Five nutrients do most of the heavy lifting for immune support during pregnancy and breastfeeding: vitamin A, vitamin D3, vitamin C, omega-3, and zinc. Each one addresses a deficiency that's common among pregnant women — and each is well-studied and safe at the amounts our practitioner community recommends.
The confusion usually isn't whether to support your immune system during pregnancy, but how to do it safely. Some nutrients get avoided out of caution when the research actually supports them, and most prenatals under-deliver on the ones that matter most. Below, we break down all five — plus three runners-up — with the specific forms and amounts to look for, so you can check them against your current routine.
Key Takeaways
- Five nutrients — vitamin A, vitamin D3, vitamin C, omega-3, and zinc — form the foundation of pregnancy-safe immune support — each one targets a widespread deficiency rather than adding redundant supplementation, which is why Needed's practitioner community prioritizes them over broad-spectrum "immune boosters."
- Vitamin D3 at 4,000 IU paired with 90 mcg of vitamin K2 goes beyond the 2,000 IU cap found in most prenatals — over 50% of women are deficient, and in a randomized controlled trial the higher dose brought 82% of participants to healthy blood levels with no side effects, so standalone D3 is often needed alongside a prenatal.
- The active retinyl palmitate form of vitamin A, around 600 mcg, is more usable than beta carotene for immune support — roughly half of women carry a genetic variation that blocks beta carotene conversion, so a prenatal that delivers at least part of its vitamin A as retinyl palmitate closes a gap plant sources leave open.
- Zinc at 15 mg, balanced with copper at a 15:1 to 25:1 ratio, supports both innate and adaptive immune function — over 80% of pregnant women have insufficient zinc intake, and because the body does not store zinc, consistent daily intake matters more than occasional high doses that can deplete copper.
- Auditing your current prenatal against these five nutrient thresholds shows where a standalone supplement is worth adding — most prenatals under-deliver vitamin C (often under 100 mg against a 500 mg target) and omega-3 (up to 95% of women of childbearing age fall short), so comparing your label to these amounts is the practical next step.
1. Vitamin A as Retinyl Palmitate
Women may avoid this “active” form of Vitamin A , Retinyl Palmitate, in pregnancy and instead just take Beta Carotene, a less “usable” form. Caution around Retinyl Palmitate exists because it is a fat soluble nutrient which means that it is not readily eliminated and can bioaccumulate. However, we think instructions to entirely avoid Retinyl Palmitate in pregnancy are misguided. Here’s why.
Though toxicity can occur at very high levels*, avoidance of Retinyl Palmitate has led to a high rate of Vitamin A deficiency in pregnancy and in newborns, which can be damaging as well. Among other benefits, Vitamin A supports fetal facial feature development including eyes and ears, adequate birth weight, full-term gestation, and normal thyroid function.
Vitamin A is also especially important for the development and regulation of the immune response, providing enhanced defense against multiple infections. One of the ways Vitamin A supports immune response is by increasing secretory IgA, an antibody that helps fight respiratory and gastrointestinal infections.
Beta Carotene is the form of Vitamin A found in plants, like carrots, sweet potatoes, and dark leafy greens. It is often poorly absorbed by the body and, once absorbed, it is inefficiently converted into the active (ready-to-be used) form your body needs. And, many women (potentially half) have a genetic variation that prevents the conversion of Beta Carotene completely.
Retinyl Palmitate is found in organ meats like liver and in dairy products, but most of us do not get nearly enough from our diet.
For these reasons, we recommend choosing a prenatal vitamin that includes at least a portion of its Vitamin A in the active Retinyl Palmitate form. We generally like to see at least 1,090 IU or 600mcg.
*The WHO says 10,000IU (equivalent to 3,000mcg) a day of the active form of Vitamin A is the upper limit. However, other research suggests that no risk has been observed at 30,000IU / 9.000mcg a day. Beta Carotene does not apply towards the upper limit, as there is no research to suggest that Beta Carotene can cause Vitamin A toxicity.
2. Vitamin D3 with Vitamin K2
Your immune system cannot function without Vitamin D. Yet, research suggests over 50% of women are deficient in Vitamin D, including in one study of women in the Northern United States, despite the fact that 90% of women studied were taking a prenatal supplement. In this case, insufficiency was measured as serum 25-hydroxyvitamin D (circulating Vitamin D in the body and the best measure of Vitamin D supply) levels of 37.5 - 80 nmol/L or less. Many practitioners in our community prefer to see levels closer to 50 - 80 nmol/L and even in Southern California see deficiency rates upwards of 90% for women that do not appropriately supplement with Vitamin D.
Your skin produces Vitamin D when it is exposed to sunlight, but for most of us direct sunlight exposure is limited by sunscreen, protective clothing, and spending a majority of our time indoors. And, it's difficult to get enough Vitamin D from diet alone. Moreover, many women have genetic variations that predispose them to lower levels of Vitamin D.
We suggest supplementing with at least 4,000 IU of Vitamin D3. Additional supplementation on top of your prenatal is often necessary, as most prenatals contain at most 2,000 IUs.* D3 is recommended over D2, as it is the more effective form. One of the roles of Vitamin D3 is to increase calcium absorption from the gastrointestinal tract. Vitamin K2 should be consumed alongside of Vitamin D3 in order to direct the calcium deposition into the bones and teeth, rather than in the arteries or kidneys. Vitamin K2 is found in organ meats, dairy products, and some animal products, but many aren't achieving the recommended daily amount of 90 mcg in diet alone.
*Most prenatal supplements will have 2,000 IU of Vitamin D3 at most due to caution around the fact that it is a fat soluble nutrient and therefore can be hard for your body to eliminate. Through research and clinical practice of our practitioner partners we do not think 2,000 IU is enough. 4,000 IU is a highly safe, and more effective, dosage. A 2011 well designed placebo and randomized controlled study on Vitamin D3 supplementation in pregnant women evaluated this dose. At 4,000 IU per day 82% of women reached proper blood levels of vitamin D and no participants had side effects of excessive blood levels of Vitamin D3. In addition, women taking 4,000 IU had far lower rates of pregnancy complications compared to those taking a lower dose. However, additional Vitamin D3 beyond 4,000 IU may be required for some women whose levels are especially low.
3. Vitamin C
Vitamin C gets a lot of attention for its role in supporting immunity--and for good reason.
Supplementing with Vitamin C has been shown to help prevent and treat respiratory and other infections, as well as to support regulating overall immune response. Food is not always a reliable source of Vitamin C-- it degrades quickly after produce is picked and substantial amounts are lost in cooking.
We suggest supplementing with 500mg of Vitamin C. Achieving this level will often require an additional supplement on top of your prenatal vitamin. (most have <100mg but our Prenatal Multi includes 300mg) Ascorbic acid is the main form of Vitamin C found in supplements and naturally in fruit and other foods.
4. Omega-3 (DHA + EPA)
Omega-3 promotes a healthy immune response. Omega-3 is required for healthy cell membrane formation of all immune cells. Omega-3 enhances the function of many immune cells including B cells, a type of white blood cell, critical to fighting bacteria and viruses. And, Omega-3 helps reduce the synthesis of proinflammatory molecules, thereby supporting healthy inflammatory levels. (Inflammation is the response of your body's immune system to injuries and harmful things that enter your body.)*
Related Reading: Omega-3 postpartum benefits
Yet, up to 95% of women of childbearing age are failing to meet their needs for this fundamental nutrient.
We suggest supplementing with our Prenatal Omega-3+. It’s clinically proven to be 5x better absorbed and delivered with other needed nutrients like Choline.
5. Zinc and Copper
Zinc plays a central role in your immune system. It is critical for everything from the normal development and function of cells that make up your innate immunity, your initial immune response, to the growth and development of T and B cells, the white blood cells that make up your adaptive, or secondary immune response. Zinc also functions as an antioxidant and supports the membrane structure of immune cells.
It’s estimated that over 80% of pregnant women have insufficient Zinc intake. Zinc is found in meat, oysters and other seafood, eggs, and many seeds, nuts, and legumes. However many of the plant based sources have phytates that limit absorption. The body does not store Zinc, so you need to consume it daily.
We recommend confirming that your prenatal supplement contains at least 15 mg of Zinc, yet more may provide further benefit. Supplementation with up to 50 mg of zinc during pregnancy has been studied and believed to be safe and effective in supporting the immune response in pregnancy. Taking higher doses of zinc can deplete copper, so it’s helpful to ensure you are getting both at a ratio of Zinc to Copper between 15:1 and 25:1.
Related Reading: Innate Immunity vs. Adaptive Immunity
Our 3 Runners-Up:
As nutrition nerds, we can't help but mention our next 3 "runner-up" supplement recommendations for supporting prenatal immunity.
1. Ginger
Ginger is the most well-studied herb used during pregnancy. Ginger is a strong antioxidant and promotes a healthy immune response.
We suggest taking fresh ginger, ginger tea, and supplementing with up to 250mg of ginger concentrated ginger extract every 6 hours.
2. Probiotics and Gut Health
It’s estimated that up to 80% of your immune system is actually located in your gut, and the health of your immune function is directly related to the bacteria that reside inside. Your gut microbiome is directly affected by what you eat. Generally good bacteria thrive off complex starch plant-based foods and pathogenic bacteria thrive off high-sugar foods. Fermented and probiotic rich foods like yogurt, kimchi, sauerkraut and kombucha are great additions, but they are often not enough to give you the target strains needed to support immunity.
We recommend supplementing with a probiotic during pregnancy that has multiple strains of Lactobacillus (including Lactobacillus rhamnosus and Lactobacillus reuteri) and Bifidobacterium, in a dose between 30-80 billion CFU (colony-forming units). (Check out our pre and probiotic capsules specifically tailored to pregnancy!)
3. Collagen Protein
Protein needs during pregnancy are higher and sufficient intake is critical. All proteins are made up of one or more chains of amino acids. Amino acids are involved in immune response including for the synthesis of antibodies. Amino acids have been delivered to hospital patients through feeding tubes for 50+ years to regenerate their immune systems by triggering new immune system cell growth.
Different types of proteins have different amino acid compositions. Collagen contains the amino acids glycine, proline, and arginine which can be difficult to get enough of from other protein sources, and all are important components of properly supporting your immune system.
To optimize your immunity, we recommend supplementing with 15g of hydrolyzed bovine collagen like our Collagen Protein.
Frequently Asked Questions
Which nutrients support immune health during pregnancy?
Five nutrients form the core of pregnancy-safe immune support: vitamin A (as retinyl palmitate), vitamin D3, vitamin C, omega-3, and zinc. Ginger, probiotics, and collagen are useful additions. Each targets a deficiency that's common in pregnancy, and all are safe at the amounts Needed's practitioner community recommends. Always check in with your healthcare provider if you have any questions on supplements or ingredients.
Is retinyl palmitate (vitamin A) safe during pregnancy?
Retinyl palmitate is safe during pregnancy in appropriate amounts, and around 600 mcg is a reasonable target. Because roughly half of women carry a genetic variation that blocks conversion of beta carotene, the active retinyl palmitate form is often more usable. The WHO sets the upper limit at 10,000 IU (3,000 mcg) per day of the active form.
How much vitamin D should I take during pregnancy?
Many practitioners suggest at least 4,000 IU of vitamin D3 daily during pregnancy, paired with 90 mcg of vitamin K2. Over 50% of women are deficient, and most prenatals contain at most 2,000 IU — so a standalone D3 supplement is often needed alongside a prenatal.
How much vitamin C is recommended during pregnancy?
A target of 500 mg of vitamin C daily is common during pregnancy. Most prenatals include under 100 mg, so an additional supplement is usually needed to reach that amount. Always check in with your healthcare provider if you have any questions on supplements or ingredients.
Is zinc safe to take during pregnancy?
Zinc is safe during pregnancy and important for immune function, with 15 mg a common minimum target. Always check in with your healthcare provider if you have any questions on supplements or ingredients.
Is ginger safe during pregnancy?
Ginger is the most well-studied herb used during pregnancy and is considered safe in moderate amounts in normal pregnancy. Always check in with your healthcare provider if you have any questions on supplements or ingredients.
The Bottom Line
Immune support during pregnancy comes down to closing the gaps most prenatals leave open. Vitamin A as retinyl palmitate (around 600 mcg), vitamin D3 (4,000 IU with 90 mcg of K2), vitamin C (500 mg), omega-3, and zinc (15 mg, balanced with copper) are the five nutrients our practitioner community returns to most — each one addressing a deficiency that's common in pregnancy, and each safe at these amounts. Ginger, probiotics, and collagen round out the list.
The practical next step is to check your current prenatal against these amounts. Most fall short on at least one — often vitamin C or vitamin D — which is where a standalone supplement earns its place. As always, review any changes with your practitioner, who can tailor these recommendations to your labs and your stage of pregnancy.
*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.
