HealthInfo Waitaha Canterbury

Nutrients and supplements during pregnancy and breastfeeding

Taiora me āpitihanga mō ngā hapūtanga anō

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 that you should take to give your pēpi the best chance of being healthy. For example, folic acid and iodine.

Folic Acid

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

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

If you are having 1 pēpi, you will need to keep taking it until you are 12 weeks pregnant. But if you are pregnant with more than 1 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 are pregnant and breastfeeding. This is because your needs increase during this time. Your pēpi 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 minerals that help build your baby's bones. If you do not get enough vitamin D when you are pregnant, you may be at risk of developing gestational diabetes and pregnancy-induced high blood pressure and pre-eclampsia. And your pēpi may be at risk of having serious bone problems.

You get most of your vitamin D from sunlight directly on your skin (not through glass). How to get your daily vitamin D has more information about how to do this safely.

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

As it is hard to get enough vitamin D, it is recommended that most people take a vitamin D supplement during pregnancy and breastfeeding. Talk to your usually healthcare provider, lead maternity carer (LMC) or midwife for advice about Vitamin D supplements.

If your pēpi is exclusively breast fed or getting less than 500 ml of formula a day, they should also have Vitamin D supplements until they are 12 months old.

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.

Vitamin C helps us absorb up to 4 times as much iron from our food. You can get vitamin C from many fruits (berries, feijoas, kiwifruit, mandarins, oranges, rock melons and tamarillos). Also, vegetables (broccoli, capsicums, cauliflowers and tomatoes). Try to include fruit or vegetables with every meal, especially if you are vegetarian.

For more tips to improve your iron intake, especially if you are 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, dietitian or general practice team 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 1 hour before or 2 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 2 serves a week (150 g per serve) of oily fish such as salmon, tuna, sardines, either fresh, canned or frozen
• 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 affordable 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. This is especially true in the last months of pregnancy when your pēpi is growing rapidly. You need 1000 mg of calcium per day. You can get this by eating a varied diet and including at least 2 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 are having more than 1 pēpi, you may need to take a calcium supplement. Talk to your LMC, dietitian or general practice team about whether a calcium supplement is right for you.

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 are eating well and choosing daily from the 4 food groups, you should not need to take a multi-vitamin supplement. But you may need one if you have 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 are 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 general practice team as you will need to have a blood test to check your B12 levels. If your level is low, you will need a vitamin B12 supplement or vitamin B12 injection.

  HealthInfo recommends the following pages

• Te Whatu Ora
  • Folate and 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. Last updated September 2024.

Sources

Page reference: 509053

Review key: HIPRC-41255