You probably know that taking a prenatal vitamin during pregnancy is important, but there’s more to it than just that simple advice. I’ve received a lot of questions recently, including: When should you start taking a prenatal vitamin? Is a prenatal really that different from a multivitamin? What can you do if you have trouble swallowing pills or experience nausea? And how long should you continue taking one after having your baby? Tune in to this episode to get answers to these essential questions and more, and ensure you and your baby are getting the right nutrients at the right time.

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When to Start Taking a Prenatal Vitamin

Hi Vanessa, thank you for all of the amazing podcast episodes. I have a question about prenatal vitamins. My husband and I are TTC and I don’t know when I should start taking a prenatal vitamin. I have a multi vitamin that I really like, is it okay to continue taking that until I am pregnant or should I start taking a prenatal now? Is there a big difference between them?

-Kim

Prenatal Vitamins vs. Multi-Vitamins

You have increased nutrient requirements during pregnancy, and prenatal vitamins are formulated differently from multivitamins. Prenatals contain ingredients that you need more of during pregnancy, like higher levels of iron and folic acid or folate.

Iron

Iron is essential for everyone, but it is critical during pregnancy. Iron is a component of hemoglobin, a substance in your red blood cells that carries oxygen from your lungs throughout your body. During pregnancy, your blood volume increases by 50%, which requires a lot of additional iron. If you are deficient in iron during pregnancy, it can cause premature labor or your baby to have a low birth weight and impaired cognitive and behavioral development.

Folic Acid and Folate

Folic acid or folate helps prevent neural tube defects. You need to constantly replenish your supply of folate through your diet. SInce it is water-soluble, it does not remain in your system for long. Folate deficiencies are rare, but folate is essential when pregnant because it helps prevent neural tube defects, which are serious abnormalities of the brain and spinal cord.

Folic acid and folate are often used interchangeably, but they are not identical. Folate is also known as vitamin B9, and this is found naturally in foods like green veggies, fruits, eggs, liver, dairy products, and beans. Folic acid is a synthetic folate often used in supplements, vitamins, and fortified foods. The main difference is that folic acid does not occur naturally. While it is easy to generalize that natural is always better than artificial, that does not mean that artificial or synthetic has no practical application because, in many cases, it does.

There is overwhelming evidence for the protective effect of folic acid supplementation, both pre-conception and during early pregnancy, on the development of neural tube defects in newborns. As a result, folic acid was introduced as a mandatory food fortification in the U.S. in 1998. Most prenatal vitamins include folic acid rather than folate. One reason is that synthetically produced folic acid is a lot cheaper than naturally occurring folate. Also, folic acid is absorbed two-fold better than folates, assuming your body metabolizes folate well.

MTHFR is short for methylenetetrahydrofolate reductase, a critical enzyme in folate metabolism involved in DNA methylation, DNA synthesis, and DNA repair. About half of the population is estimated to be carriers of certain polymorphisms in genes related to folate metabolism. Those with the polymorphisms do not process folic acid into methylfolate well. Methylfolate is the biologically active form you need at the cellular level. You do not need to go get a genetic test to see if you have this mutation, but this is why I prefer the active forms of folate over folic acid in a prenatal vitamin.

Other Nutrients

In addition to iron and folate, you are supplying your growing baby with every nutrient they need. This is why prenatal vitamins include other vitamins and nutrients like choline or DHA. All vitamins are soluble in either fat or water. You can store fat-soluble vitamins, like vitamin D, but you need to replenish water-soluble vitamins regularly. This is why it is important to take a daily prenatal vitamin.

When to Start Taking a Prenatal Vitamin

Ideally, you start taking a prenatal vitamin before you get pregnant. This ensures your body is prepared to support your health and your baby’s development from the very start. Starting a prenatal early also gives your body time to adjust to the extra vitamins and minerals. If you are trying to conceive, I would start taking a prenatal vitamin now. The next best time is as soon as you realize you are pregnant.

When to Stop Taking a Prenatal Vitamin

I would like to know if you have a recommendation for POST-natal vitamins. Maybe the same for prenatal? My baby is 22 days.
-Jocelyn

After having your baby, your body is in recovery mode from birth, and you are likely breastfeeding. You still require additional nutrients to support your health and healing and to supply your baby with all the nutrients they need through breastmilk.

If you are taking a high-quality prenatal, I do not see a downside to continuing that in the postpartum period. Some people have issues with a prenatal, causing constipation due to the additional iron. Hopefully, you are taking a high-quality prenatal that uses a form of iron that doesn’t cause constipation. The only other downside is that prenatal vitamins tend to be more expensive than typical multivitamins. You can switch your prenatal for a multivitamin anytime after you have your baby. In the future, if you plan on having more children, you can switch back to a prenatal. I took a prenatal for years while I was having kids. I started before getting pregnant for the first time and continued taking a prenatal vitamin after I had my son through having my daughter.

Difficulty Swallowing Pills

First off, I love your podcast! I am havi