Prenatal Vitamin Supplement Recomendations

[Pennilenko]

My wife and I have been getting healthy with good success regarding diet and exercise in preparation for making a little one. My wife's doctor told her that a good prenatal supplement would be a good idea considering she is in her early thirties now. Her doctor, however, didn't have a specific brand to recommend. I was wondering what supplements all the new parents used, and whether or not they were satisfied?

Any other hints and tips would be welcome.

[Trippy]

Spammer

[Abagadro]

Odd that the doc wouldn't prescribe something.  My wife's doc prescribed a generic prenatal for her.

[Pennilenko]

Odd that the doc wouldn't prescribe something.  My wife's doc prescribed a generic prenatal for her.

Her doctor is a planned parenthood doctor. We don't have insurance, we pay cash for medical visits, and have saved for the pregnancy and delivery. Also her doctor said over the counter would be as high quality as prescription but cheaper for us. I was looking for a little knowledge from a generally knowledgeable crowd. Paging Nebu.

[Prospero]

My wife took Thorne Prenatals. My kid didn't come out with two heads, so they can't be all bad.

[Rasix]

I think we took Nature Made prenatals with DHA or whatever was at Target or Walgreens (with DHA).  This is before we got the prescription from the doc.

My son is rather handsome.  No flippers.

[Viin]

My wife uses Super Nutrition Simply One prenatal, she likes it because you only have to take one a day. Also, it's suppose to be good brand, but a bit expensive.

[apocrypha]

A 10 minute search on The Cochrane Collaboration (large-scale meta-analyses of all existing research) seems to show that there is, so far, no compelling evidence that prenatal vitamin supplementation has any beneficial effects unless you're living in a developing country and suffering severe vitamin deficiencies.

Healthcare professionals recommend vitamin supplements because either they think that's what people want to hear (a pill to fix everything!) or because they get paid by the vitamin industry or because they're not very good at evidence-based medicine.

Just eat a decent diet and get some sunlight for your vitamin D synthesis. Don't waste money on magic beans.

[Tebonas]

Thanks for answering the question I was about to ask apocrypha.

Because no childbearing woman in my family did take vitamin supplements and I notice a certain lack of two-headed siblings. So I liken this to the old joke about the elephant repellant spray.

[Nebu]

A 10 minute search on The Cochrane Collaboration (large-scale meta-analyses of all existing research) seems to show that there is, so far, no compelling evidence that prenatal vitamin supplementation has any beneficial effects unless you're living in a developing country and suffering severe vitamin deficiencies.

Healthcare professionals recommend vitamin supplements because either they think that's what people want to hear (a pill to fix everything!) or because they get paid by the vitamin industry or because they're not very good at evidence-based medicine.

Just eat a decent diet and get some sunlight for your vitamin D synthesis. Don't waste money on magic beans.

Where's my check from the insurance industry? 

Taking a multivitamin is smart, particularly in a country where a vast majority doesn't eat well.  While pregnant, there are many nutrients that are used in greater amounts than when not pregnant, like folic acid and iron.  Taking any multivitamin will be better than not taking one for a great number of people.  If you'd like a metabolic rundown of why, I'd be happy to get into that.  Hell, just start with the pyruvate dehydrogenase complex. That's the tip of the iceberg.  I'm going to guess that apocrypha has never had a B vitamin shot.  Anyone that has, knows the immediate effects that B vitamins can have on metabolism. 

Any OTC neonatal vitamin is usually fine so long as you don't grossly over do it on trace metals and fat soluble vitamins (ADE & K). Too much trace metal and/or ADEK can cause tox problems over the long term.   

[Tebonas]

Taking a multivitamin is smart, particularly in a country where a vast majority doesn't eat well.

Didn't take that into account enough. You might be right. For all the crappy food we tend to eat, it still is way more healthy that the overprocessed crap you people can get if you want to eat cheap.

Basically you pee away your money if you don't eat like a hobo around here. Might be that healthy food is too expensive to consider in the US.

[apocrypha]

Is the average diet really that poor in the US? I mean, I know about the increasing obesity problem etc etc, but the studies I was looking at on Cochrane were finding no evidence of benefit except in areas of serious dietary deficiencies.

I'm not being argumentative, I'm genuinely interested, and if the diets really are that bad then fair enough, go for it!

I've never had a vit B shot, no. What do they do? I probably eat a better than average diet for the UK - lots of fresh vegetables, very little processed or packaged food, pretty much no sweets/chocolate/sugary drinks at all, try to keep salt intake low etc. Too much alcohol and red meat, no doubt, but still not a bad diet I think.

The only one that's recommended in pregnancy in the UK is folic acid for the reduction in spinal cord defect chances, but I thought there'd been some controversy about that too recently?

[Sky]

Might be that healthy food is too expensive to consider in the US.

Venn diagram: healthy, fast, cheap.

We eat very reasonably and well. We could eat cheaper if I wanted to spend more time in prep, especially meats which I buy at the butcher all nicely cut and trimmed to order. But our default meal of (chicken fish or turkey), (frozen steamed veg or broccoli) and (sweet potato or rice) is very cheap. Cheaper than fast food. And we eat well at fast food, too, and that's not all that expensive. You just need to order the correct things correctly, like hold that goddamned mayo and (processed) cheese.

Anyway, I used to take a multi but it messed with my innards, so I just boosted my intake of fruit and veg. I double up on veg at meals and have 3-4 fruits a day minimum. Part of why I was doing all that apple tasting this winter/spring. My fiancee's mother was a school nurse who is very knowledgeable about nutrition, she still gets journals that my fiancee reads through. So I've learned quite a bit in the last few years about how to eat better from a lot of different angles (habits, ingredients, prep, etc) without sacrificing flavor or satiation. Right now I'm exploring the wonderful world of legumes, which are cheap cheap.

[Oz]

I probably eat a better than average diet for the UK - lots of fresh vegetables, very little processed or packaged food, pretty much no sweets/chocolate/sugary drinks at all, try to keep salt intake low etc.

I think you just described the opposite of what most american's eat...especially those that would be considered lower-middle income on down.

[Arrrgh]

Most multis don't have enough calcium/d so grab a cheap oscal type supplement too.

[Sky]

Or drink a glass of whole milk.

[Arrrgh]

Or drink a glass of whole milk.

I find it easier to take the pill than to stand in the sun drinking milk.

[Sheepherder]

If you'd like a metabolic rundown of why, I'd be happy to get into that.  Hell, just start with the pyruvate dehydrogenase complex. That's the tip of the iceberg.  I'm going to guess that apocrypha has never had a B vitamin shot.  Anyone that has, knows the immediate effects that B vitamins can have on metabolism.

I've got this mental image of Nebu injecting himself with random vitamins for kicks that won't go away.

[Prospero]

Vitamin B hits are awesome.

[Jherad]

I've got this mental image of Nebu injecting himself with random vitamins for kicks that won't go away.

Heh, I had the same image:

http://www.youtube.com/watch?v=85PcMJ9D8X0#t=03m10s

[Slayerik]

My GF has problems with pre-natal vitamins and the iron in them (I think). She ended up taking 2 Flintstones vitamins a day and a folic acid supplement (I think).

She's 33 weeks along, so I'll be sure to report how the twins turn out :) Ultrasounds show all digits, organs, and limbs to be of the right amount!

[Nebu]

Heh, I had the same image:

http://www.youtube.com/watch?v=85PcMJ9D8X0#t=03m10s

Ouch.   

My GF has problems with pre-natal vitamins and the iron in them (I think). She ended up taking 2 Flintstones vitamins a day and a folic acid supplement (I think).

She's 33 weeks along, so I'll be sure to report how the twins turn out :) Ultrasounds show all digits, organs, and limbs to be of the right amount!

Too much iron can be as bad or worse than too little.  Excess iron can increase oxidative stress, which is why some prenatal vitamins are by prescription. 

As an aside: Children's vitamins with iron have largely been removed from the OTC market due to deaths by iron toxicity for just this reason. 

[Numtini]

We're using what's basically the Stop & Shop house brand along with a separate folic acid supplement. We generally eat a very healthy diet.

I'm not being argumentative, I'm genuinely interested, and if the diets really are that bad then fair enough, go for it!

This may be headed into politics, but pregnancy in the US has become a paranoid cult in terms of nutrition, avoiding anything possibly hazardous, and general fearmongering about what "could" go wrong. Something with even a one in a million chance of causing harm is greeted with screams of "but why take a chance!" and guilt inducing accusations of selfishness for "not putting aside your own interests for just nine months." Pre-natal vitamins, other dietary supplements, no drinking, no cured meat, no deli meats, no soft cheese, all mean must be cooked well done. We even have special parking spaces for pregnant women some places. How extreme? Someone on one forum raised an unholy freak out about someone using wine in cooking. The alcohol is evaporated, but there came the refrain "why take a chance! Don't you care about your baby enough to put your own selfishness aside? It's only nine months! Is that the best thing you could be eating for your baby?"

My partner and I have discussed this at length and think it's mixed up with all sorts of gender issues rooted in "the mommy wars" and anti-feminist impulses.

FWIW, good riddance to Fintstone's with Iron. I have had issues with anemia my whole life and grew up with those damned things. I cannot express how gross they get in the humid summer, with the little black dots of iron all over them. Of horrid childhood memories, I think the vitamins were worse than the all the blood tests to determine if they were effective.

[Lianka]

i've just always taken an OTC multi vitamin for women, and all my medical professionals said that was all
i needed throughout pregnancy.  I think it's folic acid they're hoping you'll have in abundance for your early pregnancy, hence them recommending a prenatal vitamin rather than a normal multivitamin..

One thing I'd wished I'd known earlier - one of my pregnancy books mentioned that too many antioxidants could affect your absorption of folic acid.  I didn't go out of my way to take antioxidants, as it turned out, but I can see how one  might.. and the bloody book didn't mention this until the third trimester (it was one of those week by week or month by month books..). 

[Sky]

I find it easier to take the pill than to stand in the sun drinking milk.

So...don't stand in the sun while drinking it?

[Simond]

Vitamin pills are of dubious value, generally speaking*. About the only deficiency which a pregnant women with a reasonably balanced diet really needs to keep an eye on is folic acid...and you get that by eating your greens (just like your parents told you to). Or from Marmite sandwiches, natch.

*ISTR reading somewhere that vitamins in 'raw' pill form get digested and/or metabolised differently from those in food and basically get mostly excreted right back out again, but can't find a link.

[Numtini]

If you look at the actual listings on prenatal vs regular vitamins, regular is 100% of everything and prenatal is 100% of everything and 200% of folic acid.

[Prospero]

Stuff about bad stuff.

Totally agree, folks are a bit nuts about this. I will point out however that alcohol it the worst possible thing you could consume. Worse than crack according to my doctor wife who knows such things. In the early months it can do some pretty serious damage. Sushi however? Fuck them.

[Yegolev]

I'm going with "Eat vegetables and other good food."  Personally, I suspect most people in the US are getting plenty of nutrition, based mostly on the fatasses I see everywhere instead of some actual research.  Or that could be HFCS + booze.  Avoid eating lead or mercury or booze and you're about 90% of the way to a baby with all the correct parts.

If you look at the actual listings on prenatal vs regular vitamins, regular is 100% of everything and prenatal is 100% of everything and 200% of folic acid.

They are also very large, at least the ones my wife was choking down.  They also made her quite ill.

[ghost]

The only thing that I'm aware of that is fairly important to take is folic acid to help prevent spinal cord defects.  Other than that, you're probably just fine with healthy foods.

[Nebu]

The only thing that I'm aware of that is fairly important to take is folic acid to help prevent spinal cord defects.  Other than that, you're probably just fine with healthy foods.

Patients will swear up and down that they eat healthy.  You prescribe neonatal vitamins to cover your bases. 

I would bet hard currency that 8 out of 10 people that claim to eat healthy, don't. 

[Selby]

...but pregnancy in the US has become a paranoid cult in terms of nutrition, avoiding anything possibly hazardous, and general fearmongering about what "could" go wrong.

My ex and I used to joke and laugh at all the people who wouldn't eat certain types of meat, salad, or cheese and FREAKED OUT when they accidentally consumed said banned products.  We realized that people have been delivering babies for centuries without vitamins and eating various types of foods, so we doubted it would be a problem.

She even drank for 2 weeks before she found out she was pregnant (seriously, surprise! after the doctor said it was likely a no-go forever) and while she was concerned, our child has turned out extremely well adjusted and is very intelligent for his age, so we obviously didn't screw up too badly!  She took a pre-natal vitamin that was recommended by our doctor (Flintstones vitamins were an acceptable substitute).

[ghost]

Patients will swear up and down that they eat healthy.  You prescribe neonatal vitamins to cover your basesass. 

I would bet hard currency that 8 out of 10 people that claim to eat healthy, don't. 

It's probably higher than that, haha.

This is something I've read some studies on that seems promising.  It's tough to tell if something is "working" like this though.  Juice Plus may have a little better bioavailability than some of the commercially available vitamins.  Of course, isn't there a recent study out that put doubt as to vitamins efficacy?  

Still, folic acid and McDonald's is better than just McDonald's.  Spina bifida is greatly reduced by folic acid alone and it can be a pretty horrific problem, when severe.

[Merusk]

The only thing that I'm aware of that is fairly important to take is folic acid to help prevent spinal cord defects.  Other than that, you're probably just fine with healthy foods.

Patients will swear up and down that they eat healthy.  You prescribe neonatal vitamins to cover your bases. 

I would bet hard currency that 8 out of 10 people that claim to eat healthy, don't. 

They're eating in the US and likely not growing their own ingredients, cooking products from scratch or buying fresh produce.  What a sucker bet!

[JWIV]

My wife took a generic prescription (Prenatal Plus Iron) that basically cost us barely a few dollars for a few months supply because of my health insurance.    Folic acid tends to be the big one from my limited understanding.     My situation obviously differs from yours because of it basically being free, so for us it was an easy preventative (the effectiveness of which the Internet will debate for another 100 years).