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Vitamin and Mineral Supplementation in Pregnancy

Vitamins and minerals are referred to as micronutrients.  They do not contribute calories to the diet, but do play an important role in cellular function.  Remember cells?  They make up your entire body and are responsible for your body being able to stay healthy.

I personally have never been a fan of vitamin and mineral supplementation.  I am a purist in that I believe the diet should be adjusted before a pill is taken. But I do understand there are limits to what a woman is able to eat from time to time.

Allow me to use myself as an example. Over the last two months since school began I have found myself becoming more and more tired and unable to focus.  My stress level was increasing and my schedule was really out of control some weeks.  Balancing classes, studying, clincials and family left little time for cooking and forget about shopping.  I was relying on what I could pack in the morning, selected from what my husband chose to purchase.

Two weeks ago I made two changes.  First, I decided to keep a water bottle on the counter when I am home to remind me to keep drinking water.  Secondly, I started taking a multivitamin every day.  It took a couple days, but I started feeling better. I was sold.  Because of the temporary and unique demands on my body and time right now, I will continue to use a multivitamin supplement.

Honestly, I don’t think that conflicts with my basic theory about supplementation.  Supplements are available for the unique situations that prevent a person from achieving optimum nutrition from their diet. So how does this relate to pregnant women?

Think first trimester and the most common pregnancy complaint – nausea and vomiting.  This can prevent a woman from maintaining her normally healthy diet.  Some women experience food aversions throughout their entire pregnancy.  Again, these can make it difficult to maintain a normal healthy diet.  Supplementation can help by providing a little insurance (as long as she can keep the vitamins down).

Another common pregnancy complaint is fatigue.  In many women this is linked to anemia caused by low iron stores.  Pregnancy increases your bodies need for iron, and if your iron stores where not optimum to begin with (as is common for about 40% of American women), you can experience a mild to moderate anemia.  This can be especially true if this pregnancy happened quickly after a previous pregnancy.  Iron supplementation can help to manage this problem.

Though fiber is not a nutrient, it is necessary in the diet.  Most Americans do not consume the recommended 25-30 grams of fiber a day. This can lead to problems with constipation.  Since pregnant women are more likely to experience constipation, the inability to consume adequate fiber can compound a common pregnancy problem.  Women taking iron pills may increase their risk of constipation.  Fiber supplementation can be a temporary help during this time of increased need.

Folic Acid supplementation is recommended for all women of childbearing age.  Why?  Because deficiency of this nutrient can actually cause harm to your baby in the form of neural tube defects.  Unfortunately, by the time most women discover they are pregnant the neural tube is already formed. But folic acid (or folate) is also important for preventing a different form of anemia.  So for a woman who is having difficulty consuming a healthy diet, folate supplementation can be helpful.

The key here is to understand what you are supplementing and why.  More is not always better. For example, too much Vitamin A can lead to problems for your baby. The goal of supplementation is to temporarily maintain the optimum nutrition for a woman during a time of nutritional stress.

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Jennifer Vanderlaan CNM MPH is the author of the BirthingNaturally.net website. She has been working with expectant families since 2000, training doulas, childbirth educators, and midwives. She has worked with midwives in Central America and Sub-Saharan Africa. Her interest in public health grew in 2010, and she is now a PhD student learning to become a producer of knowledge.

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