Basic Foundational Supplements for Preconception, Pregnancy and Postpartum

Let’s talk a bit about foundational nutrients I recommend most of my patients take throughout preconception, pregnancy, and postpartum. They include a good quality prenatal vitamin, additional vitamin D, and a DHA supplement. In this post, I’ll be discussing how I choose a prenatal vitamin and some key nutrients I pay attention to.

Prenatals, omegas, and vitamin D are not just essential for nourishing baby once mom is pregnant. They are also important in supporting egg quality and overall nutrition for mom during the preconception phase. Finally, they support mom’s needs during pregnancy and lactation when the baby is taking what they need and potentially leaving mom depleted if she is not fulfilling her nutritional needs. 

Aside from the basic nutrients in a prenatal vitamin, I look for products that have a few key features: adequate amounts of choline; methylated B12 and folate; and omegas separate from the prenatal to avoid issues with absorption of other key nutrients. I also appreciate products that have a nutrient profile in a reasonable number of capsules/day. There are some wonderful products out there, but unfortunately, I can’t get behind them when the daily dose requires 6-8 capsules/day. I see too many patients having issues with compliance and I’m in that camp as well.  I certainly could not have taken 8 capsules while dealing with nausea in my first trimester! Finally, I want a brand I can trust. 

Please note that this post is not intended to be used as medical advice. Consult your physician before incorporating any new supplements as recommendations and dosing may vary from person to person. 

Importance of Choline: 

One thing I am always looking for in a prenatal vitamin is adequate amounts of choline which many prenatals do not have. Choline is an essential nutrient, especially critical during pregnancy, due to its significant role in fetal development. Despite its importance, many people are unaware of choline's benefits and its necessary inclusion in prenatal vitamins.

Neural and Brain Development: Choline is vital for the development of the fetal brain and spinal cord. It plays a crucial role in the formation of the neural tube, which later develops into the central nervous system. Adequate choline intake helps prevent neural tube defects and supports overall brain development, influencing memory and learning abilities in children.

Cell Structure and Function: Choline is a building block of cell membranes. It is essential for the synthesis of phospholipids, which are vital components of all cell membranes. This function is particularly crucial during pregnancy when rapid cell division and growth occur.

Methylation and Gene Expression: Choline acts as a methyl donor in the body, which means it contributes to the process of methylation—a critical biochemical process that regulates gene expression. Proper methylation is essential for the development of the placenta and the healthy growth of the fetus.

Recommended Intake: The recommended daily intake of choline for pregnant women is 450 mg. However, studies show that less than 10% of pregnant women meet this recommendation through diet alone. This gap underscores the importance of prenatal vitamins containing choline.

Dietary Sources: Choline can be found in various foods, including beef liver, eggs, soybeans, chicken, and fish. For instance, a 3-ounce serving of beef liver provides about 356 mg of choline, while a large egg contains around 147 mg. Incorporating these foods into the diet can help increase choline intake.

Benefits of Choline Supplementation

Enhanced Cognitive Development: Research has shown that higher choline intake during pregnancy is associated with improved cognitive function in children. Studies indicate that infants born to mothers with adequate choline levels exhibit better memory and faster information processing speeds.

Reduced Pregnancy Complications: Adequate choline intake has been linked to reduced risks of pregnancy complications, such as preeclampsia and preterm birth. It also supports the health of the placenta and reduces the likelihood of inflammation-related conditions postpartum.

Lactation: Choline continues to be important during lactation, with a recommended intake of 550 mg per day for breastfeeding women. It supports both the mother’s health and the development of the newborn.

My go-to prenatal vitamin is Baby & Me Multivitamin by Innate Response. I love that it checks all the boxes and only requires two tablets/day. It is well-tolerated and easy to digest. 

DHA:

Docosahexaenoic acid (DHA) is a type of omega-3 fatty acid, which is a crucial component of cell membranes throughout the body. It is particularly abundant in the brain, retina, and heart. DHA is essential for the development and functioning of these organs.

DHA is crucial for the brain and eye development of the fetus and supports the mental health of the mother. However, the typical Western diet often lacks sufficient omega-3 fatty acids, making supplementation necessary. 

Pregnancy and Development: During pregnancy, DHA is crucial for the development of the fetal brain, eyes, and nervous system. It continues to be important during infancy for ongoing brain development. Many prenatal supplements include DHA to ensure that pregnant and breastfeeding women have adequate levels to support their child's development.

Sources of DHA: The primary sources of DHA are marine-based, including oily fish like salmon, mackerel, sardines, and trout. Algal oil is a plant-based source of DHA, making it suitable for vegetarians and vegans.

Better Absorption

Some research supports the idea that DHA and a prenatal are more effective when taken separately rather than combined into a single pill. One of the primary reasons for taking prenatal vitamins and DHA separately is to enhance absorption. Certain minerals in prenatal vitamins, such as calcium and iron, can interfere with the absorption of DHA. DHA is a delicate nutrient that can oxidize or break down when exposed to certain conditions or other compounds. By taking DHA separately, you reduce the chances of these interactions, ensuring better absorption of both DHA and the other essential nutrients in prenatal vitamins.

My go-to DHA supplement is Prenatal DHA by Nordic Naturals. 

Vitamin D in Fertility and Pregnancy

Most prenatal vitamins contain around 400 IU of vitamin D, which is often insufficient for achieving optimal levels. Experts recommend a daily intake of 2000-4000 IU of vitamin D for pregnant women to ensure both maternal and fetal health benefits. It's crucial to consult with a healthcare provider to determine the appropriate dosage based on individual needs. Vitamin D is a fat-soluble vitamin, which means that higher doses can be toxic. 

Vitamin D is a vital nutrient that plays a crucial role in various bodily functions, including immune response, bone health, and cellular function. Emerging research underscores its significant impact on fertility and pregnancy, highlighting the need for adequate levels of this vitamin during these critical phases.

Vitamin D and Fertility

Vitamin D is essential for both male and female fertility. It influences several reproductive processes, including ovarian follicle development and menstrual cycle regulation in women, and sperm quality in men. Studies have shown that women with adequate vitamin D levels have higher chances of successful conception and better outcomes with assisted reproductive technologies (ART) like IVF​.

In men, vitamin D is linked to improved sperm motility and overall sperm health. Deficiency in this nutrient can lead to reduced testosterone levels, negatively affecting fertility.

Vitamin D During Pregnancy

During pregnancy, vitamin D supports the development of the baby’s bones, teeth, and immune system. It helps in the absorption of calcium and phosphorus, which are vital for fetal skeletal development​.. Adequate vitamin D levels in pregnant women are associated with lower risks of complications such as preeclampsia, gestational diabetes, and preterm birth​.

My go-to vitamin D is Liquid Vitamin D3 by Protocol. Liquid lasts a lot longer and you can easily adjust the dose if needed. 

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Dr. Nicole Kearney sees clients in Vermont and beyond! Interested in working together? Book your discovery call to reserve your spot for the fall! Click the link here: