Last month, we talked about Whole Real Food in pregnancy; however, most of us are going to need to take supplements and the kind of supplements you take really matter.  You’re not going to get many benefits out of a poor-quality supplement and over-supplementing isn’t going to help you or your baby either.

A supplement is a supplement… it is filling in the gaps, so strive to get what you need out of real food first.  Add in only what is necessary, when it is necessary.  You simply will not get the same benefits from an isolated supplement that you will get from eating a nutrient-dense real whole food.  Nutrients work in combination as they are being digested, and some nutrients are toxic in high doses, so make real food choices a priority.

Most of the nutrients we need daily are found highest in wild or organic-small-farm-raised dark leafy greens, bone-in meat, wild fish, free range eggs, sprouted beans, and fresh fruit.  Preparation of all these foods also determine how our body will use the nutrients we eat.  Slow-cooked, steamed, and fermented preparation methods from fresh foods are ideal.  There are some supplements that are whole foods that have simply been dehydrated or freeze dried and then encapsulated such as Desiccated Beef Liver, Collagen Powder, and Spirulina or Chlorella Powder, all which can provide a variety of the nutrients we need without a lab-made isolated supplement.  Yet, some supplements are rarely needed, such as calcium if you eat a large amount of dairy.

The nutrients that we know exist and currently think are the most important to the childbearing year, daily, include:

• Calcium – 1000 mg (Calcium Citrate)
• Choline – 400 mg (Alpha Glycerylphosphoryl Choline)
• Essential Fatty Acids – 300+ mg (Both DHA & EPA)
• Probiotics – 20+ billion CFU (Wide variety of Lactobacillus species)
• Folate – 400-800 mcg (L-methylfolate – NOT Folic Acid)
• Iodine – 250 mcg (150 mcg before Pregnancy) - (Kelp, Iodine Glycinate or Potassium Iodide)
• Iron – 25 mg (Herbal Iron or Iron Bis-glycinate Chelate)
• Magnesium – 400-600 mg (Magnesium Glycinate)
• Protein – 80 g <20 weeks; 100 g >20 weeks (Collagen or Protein Powder)
• Selenium – 200 mcg w/ 800 mg Inositol (Selenomethionine)
• Vitamin A – 3,000 IU (less than 10,000 IU)
•   (Beef Liver Capsules or Retinyl Palmitate)
• Vitamin B12 – 2.4 mcg (Methylcobalamin)
• Vitamin B6 – 5-10 mg (Pyridoxal-5-Phospahate – P5P)
• Vitamin D – 2,000+ IU (D3 Cholecalciferol)
• Zinc – 15-30 mg (Enzyme-activated Zinc or Zinc Chelate)

Remember, these are daily total amounts and only the supplement form of these nutrients, not the real-food form.  Count what you eat from real whole foods, too.  These recommendations and amounts have been taken from multiple sources included Lily Nichols' Real Food for Pregnancy and various Aviva Romm sources.

Supplement ingredients (especially folate and folic acid) are constantly changing, so always read ingredient and nutrition labels.  You likely won’t find a prenatal that contains all the nutrients that are currently recommended in ideal doses, and you may need a few singular supplements to go along with your main prenatal vitamin.  It is also very difficult to find prenatal supplements that don’t contain Folic Acid (the synthetic form of folate) which is very important, especially for a mom or baby with the MTHFR gene. Blending your own herbal powders is one way of obtaining supplemental nutrients, but it can be hard to know the exact nutrient amount with this method.  These are just a few reasons why your real food choices are the most important.

While these are not a brand-endorsement, and are simply listed in alphabetical order, I do find it helpful for mothers to have a starting place.  A few prenatal brand options that may supplement balanced food choices include:

• Full Well
• Garden of Life (unfortunately, this company is owned by Nestle)
• Innate Response Baby & Me
• MegaFood Baby & Me2 (it must say “2” as the original version contains folic acid)
  
• Ritual
• Seeking Health
• Sprigs Mama Bear
• Thorne
• Zahler

Supplements can be helpful, but don’t skimp on real food, fresh air, sunshine on the skin, a walk through the forest in your bare feet, and a happy home life to support optimal nourishment, digestion, and overall balance!