Working as a nurse I see everyday the compliance issues people have when it comes to taking their medications. I can never understand what the reason is other than laziness. Most of the excuses I hear are “I forgot” or “I don’t know”. The truth is people just have a disregard for their health, and hey, it’s America and people have that right.
Who am I to tell the patient what to do? You don’t want to take your high blood pressure med? You would rather have a stroke and possibly be debilitated the rest of your life? Fine. You don’t want to check your blood sugars or take your insulin? Okay, I will still be your nurse when they amputate your leg after you suffer from severe diabetic ulcers.
My point is God gave people free will, and you can lead a camel to the water but you can’t make him drink. If people don’t want to take responsibility for their health then you can’t make them.
What does this all have to do with the pregnant or breastfeeding mom?
Well, once you become pregnant the most important thing to realize is that it’s not just about you anymore.
Becoming a mom means becoming selfless. Correction, becoming a good mom, means becoming selfless- putting that baby before you.
You never took vitamins before you were pregnant- that’s probably okay. You are young with a moderately good diet and your body can generally compensate very well. Once you get pregnant however, your body is not just supporting you but your baby as well. You need to consider supplementary vitamins.
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Where do you start?
Ideally, before you become pregnant is when you would want to start taking a prenatal vitamin.
I realize not all pregnancies are planned, but we are talking about ideal situations here.
Neurological development begins before you might even realize you are pregnant, and the primary vitamin you need is folic acid.
What is Folic Acid?
Folic acid decreases the occurrence of neural tube defects (NTD’s) for example: spina bifida. (Not sure what that is? Google it and you will probably never forget to take that vitamin again.)
Folic acid is a water soluble vitamin that is naturally occuring in several foods as well as being fortified in many other foods in the US. Question– so then don’t I get enough of that in my diet? Answer– no.
Fortification provides approximately 163mcg per day, and the pregnant woman needs to consume 800mcg of folic acid per day (Goetzl, 2018). This would be recommended to have been started one month before conception, but again not all pregnancies are planned.
Therefore, it is recommended that all women of childbearing age take this supplement. Prenatal vitamins contain the folic acid you need so if anything, take one of these daily.
The second important vitamin you should consider is calcium.
The recommended dietary allowance for all pregnant and lactating women is 1000mg per day (Goetzl, 2018). The average amount in a prenatal vitamin is only 200mg! Do you see that gap there?
Calcium is too big of an element to put enough of it into the prenatal vitamin. That is why you should supplement your prenatal with an additional calcium tablet.
If this seems like too much for you to do, just think of your little baby’s skeleton trying to develop. The fetus will require approximately 30 Grams of calcium throughout the pregnancy (Goetzl, 2018). For those who may not be overly familiar with the metric system of measurement, it takes 100 milligrams to equal 1 gram. So, the baby will require 30,000 milligrams throughout it’s stay in utero!
The baby will not suffer, though, even if mom does not supplement with calcium because you have a lot of it stored in your body. The calcium stored in your bones will be mobilized for fetal development. Sounds fine right? Wrong.
Over time and especially as you age down the road you will be prone to osteoporosis, or in other words your bones will become weak and brittle.
Where there is calcium there must be vitamin D.
Why you ask? Vitamin D is what aids the absorption of calcium. Without vitamin D, all the calcium you ingest will not matter. This is why you will see calcium supplements with vitamin D in combination.
It is recommended that all woman (pregnant and not) of child bearing age supplement their diet with 600iu of vitamin D per day (Garner, 2018). This is the typical dose you will see when you buy a combination calcium with vitamin D, and there is a reason for that!
Today, there is also much discussion on the amount of vitamin D passed from mother to infant during breastfeeding. Infant that are exclusively breastfed are recommended to be given a supplement daily as well.
For example, if a breastfed infant consumes 750ml of breastmilk a day they will only have received 10-40iu of vitamin D (Misra, 2018), and it is recommended that an infant receives 400iu per day. That is quite a large gap!
>>>Read more about vitamin D supplementation for infants in my article here.<<<
There are many things to consider for pregnant and lactating women when it comes to nutrition.
Vitamin supplementation is just the tip of the iceberg.
Folic acid, calcium and vitamin D are the three key vitamins that are pertinent for women of childbearing age to consume. For all the examples given above and for the well being of your baby.
If you are a noncompliant patient in other facets of your life, fine. I can’t change your mind on everything, but consider the impact of improper supplementation on your baby’s health and well being.
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*all resources sited are from Uptodate. An evidence-based clinical decision support resource from Wolters Kluwer.
Goetzl, Laura M. MD, MHP. Folic acid supplementation in pregnancy. 2018.
Rosen, Harold N. MD. Calcium and vitamin D supplementation in osteroporosis. 2018.
Misra, Madhusmita, MD, MPH. Vitamin D insufficiency and deficiency in children and adolescents. 2018.