NHS guide to vitamins, minerals and supplements in pregnancy

Eating a healthy, varied diet in pregnancy will help you get most of the vitamins and minerals you need.

But when you’re pregnant or there’s a chance you might get pregnant, you should take a folic acid supplement.

It is recommended that you take:
•  400 micrograms of folic acid each day – from before you’re pregnant until you’re 12 weeks pregnant.

This is to reduce the risk of problems in the baby’s development in the early weeks of pregnancy.

The Department of Health and Social Care also advises you to consider taking a vitamin D supplement.

Do not take vitamin A supplements or any supplements containing vitamin A (retinol), as too much could harm your baby. Always check the label.

Where to get pregnancy supplements

You can get supplements from pharmacies and supermarkets, or a GP may be able to prescribe them for you.

If you want to get your folic acid from a multivitamin tablet, make sure the tablet does not contain vitamin A (or retinol).

Folic acid before and during pregnancy

You should take a 400 micrograms folic acid tablet every day before you’re pregnant and until you’re 12 weeks pregnant.

Folic acid can help prevent birth defects known as neural tube defects, including spina bifida.

If you did not take folic acid before you conceived, you should start as soon as you find out you’re pregnant.

You should also eat foods that contain folate (the natural form of folic acid), such as green leafy vegetables.

Some breakfast cereals and some fat spreads, such as margarine, may have folic acid added to them.

It’s difficult to get the amount of folate recommended for a healthy pregnancy from food alone, which is why it’s important to take a folic acid supplement.

Higher dose folic acid

Some women have a higher chance of having a pregnancy affected by a neural tube defect and are advised to take a higher dose of 5 milligrams (mg) of folic acid each day until they’re 12 weeks pregnant.

You may have a higher chance if:
• you or the baby’s biological father have a neural tube defect
•  you or the baby’s biological father have a family history of neural tube defects
•  you have had a previous pregnancy affected by a neural tube defect
•  you have diabetes
•  you take anti-epilepsy medicine

If any of this applies to you, talk to a GP. They can prescribe a higher dose of folic acid.

The GP or your midwife may also recommend additional screening tests during your pregnancy.

Vitamin D in pregnancy

All adults, including pregnant and breastfeeding women, need 10 micrograms of vitamin D a day and should consider taking a supplement containing this amount.
Vitamin D regulates the amount of calcium and phosphate in the body, which are needed to keep bones, teeth and muscles healthy.

Our bodies make vitamin D when our skin is exposed to summer sunlight (from late March/early April to the end of September).

It’s not known exactly how much time is needed in the sun to make enough vitamin D to meet the body’s needs, but if you’re out in the sun, take care to cover up or protect your skin with sunscreen before you start to turn red or burn.

Vitamin D is also in some foods, including:
•  oily fish (such as salmon, mackerel, herring and sardines)
•  eggs
•  red meat

Vitamin D is added to all infant formula milk, as well as some breakfast cereals, fat spreads and non-dairy milk alternatives. The amounts added to these products can vary and might only be small.

As vitamin D is found only in a small number of foods, whether naturally or added, it might be difficult to get enough from foods alone.

Everyone over the age of 5, including pregnant and breastfeeding women, should consider taking a daily supplement containing 10 micrograms of vitamin D.

Most people aged 5 and over in the UK will probably get enough vitamin D from sunlight in the summer, so you might choose not to take a vitamin D supplement during these months.

If you have dark skin or always cover your skin

If you have dark skin (for example, if you’re of African, African Caribbean or south Asian origin) or always cover your skin when outside, you may be at particular risk of not having enough vitamin D (vitamin D insufficiency).

You may need to consider taking a daily supplement. Talk to your midwife or doctor if this applies to you.

Iron in pregnancy

If you’re short of iron, you’ll probably get very tired and may suffer from anaemia.
Lean meat, green leafy vegetables, dried fruit, and nuts contain iron.

If you’d like to eat peanuts or foods that contain peanuts (such as peanut butter) during pregnancy, you can do so as part of a healthy, balanced diet unless you’re allergic to them or your health professional advises you not to.

Many breakfast cereals have iron added. If the iron level in your blood becomes low, a GP or your midwife will advise you to take iron supplements.

Vitamin C in pregnancy

Vitamin C protects cells and helps keep them healthy.
It’s found in a wide variety of fruit and vegetables, and a balanced diet can provide all the vitamin C you need.

Good sources include:
•  oranges and orange juice
•  red and green peppers
•  strawberries
•  blackcurrants
•  broccoli
•  brussels sprouts
•  potatoes

Calcium in pregnancy

Calcium is vital for making your baby’s bones and teeth.
Sources of calcium include:
•  milk, cheese and yoghurt
•  green leafy vegetables, such as rocket, watercress or curly kale
•  tofu
•  soya drinks with added calcium
•  bread and anything made with fortified flour
•  fish where you eat the bones, such as sardines and pilchards

You also need to know which foods to avoid in pregnancy.

Vegetarian, vegan and special diets in pregnancy

A varied and balanced vegetarian diet should give enough nutrients for you and your baby during pregnancy.

But you might find it more difficult to get enough iron and vitamin B12.
Talk to your midwife or doctor about how to make sure you’re getting enough of these important nutrients.

If you’re vegan or you follow a restricted diet because of a food intolerance (for example, a gluten-free diet for coeliac disease) or for religious reasons, talk to your midwife or a GP.

Ask to be referred to a dietitian for advice on how to make sure you’re getting all the nutrients you need for you and your baby.