Good nutrition is essential for a healthy pregnancy, and the right antenatal vitamins play an important role in any woman who is trying to get pregnant or already carrying a baby. If you were actively trying to conceive before you got pregnant, you hopefully watched Unii’s Preconception Journey course with Dr. Shree Datta and started taking your antenatal vitamins well in advance. Taking care of yourself and your baby in pregnancy also involves taking supplements, and while folic acid is especially important in that first trimester and a probiotic can help prevent mastitis in any mum that plans to breastfeed, the others can vary, depending on your specific case. Unii’s advice on taking anything in pregnancy—whether it’s medication or a supplement, and even if it’s over the counter or you’ve taken it safely before—is to check with your doctor first. Every woman and each pregnancy is different. It’s also important to eat a balanced, vitamin- and mineral-rich diet while pregnant, no matter what supplements you are taking. Just as when you’re not pregnant, supplements do not adequately compensate for poor eating habits.

Folic Acid in Pregnancy

Best time of day: Any time, but taking it at the same time every day is habit-forming.

Take it with water and with or without food.

Dose: 400 mcg daily, or more if advised by your doctor.

Folic acid is often referred to as the queen of antenatal supplements. It helps to prevent anaemia, which can be dangerous in pregnancy, but is especially well known for its prevention of neural tube defects, which can result in conditions like spina bifida and anencephaly in growing babies. Somewhat alarmingly, one of the most important stages of your baby’s development happens in the first weeks of pregnancy, before many women even know they are pregnant. The development of the neural tube, which will eventually become the brain and spinal form, happens just one month in. Without enough folic acid, the abnormalities that can develop can negatively impact your baby’s brain, skull, and spine. Folic acid is only useful in preventing neural tube defects when taken at least one (and ideally two to three months) before pregnancy and in the first twelve weeks.

Ideally, you will have been taking the generally recommended dose (400 mg daily) while trying to get pregnant, but if you didn’t, it is vital that you begin taking it as soon as possible after you find out you are pregnant or think you may be pregnant. It won’t adversely affect you to take more folic than you need as long as you are taking less than 1000 mcg daily, so it is fine to take while you are not pregnant. You can’t get too much folic acid from food. Four hundred micrograms might sound like a lot to take, but your body needs roughly ten times the amount a non-pregnant woman requires to support your growing baby.

There is no specific time of day that’s best to take folic acid, but taking anything at the same time is habit-forming, which can be useful because consistency is important. If you forget to take a dose, try to do so as soon as you remember. You should take folic acid with water, and it can also be taken with food or on an empty stomach. Some healthcare conditions, including epilepsy, mean you need to take more folic acid both while trying to conceive and to get pregnant. Speak to your doctor for advice on your specific dose. You can also get folic acid from food—dark leafy greens and wholegrains are excellent sources—but because it is so difficult to work out how much you’ve absorbed from food each day, it’s still very important to take your supplements.

Iron in Pregnancy

Best time of day: in the morning

Take it with: water, orange juice, on another vitamin C-rich drink, and on an empty stomach.

Dose: 27 mg daily, or as advised by your doctor.

Not every woman who is pregnant or trying to conceive will need an antenatal iron supplement. They can be unpleasant to take, and you probably won’t want to do so if you’re already getting enough iron from your diet, so if you are not pregnant but want to be, it is important to have a blood test to check whether you need them. Iron is important for anaemia prevention as well as preventing low blood iron. They are sometimes confused as the same problem, but anaemia is a haemoglobin deficiency. You can have low blood iron without having anaemia. Vegans and vegetarians are considered more likely to need iron supplements because eggs and red meat are such great natural sources, but you can also get iron from dark, leafy greens, dried apricots, brown rice, beans, tofu, and nuts and seeds.

The best time to take iron is first thing in the morning on an empty stomach, ideally with orange juice or some other vitamin C-rich drink to enhance absorption. If you really can’t tolerate iron on an empty stomach, it’s OK to take it with food. Hepcidin, a hormone that inhibits iron absorption, is at its lowest in the morning, which makes this a great time to take iron supplements, but if you really can’t take it, then another time of day is often OK. Please check with your doctor if you have trouble finding a time that works for you. Read more about iron in pregnancy.

Vitamin D in Pregnancy

Best time of day: There is no best time to take Vitamin D, but consistency is important, and taking it at the same time each day can help you to form a habit.

Take it with: food (ideally healthy fats), or as directed on packaging.

Dose: 10 mcg (or as advised by your doctor).

Vitamin D is important for your mental and bone health and your baby’s bone and tooth formation throughout pregnancy. If you live in a dark climate, you may be taking it daily anyway, as it can be hard to get enough from your diet to compensate for your lack of direct sunlight. Taking it daily is usually very safe and comfortable for both you and your baby, and you may notice folic acid and vitamin D are often sold as combination supplements. You should also aim to eat vitamin D-rich foods, which include mushrooms, red meat, eggs, and figs. It’s also in liver, paté, and fish liver oils, but you need to avoid these in pregnancy because they are high in Vitamin A (see below), which can harm your baby.

Calcium in Pregnancy

Best time of day: There is no best time to take calcium, but consistency is important, and taking it at the same time each day can help you to form a habit.

Take it with: As directed by the packaging. Generally, you can take calcium citrate with water and with or without food, while calcium carbonate supplements are easier to take with food.

Dose: 1,000 mg (unless you are 18 or under, then the daily recommended dose while pregnant is 1,300).

Calcium is important for wound repair and teeth and bone health, as well as your baby’s healthy growth and development. It is safe to take throughout pregnancy. Calcium deficiency is very easily spotted in pregnancy through routine blood tests. It can increase your risk of pre-eclampsia, as well as your risk of osteoporosis, back pain, and other problems later in life, so your doctor or midwife should be keen to talk about supplementation if necessary. You should always ask if you hear nothing about this.

Choline in Pregnancy

Best time of day: There is no established best time, but you may find a mealtime easiest. Again, consistency is key.

Take it with food and water or as directed.

Dose: 450 mg

Choline can be hard to get enough of from your diet, and because it is a lesser-known nutrient than the others on this list, some women may not be aware of its importance in the antenatal period. Choline is a nutrient similar to B vitamins, but we are able to synthesise it ourselves in our livers. This doesn’t mean we make enough not to need it in our diets, especially in pregnancy, and unfortunately many of us do not get enough of it from our food. The richest sources are red meat and dairy-based. Peanuts are a great plant-based source. Your baby needs choline for healthy brain development. You need it for your liver, metabolism, and nervous system. Choline deficiency can make you feel lethargic and anxious, which may not be easy to distinguish from how you feel on a typical day in pregnancy. A blood or urine test can confirm choline deficiency. It is worth noting that some antenatal multivitamins do not contain choline, and if they do, it may not be enough. The recommended daily amount of choline in pregnancy is 450 mg. The best way to take it to support absorption is with food and water or as directed on the packaging. There is no best time of day for choline, but consistency is key. You could also ask your pharmacist about the source of your supplement if you are not a vegan, as egg-based phospholipid choline may be easier to absorb than synthetic forms.

Vitamin C in Pregnancy

Best time of day: There is no established best time, but you may find a mealtime easiest if your stomach is delicate. Consistency is key.

Take it with: As directed. With water or food.

Dose: 85 mg per day

Our bodies don’t produce Vitamin C, and most adults know it’s important to supplement if they do not get enough of it from their diets. This becomes especially important in pregnancy, when a woman’s daily requirement jumps from 75 mg a day to 85 mg a day (unless she is 18 or younger, in which case she should get 80 mg a day). This may not seem like a major increase, but it is important to consider that you may not be getting enough to begin with, and research shows that most vitamin levels decrease in pregnancy if unsupplemented due to the many demands that growing a baby (or multiple babies, if you’re so blessed!) puts on your body. We’re really not trying to pressure you into taking anything unnecessarily, and, as previously mentioned, it is still important to check with your doctor or midwife first and to continue to eat the fruits and vegetables you get vitamins and minerals from naturally. Vitamin C isn’t a routine pregnancy supplement; you may not have had it recommended to you, and you should always check with your doctor before taking anything. High doses can cause nausea and diarrhoea.

Vitamin B12 in Pregnancy

Best time of day: in the morning. Vitamin B12 gives some people an energy boost, and this is not typically ideal in the evening.

Take it with: water. You can take it with food if it makes you feel queasy. Try not to take it around the same time as your calcium, if you take that, as calcium decreases vitamin B12 absorption.

Dose: 2.6 mcg. More may be recommended if you are a vegan or vegetarian. Check with your doctor about the amount of Vitamin B12 you should take in pregnancy.

In case it isn’t clear from all you’ve read so far: pregnancy takes a lot out of you! Vitamin B12 helps you cope with this by boosting your energy and mood and helping with stress management. It helps with your baby’s cognitive and neurological development, as well as the healthy growth of their brain and spinal cord. Ideally, you’d get enough from milk, eggs, chicken, fish, and other easy-to-find sources, but deficiency in pregnancy is unfortunately quite common in pregnancy. Research associates it with first-trimester miscarriages, as well as neurological and cognitive problems in term babies, so it’s important to recognise that you need it and start to take supplements as soon as possible if necessary.

DHA in Pregnancy

Best time of day: Any mealtime, as long as you take it consistently.

Take it with: As directed. Generally, healthy fats help your body absorb DHA more easily. Try it with avocado on toast.

Dose: 200 to 300 mg, though your doctor may recommend more if you do not eat oily fish or some other source of Omega 3. Always choose a Vitamin A-free Omega 3 supplement when you are pregnant.

Omega-3 fatty acid docosahexaenoic acid (DHA) is crucial for your baby’s eye and brain development. Omega 3s, as is widely known, also benefit your brain and skin health whether you are or are not pregnant. It may reduce your risk of premature labour. Some research suggests that this supplement can help to alleviate symptoms of depression, but you should seek proper mental healthcare if you worry you have this in pregnancy rather than attempting to self-treat or waiting for depression to pass by itself.

Iodine in Pregnancy

Best time of day: Taking your supplements consistently is more important than the time you take them.

Take it with: As directed. In general, you should take iodine with a large glass of water or fruit juice, though if it upsets your stomach, you can have it with food.

Dose: 220 to 290 mcg

Iodine helps with your skin and normal cognitive function. Your iodine needs increase substantially in pregnancy to support your baby. Iodine regulates the production of thyroid hormones for you and your baby, which is crucial to their brain and nervous system development. Maternal deficiency can cause pregnancy complications, as well as speech and learning difficulties for your child later in life. Iodine deficiency in pregnancy is relatively common and may be checked by testing a urine sample.

Other options you may like to discuss with your doctor:

Vitamin A: Research shows that pregnant women are more likely to be Vitamin A deficient than pregnant women, even if they supplement. However, supplementation with Vitamin A is not recommended in pregnancy because of the health risks to your baby if you get too much. Don’t take a vitamin A supplement or a multivitamin with vitamin A if you know you are or think you may be pregnant. You should avoid taking fish liver oil supplements and eating liver or paté in pregnancy, as all of these are high in Vitamin A. You should also avoid using makeup or skincare products containing vitamin A-based ingredients (retinoids).

A good probiotic in pregnancy is an evidence-based way to prevent mastitis during the postpartum period. You can hear more about this from Dr. Venita Patel on the Baby Nutrition episode of the Unii Babies podcast with Dr. Saranya. There is also some evidence to suggest that taking a probiotic in pregnancy decreases your genetic risk of passing on eczema to your baby, though this is not yet conclusive enough for it to be a standard recommendation. However, eczema in infancy can be so distressing for both parents and children that the desire to mitigate this risk is understandable. You may want to try both a probiotic in pregnancy and exclusively breastfeeding your baby for the first six months after birth, as some research suggests that this also lowers (though cannot eliminate) your risk of passing it on. Mastitis prevention will help you breastfeed comfortably. While you can’t take anything to decrease your genetic risk of passing on asthma to your baby, breastfeeding may also help with this. It’s important to ensure your asthma is well-controlled during pregnancy. You may also find it helpful to know that some research suggests maternal paracetamol use in pregnancy increases your baby’s risk of developing asthma, though here again there is not yet enough evidence for this to support widespread medical recommendation.

Magnesium can be hard to get enough of from a traditional Western diet throughout your life, which is unfortunate because it is important to a woman’s bone health, sleep, blood sugar regulation, and stress management whether she’s pregnant or not. You should definitely be considering whether you’re getting the required daily amount if you are trying to conceive a baby, as it can help to regulate your menstrual cycle, help with PCOS symptoms (if you have these), and promote good egg quality and a healthy blood supply to your womb.

In pregnancy, magnesium supports your baby’s healthy growth and the growth of the placenta, as well as to prevent preeclampsia, gestational diabetes, and premature labour. A magnesium deficiency can be hard to distinguish from regular pregnancy symptoms like constipation, headaches, and muscle cramps. You should always report these symptoms to your doctor or midwife. In the UK, the NHS does not routinely check women for magnesium deficiency, but you may be checked if you have symptoms, and you can also ask your doctor about supplementing if you are worried. Hypomagnesaemia, the term for low magnesium, is common in pregnancy, and lots of women don’t know they have it. You can develop it in pregnancy even if you haven’t had it before because of hormonal and digestive changes and the increased demands that pregnancy places on your body generally. A dose of 350-400 mg is generally recommended in pregnancy, though you should speak to your doctor first. You should speak to your pharmacist about the best way to take your dose, but it’s often a good idea to split it (half in the morning, half in the evening) and to take it with a balanced meal or a low-fibre snack because magnesium can cause diarrhoea.

For more advice on taking care of yourself in pregnancy, labour, and birth, check out Unii’s Antenatal Classes, with prenatal video episodes taught by senior NHS midwives, an award-winning obstetrician and gynaecologist, and six other leading healthcare experts. Only at unii.com.

What are the top ten antenatal vitamins for a healthy pregnancy?

Unii explains the most essential antenatal vitamins for pregnancy, as well as some other supplements to consider.