Good nutrition and appropriate weight gain can improve pregnancy outcomes. Although, in the general population, a healthy balanced diet should largely obviate the need for vitamin and mineral supplementation, pregnancy and lactation create extra nutritional demands that, for some individuals, may make supplementation advisable.

Recommendation 1

A healthy, balanced diet is strongly recommended before, during and after pregnancy.

Recommendation 2

The recommended dose of folic acid is at least 0.4mg daily to aid the prevention of neural tube defects (NTD). Where there is a known increased risk of NTD or a risk of malabsorption, a 5mg daily dose is recommended.

Recommendation 3

Vegetarians and vegans should be supplemented with Vitamin B12 in pregnancy and lactation. The RDI of B12 in pregnancy is 2.6 mcg/day. The RDI of B12 during lactation is 2.8 mcg/day.

Recommendation 4

Pregnant women with Vitamin D level below 50nmol/L: For pregnant women with levels 30–49 nmol/L, commence 1,000 IU (25μg)/day. Pregnant women with levels < 30 nmol/L should commence 2,000 IU (50μg)/day. Repeat the Vitamin D level at 28 weeks gestation.3

Pregnant women with Vitamin D level above 50nmol/L: These women should take 400 iu Vitamin D daily as part of a pregnancy multivitamin.

Recommendation 5

Vitamin K should be administered in late pregnancy to women with proven cholestasis of pregnancy, due to reduced Vitamin K absorption.

Recommendation 6

Routine iron supplementation is not recommended in every pregnancy. All women should have their haemoglobin level checked at the first antenatal visit and again at approximately 28 weeks’ gestation and any anaemia investigated and treated.

Recommendation 7

The recommended dietary intake of calcium per day for pregnant women is 1300mg (ages 14-18 years) and 1000mg (19-50 years). If the woman avoids dairy in her usual diet and does not consume alternative high calcium foods, she should take a calcium supplementation of at least 1000mg per day.

Recommendation 8

Women who are pregnant, breast feeding or considering pregnancy should take an iodine supplement of 150 micrograms each day.

Recommendation 9

Women whose dietary intake of Omega-3 fatty acids is low, for example those who eat very little seafood, should consider a dietary supplementation which may be obtained from fish oil and some commercially available pregnancy supplements.

It is best to work with your GP or obstetrician to find a supplement regime specific for you as an individual based on the above information.