The Little White Pills Every Pregnant Woman Should Know About
Ok, I like specifics so let’s get friendly with this one:
Prenatal vitamins: An American term. Used by Americans. And people who watch too much TV.
Antenatal Supplements: The New Zealand term. Referring to various nutritional supplements recommended by the NZ Ministry of Health as part of a healthy pregnancy.
Confession. I was born with a compulsive urge to tell it like it is so one of the convos I regularly find myself having with newly pregnant women is around the use of vitamin and mineral supplements. This is mostly because I like pointing out that for otherwise healthy women (that is, no pre-existing health conditions, and no weight loss/ hyperemesis) they’re a waste of money. Yeah that’s right, the $89.99 you just paid for a three month supply of Elevit was probably unnecessary. Gasp.
Most nutrients in supplement form are more difficult for the body to absorb than nutrients from a natural food source so while some of it is being metabolised, some of it is also being excreted out and flushed down the toilet. Whole fruit and vegies on the other hand (actually whole foods in general) tend to go in and stay in. Baby-growing win. For the vitamins that do make it into our circulation, most are fat soluble (stored in our body fat) and because of this vitamins D,E,K & A can become toxic to pregnant women. For this reason it is not safe to take standard multi-vitamin supplements when pregnant. The vitamins that the body does not store away (mostly Vitamin C, and the B family) move more freely through the body and require a continuous supply to be replenished.
OK so let’s get specific (yay). If you are eating massive amounts of oranges every day your body will probably have a pretty healthy level of vitamin C circulating around. When the body reaches its' tolerance level for vitamin C but you keep eating them, all the excess vitamin C will be directed to your kidneys and excreted out in your pee. For this reason, up to 80% of a synthetic vitamin C supplement can be excreted into your urine before it has even been absorbed into the body and there goes ya prenatal vitamin money down the toilet.
For most women (remember - those without a pre-existing health condition, and those who can tolerate a balanced diet) the sensible thing to do is eat a wide variety of fruit and vegies, and food in it's whole form. Your body knows exactly what it needs to grow a mini-human, and if you feed it the right foods it will absorb or excrete as required. Amazing.
Glad we clarified? I am. But we’re not done yet. Kiwi mums do need some support to cover all their nutrient bases while pregnant and breastfeeding. I could write for days about nutrition in pregnancy but to keep things not boring I’ma pick the two recommended by the MoH and leave it at that. You’re welcome.
A mineral essential to thyroid function, and the developing brain (especially babies and young children). When adults are really low in Iodine, they get goitre. When babies and children are low in iodine, in extreme cases it can lead to stunted growth, and hearing and cognitive impairment. Going all the way back to the 1800s, Kiwis have more or less always been low in iodine at different times so historically there have been national campaigns to get everyone on the iodine train, which is why our grandmothers are still likely to have a bottle of iodised table salt sitting around as a pantry staple. You know the stuff… it’s virtually a Kiwi icon:
Interestingly, the low iodine issue subsided from New Zealand for a couple of generations, then as you might expect, came back again when we started eating more processed food, meaning it is still a relevant issue for all the baby makers of 2019. There are natural sources of iodine we can rely on if our inner hippy is offended by supplements, but unfortunately for pregnant women it involves eating a lot of shellfish, and if you are hapu you should definitely not be doing that. So for those of us who are all about keeping life simple – just take ya supplements, people. 150 mcg of iodine per day while pregnant AND breastfeeding (unless you have ever been diagnosed with a thyroid disorder in which case, do not take any). Your midwife can prescribe you three months worth at a time for $5, potentially saving you hundreds of dollars. Which your new baby will burn through in no time *grin*.
Folic Acid is the synthetic form of folate, which is a B vitamin. Folate is an essential component in avoiding neural tube defects (mostly Spina Bifida) in a developing baby but is one of the few nutrients which in its’ natural form, is not very easily absorbed by the body so the chances of most people getting adequate amounts of it during the first trimester (when the babys' neural tube is being formed) are slim to none. To be really sure you are minimising the risks of neural tube defects in an unborn baby, you want to be taking 0.8 mg of folic acid every day (unless you have a family history of NTDs, in which case 5 mg is the recommended daily dose) from at least four weeks prior to conception, until twelve weeks gestation. If you’re one of the fortunate mums who got a head start on their kid by anticipating a pregnancy then, well, go you for being ahead of the game! An Otago Uni study begun in 2010 (it's still ongoing) shows that Auckland’s rate of unplanned babies sits at around 40%. Previous estimates from the MoH for NZ as whole suggest a rate closer to 50%. So, if you’ve managed to achieve four weeks worth of folic acid insurance prior to getting pregnant then high five! You are an exception. Remind your child to thank you one day for your responsible baby making. For most mums though, who were either not anticipating a pregnancy or you just didn’t get a handle on the whole folic acid thing, don’t panic! To keep things in perspective, the same Otago Uni study showed that NINE OUT OF TEN mums do not take folic acid as prescribed, so, no one is about to call CYFS over it. If you’re in the first trimester you still have time for daily folic acid and up until twelve weeks, and every little bit will help. My advice is to get both folic acid and iodine in ya as early as possible, then make your peace with mother nature because - like so many things to do with growing a baby - the rest will be her domain.