There is a wide range of nutritional supplements on the market, including prenatal vitamins.
I’m sure you’ve noticed that some prenatal vitamins are a lot more expensive than others. Some have completely different ingredients. The amounts of nutrients in many of them vary. Drug stores tend to carry different brands than health food stores do, and there are certain brands that only doctors can prescribe. And all of these boxes say, “pick me, me, ME!”
You’re getting agitated, sweaty, and you want to pee.
Finding the best kind of prenatal vitamin isn’t easy when there are so many choices to consider, right?
Don’t worry though. I’m here to help you find the best prenatal vitamin for you and your baby in just a few simple steps!
5 Steps To Choosing The Best Prenatal Vitamins
#1 Choosing the best prenatal vitamins – BIOAVAILABILITY
There are two kinds of vitamin supplements on the market – SYNTHETIC and NATURAL. Most doctors give a thumbs up to synthetic vitamins which are almost chemically identical to the natural ones, but there are actually disadvantages to those.
— Natural vitamins vs. Synthetic vitamins
> NATURAL VITAMINS
As the name suggests, natural vitamins can be found naturally in the foods we eat. They are complex compounds of micronutrients that the body recognizes and utilizes for proper absorption.
Supplements made with natural vitamins are still your best bet though because they are much more bioavailable. Per dose, they may contain lower levels of nutrients than their synthetic counterparts, but high amounts may not be needed because of their easy absorption.
> SYNTHETIC VITAMINS
The majority of multivitamins and prenatal vitamins on the market are synthetic.
Synthetic vitamins are lab-made versions of isolated portions of natural vitamins. Because of that, they lack the much needed micronutrients. They’re also said to be harder on the kidneys.
If you take multivitamins and your urine is crazy yellow, it’s not because the vitamins work. It’s a sign that nutrients are being flushed out of your body unabsorbed. Some vitamins are water soluble (like vitamin C and B vitamins), and what doesn’t get used is simply excreted in the urine.
The consensus is that the surplus of water soluble vitamins gets excreted in the urine regardless of their source, but women often report that after switching from synthetic to food-based prenatal vitamins, their urine was no longer bright yellow.
— How to avoid prenatal vitamins with synthetic nutrients?
Don’t settle for words like natural or made with natural ingredients. Regulations are fairly lenient for products labeled natural.
In order to avoid synthetic vitamins, focus on products that are made with whole foods. Look for “100% natural”, “food-based”, or “whole food multivitamin” on the product’s label, and always check the ingredients including food sources of the vitamins.
— FOLIC ACID or FOLATE?
The single biggest reason that prenatal vitamins are promoted in pregnancy is for folic acid, or folate. This key nutrient helps prevent neural tube defects like spina bifida and anencephaly, and it’s especially important in the first few weeks of pregnancy.
Both folic acid and folate are versions of vitamin B9. While the names are often used interchangeably, there are actually key differences.
The naturally occurring form of vitamin B9 is folate whereas folic acid is its synthetic form. Folic acid is the more common form found in supplements, and it’s used in food fortification as well.
Folic acid needs to be converted by the body to methylfolate, a usable form of folate. In order for folic acid to be converted, it must undergo a series of enzymatic conversions.
For many people, synthetic folic acid will work just fine. Some people have inherited genetic mutations, however, that make it difficult to convert folic acid properly.
It is estimated that as much as half of the population lacks the enzymes necessary to convert folic acid, though the exact number is up for debate. That said, many people with this gene mutation remain unaffected, because more factors are in play.
Aside from synthetic folic acid, there are 2 forms of NATURAL vitamin B9 available: Folinic acid (also known as 5-formyl tetrahydrofolate) and 5-methyltetrahydrofolate (5-MTHF).
Both are activated forms of folate. They don’t require enzymatic conversion before they can be utilized and aren’t affected by metabolic defects.
To be on the safe side, avoid products that contain folic acid if you don’t know your MTHFR status.
Look for products that contain folate, specifically 5-methyltetrahydrofolate, L-Methylfolate, Metafolin, L-5-MTHF, or 6S-5-MTHF instead.
#2 Choosing the best prenatal vitamins – INGREDIENTS
Prenatal vitamins are not all the same.
— When looking for the best prenatal vitamin, pay close attention to all ingredients.
Some prenatal vitamins contain questionable ingredients and unnecessary additives and fillers which can range from useless to possibly harmful.
Many commonly used undesirable ingredients in dietary supplements are potential neurotoxins and are linked to cancer or other adverse health outcomes.
Prenatal vitamins can be made with GMO soy and/or corn derivatives. You may or may not be OK with that information depending on your stance on GMOs.
Prenatal vitamins can also contain synthetic dyes which are not only completely unnecessary but are also linked to a number of health issues. Very little research has been done on how synthetic dyes can affect pregnancy, but tests on pregnant rats revealed that synthetic dyes can lead to learning and memory problems in adult offspring.
If you see ingredients that you don’t recognize, do a quick Google search, or check with EWG.
— There are no set standards when it comes to prenatal vitamins.
Ingredients aside, it would be great if at least the nutritional content of prenatal vitamins was the same, right? But that’s not the case.
Prenatal vitamins contain varying amounts of vitamins and minerals that may include vitamin A, C, D, E, K, B vitamins, calcium, iron, iodine, magnesium, zinc, copper, as well as other nutrients.
Always try to choose prenatal vitamins according to YOUR OWN nutritional needs. Be honest – what does your diet lack in?
For example, some prenatal vitamins contain NO CALCIUM, some have NO IRON.
FYI, no prenatal vitamin contains the recommended daily amount of CALCIUM in pregnancy. That means you’ll still need to eat plenty of calcium-rich foods regardless, or take a separate supplement.
What about IRON? Maybe your diet is fairly rich in iron, and the fact that the prenatal vitamin of your choice doesn’t contain iron isn’t a huge deal. Or perhaps you don’t care for foods that tend to contain iron and you want to include iron in the prenatal vitamin of your choice.
Make it personal.
I’m talking more about the importance of calcium and iron in pregnancy (as well as their food sources) here. I highly recommend you read that as well.
While all prenatal vitamins contain folic acid or folate, only some contain choline. Have you heard of choline?
This micronutrient is closely related to the B vitamin family. Like folate, choline is said to be important for a healthy development of the baby’s brain and spinal cord.
Choline has only become a hot topic fairly recently which is why many prenatal vitamins don’t contain choline yet. (Out of those that do, most only have very small amounts.)
The current recommendation for pregnant women is to get 450 mg of choline per day. (For a reference, one whole large egg provides around 125 mg of choline. — Click here for more information about choline-rich foods.) Current choline recommendations are based on insufficient data and have been merely deduced from studies based on the prevention of liver damage. Some experts believe that they’re too low.
You many have heard about the study from early 2018 that found that eating foods with choline during pregnancy can boost baby’s brain, and eating foods containing about double the amount of choline currently recommended during pregnancy can REALLY boost baby’s brain.
I can’t NOT mention that the study was funded by organizations like the Egg Nutrition Center, the Beef Checkoff, and the U.S. Department of Agriculture. The exact organizations that would benefit from putting more eggs, beef, and poultry on the plates of pregnant women. Just so we’re clear, I’m not saying that choline is useless. I just find this a little funny, that’s all.
Is your diet fairly rich in choline??? What do you think?
Another popular ingredient that some prenatal vitamins contain is DHA.
This omega-3 fatty acid is a heavily marketed nutrient for pregnant women that’s said to be crucial for the baby’s brain, eye, and nervous system development. DHA can be naturally found in cold-water fatty fish (particularly mackerel, salmon, and sardines), fish oil, and shellfish.
Not too long ago, the most common source of DHA in supplements was fish. To avoid or reduce exposure to environmental contaminants like heavy metals (particularly lead and mercury) and PCBs (polychlorinated biphenyls – highly toxic industrial chemicals that are no longer used as of 1977 but are still persistent in the environment), some manufacturers have switched to algae or yeast-based DHA.
There are 3 main types of omega-3 fatty acids – ALA (alpha-linolenic acid), EPA (eicosapentaenoic acid), and DHA (docosahexaenoic acid). ALA can be found in plants, whereas EPA and DHA come from marine sources.
Current science says that even though DHA can be produced by the body from ALA (which is found in walnuts, chia, flax, and hemp seeds), the conversion appears to be rather inefficient. Some experts believe, however, that as long as you get adequate ALA, you don’t need to worry about EPA or DHA.
Although omega-3s like DHA are important building blocks for the developing brain, there is no hard evidence that DHA positively affects children’s intelligence. Surprisingly many studies have shown no cognitive and language development in the children of mothers that consumed DHA-rich foods or took DHA supplements during pregnancy.
DHA-containing prenatal vitamins may have a strong smell or taste to them which can be bad news, especially when combined with pregnancy nausea.
How much significance you put on DHA is up to you. If you insist on DHA and find an otherwise perfect prenatal vitamin that doesn’t contain it, you can take a separate DHA supplement in addition to the multivitamin.)
— Nutrients may interact
Even if a multivitamin contains a seemingly perfect balance of nutrients and micronutrients, it doesn’t mean that they will all work.
Different components of multivitamins may reduce or limit the absorption of other nutrients.
There is some evidence that calcium (in both food and dietary supplements) may inhibit the absorption of iron. For this reason, vitamins that contain iron are usually lower in calcium, or don’t contain any calcium at all.
Likewise, zinc, magnesium, copper, and iron also compete with each other for absorption, so some of these vital nutrients may not be absorbed when taken in one supplement.
#3 Choosing the best prenatal vitamins – POTENCY & PURITY
Does the product contain the amounts listed on the label?
Has the product been tested for harmful levels of contaminants?
Look for manufactures that guarantee potency and meet the standards and specifications set by independent organizations.
Manufacturers that comply will be literally bragging about all of their accomplishments on the label – it will be mentioned, trust me, probably several times.
#4 Choosing the best prenatal vitamins – PRESCRIPTION vs. OTC
Unless you have specific nutritional needs, you don’t need a script for prenatal vitamins. Even though they may come with certain bells and whistles, they’re not necessarily better.
What’s important is the ingredients and nutrient forms, and that’s where prescription prenatal vitamins tend to fall short.
Be assured that there are plenty of great over-the-counter prenatal vitamins available!
#5 Choosing the best prenatal vitamins – FORMAT
Prenatal vitamins come in many varieties, and one isn’t necessarily better than the other. It boils downs to personal preference.
— Once a day prenatal vitamin? Two pills, three, or more per day??
It’s important to find a prenatal vitamin that not only meets your nutritional goals but also one that you’ll be able to consume regularly. The most common complaint about prenatal vitamins is that they can be so darn HUMONGOUS! Oversized supplements just don’t go hand in hand with morning sickness…
As for dosage, taking just one multivitamin a day is easier or more tolerable for some pregnant women.
If a package calls for multiple pills a day, they can be taken together or you can split them up which may improve absorption. It might be harder to remember to take them though.
— Tablets, capsules, or gummies?
Out of all forms, tablets tend to be the most cost-effective option because they’re less expensive to make than other forms of supplements. They also retain their potency for longer periods of time and are therefore the most shelf-stable choice.
Tablets allow manufacturers to pack more nutrients into the supplement, but their hardness can make it difficult to swallow for some pregnant women, especially when morning sickness kicks in.
Capsules are easier to swallow than tablets and thought to be more gentle on the stomach. They come in a powder form, so they dissolve better and can deliver the nutrients quickly.
Capsules don’t contain binders or flavoring, but they tend to be more expensive. They are sometimes made with gelatin, but some are vegan-friendly and made with a plant fiber derivative instead.
> GUMMY VITAMINS
If you aren’t thrilled about swallowing tablets or capsules, there are gummy vitamins to try. They generally don’t contain as many nutrients as tablets or capsules because it’s difficult to incorporate certain nutrients into gummies (it’s rare to find a gummy vitamin containing iron, for example), but what they lack in strength they make up for in absorption rate.
Gummy vitamins usually have flavorings and sugar added. If you’re a vegan, watch out for animal gelatin which is added to some gummy vitamins.
There are other forms of prenatal vitamins like liquids and powders, but they’re much less common.
— ORGANIC VITAMINS?
Whether for personal beliefs or dietary preferences, you may choose prenatal vitamins that are CERTIFIED ORGANIC or at least made with ORGANIC ingredients.
My only advice is – if you’ve been eating healthy so far, there is no reason to take a step back now.
Organic multivitamins tend to have cleaner ingredients, but if you’re not a fan of organic farming for some reason, that is your choice and nobody’s business.
Coming soon: Best Over-The-Counter Prenatal Vitamins – My Top Picks!