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Prenatal vitamins are a hot topic these days. Everyone is touting the benefits of using them prior to getting pregnant to help prevent certain birth defects and continuing them during pregnancy and breastfeeding for continued protection from nutrition deficiencies. However, despite all of the attention these little pills get there are a lot of fallacies as well.

Myth: Taking prenatal vitamins will be adequate no matter what your diet is like.

Reality: This is false because the goal of prenatal vitamins is to supplement your diet not to replace it. In fact, prenatal vitamins work better when you are eating a healthy diet that includes a variety of foods. There are also known deficiencies in prenatal vitamins, for example calcium. The levels of calcium in the average prenatal vitamin are 250 mg. A pregnant woman needs about 1,200 - 1,500 mg of calcium daily to help her and the baby adequately grows.

Myth: All prenatal vitamins are alike.

Reality: Again false because recent studies showed that out of 9 prescriptions vitamins only 3 actually released the amount of folate that they claimed to contain. This means that even though they really contained the folate the body didn't absorb it.

Myth: Prescription vitamins are better than non-prescription vitamins.

Reality: Nope. Not all vitamins are created equally and many vitamins that are available by prescription are also available over the counter. What is more important are the ingredients in the vitamins and how well they absorb into your body. Many times prescriptions are written so that the cost of the vitamins will be picked up by insurance companies.

When you're trying to decide which prenatal vitamin is right for you, talk to your doctor or midwife about their recommendations and keep some things in mind:

· No prenatal vitamin will contain all of the calcium you need.

· Too much vitamin A can cause birth defects, be sure that you're using a prenatal vitamin or a multi-vitamin with under 10,000 IU.

· Too much iron in a prenatal vitamin will not be absorbed properly.

· The taste and texture of vitamins do bother some women. If you can't keep your prenatal down, consider switching brands.

Do I really need to take a prenatal vitamin?

If you're very tuned in to nutrition and regularly eat a broad range of foods, including meat, dairy products, fruits, vegetables, grains, and legumes, your diet will provide almost all the nutrients you and your baby need. Realistically, though, most women — especially those in the throes of morning sickness — can benefit from taking a prenatal vitamin and mineral supplement, preferably before they start trying to conceive. Think of it as an insurance policy to make sure you're getting the right amount of certain important nutrients during pregnancy.

And women with certain health issues, dietary restrictions, or pregnancy complications definitely need to take a prenatal vitamin. This includes vegetarians and vegans, women who are lactose-intolerant or have certain other food intolerances, smokers and women who abuse other substances, women who are having twins or higher multiples, and women with certain blood disorders and certain chronic diseases.

What's in a vitamin supplement that I can't get from food?

If you're a stickler for nutrition, you may already be doing a pretty good job of getting what you need, but there are two crucial nutrients that most pregnant women don't get enough of from food alone:

Folic acid
Taking a supplement is the only way to make sure you're getting the amount offolic acid you need each day. All medical authorities recommend a daily dose of 400 micrograms (mcg) starting at least a month before you begin trying to get pregnant and at least 600 mcg a day once you know you're pregnant. (And that's in addition to the folic acid you get from food, which is actually not as easy for your body to absorb as the synthetic kind in a supplement.) Research has shown that doing this can reduce the risk of neural tube defects in your baby by up to 70 percent.

Most prenatal vitamins contain between 600 and 1,000 mcg of folic acid. If you don't take one, make sure you still take a separate folic acid supplement. If you've previously had a baby with a neural tube defect, you'll need to take 4,000 mcg, or 4 milligrams, of this vitamin every day, starting at least a month before conception. See your practitioner about getting a prescription for pills that provide this larger dose.

Iron
A prenatal supplement can also help you get enough iron. Most women don't get enough of this mineral in their diet to meet their body's increased needs during pregnancy. That's because your body makes a lot more blood when you're pregnant to support your growing baby, and as a result, the iron stores in your blood can get spread pretty thin. To avoid developing iron-deficiency anemiaduring pregnancy, most women need to take a supplement.

The amount recommended when you're pregnant is 27 milligrams (mg) of iron per day, 50 percent more than you need when you're not pregnant. The Centers for Disease Control recommends that all pregnant women start taking a low-dose iron supplement of 30 mg at the first prenatal visit, either as an individual supplement or in a prenatal vitamin. Most prenatal vitamins contain between 27 and 60 mg of iron. (Be sure to keep your pills out of reach of children; supplemental iron can be fatal to them.)

Some women need to take even more during pregnancy. After reviewing your prenatal blood work, your caregiver will let you know if you need to boost your iron intake. Women with iron-deficiency anemia are usually advised to take between 60 and 120 mg of iron each day in addition to a prenatal vitamin that contains iron. If you're not yet pregnant but already know you're anemic, your caregiver may suggest that you start taking an iron supplement now.

Is there anything that I won't get in a prenatal supplement?

Calcium is one of the nutrients that you won't find a full day's supply of in your prenatal vitamin and mineral supplement. Most prenatal vitamins contain between 100 and 200 milligrams (mg) of calcium, but some don't contain any. That's because calcium is a particularly bulky mineral, and the pills are already big enough!

The amount of calcium you need during pregnancy is about 1,000 mg per day — the same amount you need when you're not pregnant. (If you're 18 or younger, you need 1,300 mg per day.) But it's even more crucial that you get the recommended amount during pregnancy because you'll need to replace the calcium your growing baby is getting from your own bones. Skimping on calcium now increases your risk for osteoporosis later in life.

Luckily, there are many ways to get this mineral. For example, a cup of milk and a container of yogurt each contain about 300 to 350 mg. If you can't stomach dairy products, you can get your calcium from separate supplements. Some of the chewable ones taste pretty good. Look for them near the vitamins in your drugstore.

Prenatal vitamins don't contain any essential fatty acids either. DHA, an omega-3 fatty acid, is important for the development of your baby's brain, nerve, and eye tissue. The recommended intake of DHA during pregnancy is 300 mg a day — the amount you'd get if you ate about 5 to 10 ounces of cold water fish, such as salmon or trout, every week — but few Americans get that much from their diet. Ask your healthcare provider if she thinks you could benefit from a DHA or other omega-3 supplement.

How do I choose a prenatal supplement that's right for me?

Unfortunately, since the Food and Drug Administration doesn't regulate what goes into vitamin and mineral supplements, no standards have been set for what should be in them. That means it's up to you and your practitioner to make sure you choose one that's safe and appropriate for you.

At your first prenatal checkup or at a preconception visit, your practitioner will probably recommend that you start taking a prenatal vitamin. She may prescribe one for you or she may recommend an over-the-counter brand. Make sure you don't take any other vitamin or mineral supplement while you're taking a prenatal supplement unless your practitioner recommends it.

You already know that your supplement should contain more of certain nutrients (such as folic acid and iron) that you may not be able to get enough of from your diet. Just as important is to find one that includes no more than the recommended amounts of other nutrients, particularly vitamin A, that can be harmful to your baby if you take too much.

This is one of the reasons that most prenatal vitamins contain vitamin A at least partly in the form of beta-carotene, a nutrient that you get from fruits and vegetables that converts to vitamin A in the body. Unlike vitamin A from animal products, which can cause birth defects when taken in high doses just before conception or during pregnancy, beta-carotene is not considered toxic in high doses.

What if I mistakenly take two prenatal vitamins on the same day?

Don't worry. Taking twice the recommended amounts of these nutrients on just one day won't harm you or your baby. But doing that more often can be harmful, so it's important not to make a habit of doubling up on your prenatal supplements. If for some reason your caregiver has told you that you need more of a certain nutrient (iron or calcium, for example) than is in your prenatal vitamin, take the extra amount as a separate supplement.

Multivitamins are designed to give you what you need daily, and getting an extra dose of everything in them is definitely not better. Vitamin A is not the only nutrient you can get too much of if you regularly take extra doses.

What can I do if I'm having trouble swallowing the pills?

Prenatal vitamin and mineral supplements tend to be pretty big, and some women find them hard to swallow, especially when they're dealing with nausea. If this is a problem for you, your practitioner may be able to prescribe a smaller pill or one with a slick coating that makes it easier to get down. (Pills that don't contain calcium tend to be smaller, and you can get your calcium in other ways.) Chewable versions are also available, although they generally don't taste great.

What can I do if I think the pills are giving me an upset stomach?

If you're taking a vitamin with a particularly high level of iron, it may upset your gastrointestinal tract. (Supplements that contain no more than the recommended amount of 30 mg probably won't cause you any problems.) Taking a lot of iron can lead to constipation, which is already a problem for many pregnant women, but it can also cause nausea or, more rarely, diarrhea.

If you think iron is distressing your stomach, talk to your practitioner about it. If you're not anemic, it may make sense for you to switch to a prenatal vitamin with a lower dose of iron. If that's not an option for you, try drinking prune juice to help you stay regular or take your supplement at bedtime to avoid queasiness. Your practitioner may also recommend taking the pill after a meal because you're likely to tolerate it better with a full stomach.

What are they?

Prenatal vitamins are specially formulated multivitamins that mothers-to-be are advised to take for their own health as well as for the health of their babies. These vitamins make up for any nutritional deficiencies in your diet during your pregnancy. While the supplements contain numerous vitamins and minerals, their folic acid, iron, and calcium content are especially important.

Why do pregnant women need high levels of folic acid, iron, and calcium?

Taking folic acid can reduce your risk of having a baby with a serious birth defect of the brain and spinal cord, called the "neural tube." A baby with spina bifida, the most common neural tube defect, is born with a spine that is not completely developed. The exposed nerves are damaged, leaving the child with varying degrees of paralysis, incontinence, and sometimes mental retardation.

Neural tube defects develop in the first 28 days after conception. Because about half of all pregnancies are unplanned, the U.S. Public Health Service recommends that all women of childbearing age get 400 micrograms of folic acid each day. In fact, the FDA now requires that all flour products, such as breads, buns, and bagels, be fortified with extra folic acid.

There are natural sources of folic acid: green leafy vegetables, nuts, beans, and citrus fruits. It's also found in many fortified breakfast cereals and some vitamin supplements.

Taking calcium during pregnancy can prevent a new mother from losing her own bone density as the fetus uses the mineral for bone growth.

Taking iron helps both the mother and baby's blood carry oxygen.

While a daily vitamin supplement is no substitute for a healthy diet, most women need supplements to make sure they get adequate levels of these minerals.

Are all prenatal supplements the same?

No, they're not. Look for one that contains approximately:

• 4,000 and 5,000 IU (international units) of vitamin A
• 800 and 1,000 mcg (1 mg) of folic acid
• 400 IU of vitamin D
• 200 to 300 mg of calcium
• 70 mg of vitamin C
• 1.5 mg of thiamine
• 1.6 mg of riboflavin
• 2.6 mg of pyridoxine
• 17 mg of niacinamide
• 2.2 to 12 mcg of vitamin B-12
• 10 mg of vitamin E
• 15 mg of zinc
• 30 mg of iron

mg = milligrams
mcg = micrograms

Your doctor or midwife can also advise you on certain brands. In some cases, your health care provider will give you a prescription for a certain type of prenatal vitamin.

My prenatal vitamin makes me nauseous, what should I do?

Some prenatal vitamins can cause nausea in an already nauseous pregnant woman. If your prenatal vitamins make you sick, talk to your health care provider. He or she may be able to prescribe a different kind of prenatal vitamins (for example, chewable vitamins as opposed to those you swallow whole may be better tolerated by some women).

VITAMINS

Most couples plan their pregnancy in order to ensure the birth of a healthy baby. Also, nowadays, couples are concerned about their financial status and prefer to plan a pregnancy when they know they are financially stable to not only go through a healthy pregnancy, but also ensure proper education. They want to be sure that they can give their child all the needs and fulfil the wants of their little one.

In order to avoid accidental pregnancy most couples go onto contraceptives and consult with a gynecologist as to when they need to stop birth control measures in order to conceive when they are ready. With such guidance the doctor also suggests certain prenatal vitamins prior to conception to ensure that the body is completely prepared for a new form to take shape in the womb.

Though there are vitamins available in the market, yet most health care specialists suggest that expectant mothers should consume their requirement in the natural form and so they suggest a diet that contains all the nutrients for the healthy growth and development of the fetus, as well as good health of the expectant mother, which is a prime requirement.

Every one of the suggested prenatal vitamins and minerals are essential for the mother-to-be and the being growing and developing within. Sometimes due to aversions and cravings women tend to overlook the need to maintain a daily prenatal food regime, thereby skipping the consumption of the vitamins. Once in a way one can forget to take their routine prescribed in-take, but continuing to do so over a period of time can bring about some dangers to both the mother and child.

Essentially the foods that one consumes should contain folic acid, vitamins and minerals as prescribed by the gynecologist and obstetrician. The following are the various vitamins to take during pregnancy:

• Vitamin C: This is important as it promotes tissue repair, healing of wounds and the bone; and it increases the resistance of the body to infections. It functions as an agent that binds the cells together of the fetus.
• Vitamin D – This helps in general growth by regulating the appropriate calcium and phosphorus; both of which are vital for the development of healthy bones and teeth.
• B Vitamins (thiamine, vitamin B6, riboflavin, folic acid)
o Thiamine is an agent that converts the carbohydrates to energy in the mother; which in turn is essential for the healthy brain development of the fetus.
o Vitamin B6 is important for the development of the fetus’ brain and nervous system.
o Riboflavin is important for the growth and development of the fetus’ bones, muscles and nervous system.
o Folic Acid – This is one of the B Vitamins, which is essential for the production of red blood cells.
• Vitamin A – This is vital as it promotes the growth of cells, skin and mucous membranes.

The foods one should avoid during pregnancy include soft cheese, unpasteurized milk, caffeine and unwashed fruits and vegetables. And one should compulsorily be aware of the prenatal vitamin rich foods. Ideally, one should seek the guidance of a certified nutritionist in order to be sure that through each trimester one is eating appropriately.

Early pregnancy diet health supplements ensure that the expectant mother is consuming all nutrients in the right balance. However, one should avoid picking up the supplements off the counter and instead seek expert guidance that one is taking the right one. Yet, no supplement can make up for the natural sources of vitamins and other nutrients.

During pregnancy women go through various problems such as brittle nails, excessive hair fall, dryness of hair and skin, or then very oily skin. Gynecologists and obstetricians also consult expectant mothers on prenatal vitamins and hair growth, which seems to be a major worry amongst most women. While they are eager and excited about the birth process, yet they are concerned about the various side effects of pregnancy.