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Vitamin
and Mineral Supplements
Pregnancy
and lactation will increase a woman's need for many vitamins and minerals.
The most important thing for women who are preparing for pregnancy
or between pregnancies to do is eat a well-selected diet with a rich
supply of fruit, vegetables, calcium-rich food and adequate sources
of zinc and iron. During pregnancy, a prenatal vitamin-mineral supplement
is usually prescribed by the doctor.
If
you are already taking vitamin or mineral supplements be sure to
discuss this right away with your physician as too much can be harmful.
For example, excess intake of vitamin A has been shown to increase
the risks of certain birth defects. All other dietary
supplements should be discontinued, unless approved by your
obstetrician.
First
Trimester
During
the first trimester of pregnancy, folic acid (folate) and zinc are
important nutrients to promote cell division and early embryo development.
An adequate amount of maternal folic acid reduces the risk of having
a baby with a birth defect of the spine (neural tube defect) or
spina bifida. Ideally, all girls and women who are in their childbearing
years should consume at least 400 micrograms of folate daily. Once
pregnant, 600 micrograms per day is needed. Folic acid is naturally
high in many foods, and it is
now added to fortify many grain products in the United States. If
you are not eating enough folic acid, a multivitamin-mineral supplement
with folic acid is recommended.
In
early pregnancy, zinc supplementation is not usually recommended,
however, adequate consumption of zinc
in foods and conditions for optimum absorption are urged. During
pregnancy, zinc requirements increase from 12 mg to 15 mg per day.
Second
and Third Trimester
During
the second and third trimester of pregnancy, iron and calcium requirements
significantly increase as the fetus begins to draw more from the
mother to meet its own demands. The dietary recommendation for iron
doubles at this time (from 15 to 30 mg). The iron content of prenatal
vitamin-mineral formulas is generally 30 mg. It is also contained
in several key foods such as fortified
grain products, red meats and legumes. Your health care provider
may prescribe extra iron if lab tests indicate you are anemic.
Some women find supplemental iron difficult to tolerate because
of its effect on their digestive tract. Be sure to discuss your
concerns about this with your physician. Dietary adjustments, supplement
adjustments or a combination of both can help.
It
is best to take your prenatal vitamin on an empty stomach with water
or juice. If it upsets your stomach take with a small amount of
food. For best absorption, do not take your supplement with milk,
dairy products, coffee, tea, other vitamins or minerals, or antacids.
Prenatal
supplements are not highly fortified with calcium. It is generally
recommended that calcium be consumed in food. In addition to milk,
cheese and yogurt, there are several good calcium-fortified foods
from which to choose. If you don't have enough calcium
rich foods in your diet, you may need an additional calcium
supplement. Iron and calcium supplements should not be taken together
as calcium will interfere with the absorption of iron.
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