Did you struggle to take your recommended prenatal vitamin every day for nine months, only to be blindsided when your doctor told you to continue taking them после the baby came? Why are vitamins recommended after birth? What’s the difference between “prenatal” and “postnatal” formulas? Does the brand really make a difference? Can’t you just eat healthy food?
Let’s talk about it.
The entire process of growing, birthing, and breastfeeding a new baby is a time of uniquely increased dietary needs. Not only are you using up your own nutrient stores to build and then sustain an entire other person, but pregnancy brings all kinds of changes to metabolism and blood flow that can change your own dietary requirements [1]. And those needs don’t stop with birth. Particularly if you’re breastfeeding, but even if you’re “just” recovering from the blood loss and exertion of birth, your nutritional needs don’t return to pre-pregnancy levels right away.
In a busy world of quick week-night dinners and processed food, prenatal vitamins (and other additional supplements we’ll discuss further down) are designed to fill in the nutritional gaps that might widen during pregnancy and postpartum, and can even provide nutrients that are hard to consume in adequate quantities from food alone.
What’s the difference between a “prenatal” and “postnatal” vitamin?
If you’re approaching or in postpartum, you may wonder whether to keep taking your prenatal or whether there’s a multivitamin designed specifically for after birth. Mostly, the nutrients you need to replenish after pregnancy are the ones you used up during pregnancy, i..e, the ones targeted by your prenatal vitamin already. Some specifically postnatal formulas could include additional ingredients to support recovery from blood loss during birth and/or additional amounts of nutrients in which breastmilk will be deficient if mom is herself deficient.
How long do you need to take a prenatal or postnatal vitamin?
A generic recommendation for prenatal or postnatal vitamin consumption is to take them as long as you’re breastfeeding. Alternatively, if you anticipate having another child or children in the future, consider taking prenatal vitamins daily even after you’ve weaned. Because the neural tube development for which folate is so crucial takes place at the very beginning of a pregnancy (starting before the woman even knows she’s for sure pregnant), it may be best to take a pre- or postnatal vitamin continuously.
Ingredients to look out for
Here, I’ll highlight a few nutrients that are especially important for the postpartum period, and those which are frequently lacking in the available vitamins on drugstore shelves.
Vitamin B12
Multiple B vitamins, including folate (B9) are important for pregnancy. Vitamin B12 is especially important postpartum as well. B12, also called cobalamin, is crucial for a baby’s brain development throughout their first months of life. Breastfed children of mothers with B12 deficiency may have developmental regressions, brain growth delays, failure to thrive, and/or muscular and behavioral problems, according to registered dietitian Lily Nichols in Chapter 12 of her book Настоящая еда для беременных. Vitamin B12 deficiency is more likely in women who follow vegan or vegetarian diets. Importantly, if your prenatal vitamin contains L-methylfolate instead of folic acid, be sure you’re also supplementing Vitamin B12, because the body cannot properly absorb L-methylfolate without it.
Vitamin D3
Vitamin D regulates calcium absorption in both mother and baby, and comes from sun exposure and food sources. Vitamin D drops are routinely prescribed to breastfed infants, as breastmilk is commonly considered to be deficient. However, Lily Nichols points out in Chapter 12 of Настоящая еда для беременных, vitamin D можно be supplied in sufficient amounts to a breastfed baby if the mother gets sufficient amounts daily. Nichols recommends 4000-8000 IU supplemented daily, especially for those who live where they cannot get sufficient mid-day sun. Personally, with my family history of melanoma, I’d rather take a supplement than risk too much UV exposure.
Increased incidence of immune-mediated diseases like multiple sclerosis, type 1 diabetes, and Crohn’s disease has been correlated with birth in a month where the mother got less sunlight and less vitamin D [2]. So get your sunlight or take your supplement!
Choline
Choline has been linked with brain development in babies (much like folate), as well as mood regulation and cognition for mom. These are all much needed during the четвёртый триместр! Choline is the только nutrient with a higher daily recommendation после birth than before, as you’re supporting your own brain as well as your baby’s. In Chapter 12 of Настоящая еда для беременных, Nichols recommends 550 mg daily while breastfeeding.
Choline sources include egg yolks, chicken liver, and lecithin (which you might see recommended for preventing and treating clogged milk ducts).
Iodine
Another nutrient that doesn’t get a lot of press is iodine, an important component of both thyroid and breast health. In 1928, iodized table salt entered the market and quickly resolved a desperate iodine deficiency crisis in America. Since then, goiter has all but vanished, but that не mean you get enough daily intake of this essential nutrient. If you go to your cabinet right now and read the label on your salt grinder, you might find that the kosher salt or sea salt you use for your everyday cooking is non-iodized. If so, and if your pre- or postnatal supplement doesn’t include much (or any) iodine either, you consider an additional supplement. The American College of Obstetricians and Gynecologists (ACOG) recommends 220 micrograms per day, and Nichols suggests at least 290 micrograms.
DHA
You’re probably familiar with omega-3 fatty acids. Like choline, the omega-3 fatty acid DHA is crucial for brain development, cognitive function, and emotional regulation. Your multivitamin might or might not contain any DHA (which is separate from EPA or ALA).
If you cannot or would rather not get two to three servings of fish per week, you’ll need DHA from a multivitamin or as an individual supplement.
Additional supplements to consider during postpartum
These are a few extra supplements to consider, based on your circumstances, that you probably won’t find in your multivitamin.
Probiotics
Probiotics are useful at any time to keep your gut flora healthy, but can be especially important if you received antibiotics during your pregnancy or hospital stay. They’re available in pill form if you don’t like yogurt, kimchi, kombucha, or other fermented foods.
Iron
Ask your doctor if they recommend you take additional iron for a time after delivery to build up your stores. This could be especially necessary if you were anemic in your third trimester, or if you had a surgical birth or excessive blood loss. Iron rich foods include dark leafy greens, eggs, and red meat.
Glycine
Found in gelatin and collagen, glycine helps with healing and recovery from delivery. Enjoy it via bone broths, slow cooked meats, Jello, or a supplement.
Calcium and magnesium
While calcium deficiency is rare, calcium supplements can be very helpful to your nursing journey as it continues. If you’re still nursing when your fertility returns, you may find that your milk supply dips around the end of one cycle into the beginning of the next. Calcium supplementation, combined with the crucial magnesium that helps you absorb it, has been found to help maintain your breastmilk supply during the luteal phase. You can take 500-1500 milligrams (mg) calcium with 250-750 mg magnesium from ovulation through the first few days of your period, according to breastfeeding website Kelly Mom.
Be sure to take calcium at a different time of day from any iron supplements you’re taking, as these two compete for absorption. Also, if you’re taking the larger dose, split your calcium (with its accompanying magnesium dose) into smaller chunks of 500 mg each, as you won’t be able to make use of all 1500 mg in one sitting.
Why do some brands require you to take many pills each day?
When choosing a vitamin, consider that more comprehensive formulas are going to have larger doses (read: you’ll have to take more capsules), simply because vitamins and minerals take up space. This allows you to spread the dose over the course of the day, taking the best advantage of all of its nutrients.
You can get a lot of the vitamins and minerals you and your baby need from your diet, but depending on your budget, schedule, and lifestyle, it can be difficult to maintain a healthful, whole-food diet that checks every box. A comprehensive multivitamin acts as an insurance policy for the days when you don’t have it in you. And postpartum, there may be a lot of those days!
Take your supplements with or after meals, and if possible, split a large dose throughout the day, after each time you eat. Do your best to take different minerals at different times, as they compete with each other for absorption. Vitamins B12 and Folate are also known to interfere with each other as well.
What about women who follow a vegan or vegetarian diet?
If you’re vegan or vegetarian, you’re missing out on multiple food sources of many essential postpartum nutrients. You’ll have to rely on additional supplements to make up the difference. In Chapter 3 of RFF, Lily Nichols recommends paying special attention to Vitamins B12, A, and K2, choline, glycine, zinc, and DHA.
Which prenatal or postnatal vitamin is best?
There are so many different brands of prenatal vitamins on the market, and unfortunately, none of them is perfect. I’ve combed through ACOG’s nutrient recommendations during pregnancy, those found in Marilyn Shannon’s Fertility, Cycles and Nutrition и Настоящая еда для беременных, also taking into account price and availability. There’s no way for my list to be exhaustive, so take this as a starting point for your own research. (Also: I am not a medical professional and this is not medical advice!)
Top-tier options
Needed products are among the most comprehensive multivitamins I could find. They also offer a convenient powder formula. I wouldn’t choose their “essential prenatal” though – it has less of each nutrient found in the regular prenatal, making it comparable to many cheaper brands, but at a much less attractive price.
See also Full Well’s Prenatal, which looks remarkably similar at $1.50 per day, or Seeking Health Optimal Prenatal, which also looks similar, except with additional herbs, and the additional money of $2.17 per day.
Needed multivitamins do not include iron, DHA, or enough choline. They’ll sell you each индивидуально for an additional cost.
Vegan options
For all their YouTube sponsorships, I would have expected Ritual’s Postnatal Vitamin to be more expensive than $1.04 per day. They do include a good amount of DHA, and most of your iodine, but you’ll need to find vitamins B6 and K2 elsewhere, and will probably need to supplement with additional choline, and maybe vitamin A, zinc, and/or selenium, especially if you’re vegan.
Garden of Life has an organic vegan prenatal formula derived from whole foods. I’m impressed by their bioavailable ingredients. They don’t include any DHA, choline, or magnesium, but do include a respectable amount of most everything else, at a mid-tier price of $1.36 per day.
Budget options
If you’re put off by some of these prices, there are some decent options on the market for less than a dollar per day.
Marilyn Shannon, the author of Fertility, Cycles and Nutrition was involved with the development of LifeTime Professional Prenatal Formula, which has been discontinued. American Pro-Life Enterprise sells their proprietary version of this supplement called Vita Prenatal Formula on their website. It’s a very robust option for only $0.80 per day. It does not include DHA or vitamin K2, and has less of the vitamins D3 and B12, as well as choline and iodine, than some of the formulas above.
Megafood’s Baby & Me 2 Postnatal includes the recommended 290 mcg per day of iodine, but you’ll need to find calcium, magnesium and DHA elsewhere, and potentially supplement more vitamins D3, B12, choline, and even folic acid.
Сайт Thorne Basic Prenatal has respectable amounts of vitamins D3 and B12, and some choline and iodine, but not enough on its own. Supply DHA elsewhere.
Horbaach’s Prenatal is the least expensive one I compared, at $0.33 per day, and you’ll have to spend some of those savings on separate choline, iodine, magnesium, and possibly additional B12.
Gummy option
Typically, gummy vitamins aren’t a great option if others are available. They can’t include any minerals, and do include empty calories for flavor. However, if you need to choose a gummy vitamin because you can’t stomach tablets, look at Smarty Pants. Unlike many tablets, it делает include DHA and iodine. As a gummy, it lacks iron, calcium or magnesium, and you’d want to supplement with additional choline and B12 if you don’t eat many eggs or meat.
The bottom line on how long to take a prenatal vitamin
Yes, it’s important to continue taking your prenatal during the early postpartum period if you’re not breastfeeding, and perhaps until you wean if you are nursing. For further reading, check out our Postpartum Guidebook on Nutrition, Fertility, Cycles and Nutrition by Marilyn Shannon, Настоящая еда для беременных by Lily Nichols, Малыш и не только by Allison Auth, and Средство от послеродового истощения by Dr. Oscar Serrallach.
