when your pēpi baby is growing rapidly. You need 1000 mg of calcium per day. You can get this by eating a varied diet and including at least three servings of milk and milk products each day. A serving is 250 ml of milk, ¾ cup of yoghurt (200 g) or 2 slices of cheese (40 g).

Milk and milk products such as cheese, yoghurt and custard are the best sources of calcium. Other good sources of calcium include:

• calcium-enriched almond, rice or soy milk
• canned fish with soft edible bones, such as salmon and sardines
• nuts and seeds
• dark green leafy vegetables
• tofu.

If you cannot get enough calcium from your diet or you're having more than one pēpi, you may need to take a calcium supplement. Talk to your LMC or GP for advice. The best calcium tablets are those that contain around 600 mg of calcium per tablet, such as Caltrate.

Zinc

Zinc is essential for your baby's growth. The best sources of zinc are lean red meat, chicken, wholegrain breads and cereals, legumes, nuts, seeds and dairy products.

Multi-vitamin pregnancy supplement

If you're eating well and choosing daily from the four food groups, you shouldn’t need to take a multi-vitamin supplement. But you may need one if you've had severe morning sickness and have been vomiting often.

If you take a multi-vitamin supplement, choose one that is designed especially for pregnant women. Regular multi-vitamin supplements may contain too much vitamin A and this can harm your pēpi.

Thiamine (Vitamin B1)

Thiamine helps your body turn food into energy. Food sources include wholegrains, meat and fish. If you were vomiting a lot in early pregnancy, you may have been prescribed thiamine. Keep taking this until you're eating normally again, and the vomiting has stopped.

Vitamin B12

Vitamin B12 helps keep your body's nerve and blood cells healthy. It helps make DNA, the genetic material in your cells. It also helps prevent a type of anaemia that can make you feel tired and weak.

B12 is only found in animal foods or specially fortified foods, such as Marmite, So Good soy milk and Special K breakfast cereal.

If you eat little or no animal foods, talk to your LMC or GP as you'll need to have a blood test to check your B12 levels. If your level is low, you'll need a vitamin B12 supplement or vitamin B12 injection.

  HealthInfo recommends the following pages

• Ministry of Health
  • Folic acid, iodine, and vitamin D

    This page has recommendations for how much folic acid, iodine and vitamin D you should have when you're pregnant or breastfeeding.

  • Folate/folic acid

    This page has more detailed information about folic acid.

  • Iodine

    This page has more detailed information about iodine.

Written by Nutrition and Dietetics, Christchurch Women's Hospital. Adapted by HealthInfo clinical advisers. Last reviewed December 2021.

Page reference: 509053

Review key: HIPRC-41255