Which supplements to take and what to avoid during pregnancy


  • Nutrition
  • Monday, 07 Oct 2019

Supplements should be treated like medication during pregnancy, with advice from the doctor on what and how much to take. — TNS

The moment a woman discovers she’s pregnant, the range of emotions is overwhelming – most notably, confusion and worry sets in once the initial excitement wears off.

We’re all generally aware that things like smoking and alcohol can negatively affect a pregnancy, but we rarely think about how supplements impact the health and development of a precious foetus.

Shouldn’t the label of “health supplement” be a key indicator that it’s beneficial to consume? Not so, and there’s a lot of misinformation out there when it comes to the types of supplements you need during pregnancy.

With this article, I hope to educate you on the types of supplements that are essential to take in greater quantities during a pregnancy. I’ll also highlight supplements that are often marketed to pregnant women, but are either not necessary or just downright harmful.

Less nutrients

The saying “eat for two” doesn’t really refer to the amount of food intake. Wouldn’t that be nice though? When you are expecting, your body’s need for macronutrients – carbohydrates, fats and protein – does increase.

But it’s the body’s need for micronutrients – minerals, vitamins and trace minerals – that increases exponentially, as they are necessary parts of the building blocks of a healthy foetus.

Specific micronutrients support a woman’s pregnancy at every stage, enabling key functions like cell growth. While you can obtain lots of micronutrients by eating a nutrient-rich diet, here are some common reasons why a pregnant woman will need supplements:

● Hyperemesis gravidarum

More commonly known as morning sickness, symptoms of this pregnancy complication include feeling faint, nausea and vomiting, and may result in dehydration, weight loss and nutrition deficiency.

● Carrying more than one foetus

Women who are pregnant with more than one baby should definitely not skimp on supplements. The more babies you are carrying, the more nutrients you are going to need to help them develop well. So ensure that you and the little ones are getting the right nutrition with a nutrient-dense diet, as well as with supplements.

● Special diets

Vegans, vegetarians, gluten-intolerant and other individuals with special dietary restrictions will have to consider whether their diet is nutritionally suitable for pregnancies. If you’re medically unable to modify your diet for the duration of the pregnancy, then you must take supplements to make up the gaps in your nutrients.

● Nutrient deficiency

A lack of nutrients can occur for various reasons, such as poor food choices, not eating enough, or even special diets that omit key food groups. These need to be made up for in order to have a healthy pregnancy.

● Smoking

Expectant mothers should avoid cigarettes and vaping, but generally, smokers have an increased need for folate and vitamin C.

● Genetic mutations

One example is a condition known as MTHFR. Short for methylenetetrahydrofolate reductase, this genetic mutation breaks down folate and homocysteine. You will require folate and vitamin B supplements to counter deficiencies.

Recommended supplements

Supplements, vitamins, minerals, diet, vegan, vegetarian, gluten-free, pregnancy, Star2.com
Women on vegetarian, vegan or gluten-free diets have to take supplements to make up for gaps in nutrition during pregnancy if they're unable to change their diets. Photo: AFP

During a pregnancy, supplements should be treated like medication and discussed with a doctor prior to taking any. Buy reputable brands to ensure that you are consuming safe and better quality products.

● Prenatal vitamins

These are specially formulated multivitamins that are meant to address micronutrient deficiency during pregnancy and lactation periods. Prenatal vitamins may reduce preterm births and preeclampsia – a pregnancy complication that increases protein in the urine and raises blood pressure.

● Probiotics

Probiotics improve gut health by increasing the amount of good bacteria in the digestive system. Adding a probiotics supplement can remove the risk of an infant experiencing skin problems, gestational diabetes, and even reduce postpartum depression.

● Folate

Folate is a critical component in the production of red blood cells, foetal development and DNA synthesis. Folic acid supplements can be converted into active folate in the body to do all that work. It may reduce the risk of birth defects like cleft palate or neural tube defects.

● Vitamin D

A lack of vitamin D increases risk of gestational diabetes, preeclampsia and preterm birth. It is critical to bone health, immune function and cell division.

● Magnesium

This mineral plays a role in your nervous, immune and muscle systems. Without adequate amounts, there is a risk of premature labour and chronic hypertension.

Iron

Iron is necessary to carry out foetal development and proper oxygen transport. Deficiency in iron has been linked to infant anaemia, preterm delivery and maternal depression.

Ginger

Ginger supplements are safe to use for nausea and vomiting. You may prefer to take ginger in raw form, brewed as a tea with some honey.

Fish oil

Fatty acids like EPA (eicosapentaenoic acid) and DHA (docosahaexanoic acid) are critical for brain development and can be found in fish oil. Supplementing is safe, but if you plan to consume fish oil through fatty fish, beware of mercury levels found in seafood.

Avoid these supplements

Supplements, vitamins, minerals, ginger, pregnancy, nausea, vomiting, morning sickness, Star2.com
Ginger, either in tea or as a supplement, is good at counteracting nausea and vomiting during pregnancy. Photo: Marco Verch/Flickr

There are many supplements that should be avoided as well. Particularly risky are herbal supplements that haven’t been tested by the right health governing bodies and have little research done on its effects. These supplements are not necessarily bad, but they are not recommended for consumption during pregnancy.

Vitamin E

The possible risk of increased abdominal pain or premature amniotic sack rupture is why vitamin E isn’t recommended as a pregnancy supplement. But for a non-pregnant person, it is useful for immune function.

Vitamin A

Over-consumption of this vitamin can cause liver poisoning and damage, as well as birth defects. But you do need the recommended amounts of vitamin A for vision and immune system development of the foetus. It can be found in foods like eggs and dark green leafy vegetables.

Dong quai

Proponents of Chinese herbs are familiar with the use of dong quai for the treatment of high blood pressure and menstrual cramps. However, dong quai is known to increase womb contractions and raise the risk of a miscarriage.

Yohimbe

Yohimbe comes from the bark of an African tree used to combat obesity. If you have been taking it before pregnancy, please stop as the side effects include high blood pressure, seizures, and even heart attacks.

Goldenseal

It’s a plant supplement used to treat respiratory infections and diarrhoea. Goldenseal contains berberine, a substance that potentially increases jaundice symptoms in infants.

Other herbal supplements to avoid while pregnant are:

● Saw palmetto

● Wormwood

● Mugwort

● Ephedra

● Yarrow

● Tansy

● Blue cohosh

● Pennyroyal

● Angelica

● Red clover

Nutrition is a top priority before, during and after pregnancy, hence, the right supplements should not be ignored. You should naturally stay away from herbal supplements that may be harmful to you and your baby.

But don’t forget that even with beneficial supplements, you need to seek your doctor’s help to determine the right dosage, as well as to discuss any potential risks or concerns.

Datuk Dr Nor Ashikin Mokhtar is a consultant obstetrician and gynaecologist, and a functional medicine practitioner. For further information, email starhealth@thestar.com.my. The information provided is for educational and communication purposes only and it should not be construed as personal medical advice. Informa-tion published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader’s own medical care. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.


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