When should I start taking vitamins?
It’s up to you really, but as eggs mature inside your body about three months before they are released into the womb, you might like to start taking prenatal vitamins three months before you start trying for a baby (and congratulations for being so organised).
Don’t worry if you don't start until later though. If your pregnancy was unplanned (or simply spur of the moment!) just start taking vitamins as soon as you start trying for a baby or find out you're pregnant.
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Make sure the one you choose is a version for conception or pregnancy. Some other supplements contain things such as the retinol form of vitamin A or fish liver oil, neither of which are suitable during pregnancy.
You can find prenatal vitamins in your local pharmacy or health food shop but speak to your doctor if you’re concerned you’re not getting enough vitamins, or have suffered from vitamin deficiency in the past.
The one thing that’s very important during pregnancy is to take folic acid, to help reduce the risk of serious neural tube defects such as spina bifida (where the bones of the spine don't form correctly around the spinal cord) and anencephaly (where part of the brain, skull and scalp don't form properly).
Here in the US, all doctors recommend prenatal vitamins, and nearly all pregnant women take them. I only took them occasionally though – they made me nauseated and constipated.
The neural tube is part of the embryo from which your baby's spine and brain develop, and it's crucial to healthy development. The NHS recommends you take folic acid every day while trying to conceive, and for the first 12 weeks of pregnancy, as the first trimester is when your baby's neural tube develops and defects may occur.
Again, a general prenatal vitamin is the best and most simple way to go – most supplements contain the recommended 400mcg of folic acid.
However, certain women need to take a higher does of 5mg a day (see your GP to get this on prescription). You may need the higher dose if you:
- Have a child or close relative with a neural tube defect such as spina bifida (or if you or your partner do).
- Have a BMI of over 30.
- Are diabetic or taking drugs for epilepsy.
- Have sickle cell disease, coeliac disease or thalassaemia.
You can also get more folic acid into your diet through eating lots of green leafy vegetables, nuts, beans, fortified cereals, and citrus fruits, but it’s difficult to get all the folic acid you need from food alone, so it’s worth taking a supplement too.
Can you take too much folic acid?
No, but taking more than 1mg of folic acid regularly can cover up the symptoms of vitamin B12 deficiency, which can damage the nervous system if not spotted and treated. This is particularly important if you’re a vegetarian or vegan, as B12 deficiency is more common amongst them. So long as you stick to the dose recommended by your doctor and don’t eat your body weight in leafy greens every day, you should be fine.
If you’ve been trying to conceive for a long time but are only taking the recommended 400mcg daily, you should be okay – but do speak to your doctor if you have any worries.
What happens if I don’t take folic acid?
There are lots of reasons you might not get enough folic acid during early pregnancy – maybe you weren’t trying to conceive, or didn’t realise you needed it. Try not to worry too much – many expectant mothers do not receive the recommended 400mcg daily, and go on to have perfectly healthy babies. Similarly, folic acid does not prevent neural tube defects – it only reduces your risk. If you’re worried about having missed folic acid, have a chat with your midwife or doctor – they will be able to advise you accordingly, and hopefully put your mind at rest.
Should I stop taking folic acid after the first three months of pregnancy?
After three months, your baby’s neural tube will have developed, so folic acid will not impact upon the baby's development. However, you can keep taking the recommended 400mcg per day – it won’t do you any harm.
What other vitamins do I need?
Carrying a baby is a tough job, so your body will need a lot of fuel over the coming months. Make sure you’re getting enough of each of the following, which can all be found as part of a healthy diet and in prenatal vitamins – just make sure you check the label so you know what you’re getting.
- Calcium – helps ensure you don’t lose bone density during pregnancy.
- Iron – helps your blood carry oxygen to the placenta.
- Vitamin C – encourages cell production.
- Vitamin D – regulates the amount of phosphate and calcium in your body to keep your bones, teeth and muscles healthy.
If you’re vegetarian or vegan, or have other dietary restrictions, you might need to take additional vitamins – speak to your doctor or pharmacist if you have any concerns.
Avoid Vitamin A
If you’re trying to conceive, make sure you don’t take a multivitamin containing Vitamin A, or fish liver oil supplements. Whilst Vitamin A is important for your baby’s development, it’s surprisingly easy to take more than the recommended daily amount, which you probably already get from a balanced diet – Vitamin A is found in meat, fish, dairy, eggs, and many fortified cereals.
Too much Vitamin A can lead to birth defects and liver toxicity, so try to cut out foods that are rich sources of it (such as pate and liver), and read the labels carefully on any vitamins you buy.