There are a number of factors that should be considered when evaluating the quality of prenatal vitamin formulas. These include:
1. Patient friendliness. Ideally, a prenatal vitamin should be a one piece, once a day product that is not too large. It should go down easy, and it should not cause stomach irritation, nausea, or an objectionable aftertaste.
2. Folic acid. In adequate amounts, this important B-vitamin can essentially prevent neural tube birth defects like spina bifida and meningomyelocoele. It is also important for proper red blood cell production. Most doctors recommend 1000 mcg per day of folic acid during pregnancy. Prenatal vitamin formulas containing 1000 mcg per serving require a prescription.
3. B-complex vitamins. There should be most of the B-complex vitamins (with the exception of vitamin B5, which can potentially cause toxicity) present in a good prenatal vitamin formula. The B-vitamins are cofactors in all of the steps for cellular energy production, and growing a baby is an energy intense process.
4. Biotin. This B-vitamin is unfamiliar to many people, but it is required for proper tissue growth and development. A recent study indicated that up to 50 % of pregnant women in the US are deficient in biotin.
5. DHA. This essential fatty acid is important for proper development of the baby’s nervous system. It is so important that it will be pulled from the mother’s body for the benefit of the baby. This also applies to the period of breast feeding – breast milk is rich in DHA. Many women start with deficient levels of DHA, and become especially depleted after pregnancy and breast feeding. Internationally, an amount of 200 mg per day is recommended for supplementation during pregnancy and breast feeding. The DHA should be highly purified and concentrated to reduce aftertaste and size issues.
6. Iron. This mineral is vital for formation of red blood cells in the baby. The mother’s needs are increased during and following pregnancy. Most good formulas have 25 to 30 mg of elemental iron per serving.
7. No calcium. While calcium is an important mineral needed in significant amounts during pregnancy and breast feeding, it has no place in a good prenatal vitamin formula. Calcium binds iron when the two minerals are consumed together, and neither is absorbed when bound. Also, prenatal vitamin formulas that do include calcium typically have only 10 to 15 % of the daily amount needed – any more results in unacceptably large size for the prenatal vitamin. This means that the rest must be obtained elsewhere anyway. Why seriously diminish the impact of needed iron for a relatively insignificant amount of calcium?
8. Contains a stool softener, such as docusate sodium. This helps counter the common affliction of constipation during pregnancy. Constipation can be aggravated by certain forms of iron, and is a particular problem with iron bound to calcium.
9. Requires prescription. We already discussed this with regard to folic acid. Studies have shown that expecting mothers are more compliant with regard to taking prenatal vitamins in proper amounts and on schedule when they are prescribed rather than over-the-counter. Many doctors prefer their pregnant patients to have prescribed prenatal vitamins, because this “keeps them in the loop” and allows for better oversight in their patient management.
For a really helpful tool in comparing the ingredients and relative sizes of the leading prescription prenatal vitamin brands, you can view our comparison chart on our “Compare Us” page.