What to Look for in a Prenatal Vitamin (and Why Yours Isn't Cutting It)

Approximately 97% of women take a prenatal vitamin during pregnancy in the United States, yet 95%+ of us mamas are deficient in key nutrients. 

But, you can’t rely on just any old prenatal you find in a pharmacy or health food store. We’ve heard a majority of mamas say, “My OB-GYN said ‘take any prenatal, it doesn’t matter, just as long as it has folic acid.’” This is very incomplete, and often misleading advice.

Quality matters when it comes to your prenatal. And, unfortunately, the quality of most prenatal vitamins is subpar. Here, we break down at a high level, what to look for in a high quality prenatal. 

We couldn’t find a prenatal that fully met our needs, so we’ve spent the last 3 years designing one from the ground up. Leading up to launch, we’ll take a deeper dive into the specific nutrients, nutrient forms, and dosages to look for (and what to avoid!) in our Instagram series. We hope you’ll follow along, mama. 

What is a prenatal supplement? 

A prenatal is broadly used to describe a multivitamin and mineral supplement. They sometimes also include botanicals, Omega-3, and other nutrients. Beyond a Prenatal Multi, we also think it's important to supplement with Collagen Protein, a Pre/Probiotic, and an Omega-3 (if is not already in your prenatal as 80%+ of prenatals do contain Omega-3) to meet your needs before, during, and after pregnancy. (Yes, your prenatals should be started before and continued as postnatal vitamins to support optimal health throughout your entire mamahood journey!). 

What are the main things to look for in a prenatal supplement? 

At a high level, there are five main things to look for in a prenatal supplement: 

  1. Does it contain the nutrients your body can best absorb and use?
  2. Does it contain the right amount of those nutrients?
  3. Does it contain any unwanted additions?
  4. Can you trust that what it says on the label is actually in the supplement?
  5. Are you able to take it daily before, during, and after pregnancy? 

 What do you mean by, “the nutrients your body can best absorb and use”? 

When it comes to nutrients, many vitamins and minerals can have different molecular structures, or forms. The most optimal nutrients exist in the forms that work best in the body. Let’s use two nutrients as an example: 

First, magnesium during pregnancy is super supportive, and the mineral Magnesium can be found as Magnesium Glycinate or Magnesium Oxide, along with many others. We choose Magnesium Glycinate because the body is able to absorb and utilize it better than other magnesium forms. Magnesium Oxide, on the other hand, is so poorly absorbed that it can cause loose stools for many and inhibit the absorption of other nutrients. Yet, Magnesium Oxide is a cheap ingredient, so it is still used in many prenatals. (Mamas, if you need a little stool support, Magnesium Oxide could be a good option, just not in your prenatal or with a meal.)

The B Vitamin Folate can be found as Methylfolate and Folic Acid, along with other forms. We want to avoid Folic Acid and choose Methylfolate, which is the form readily usable by the body. 40% to 60% of women carry variants of the gene MTHFR that prevents the conversion of Folic Acid into Methylfolate. And for many, even those without the MTHFR gene variants, Folic Acid can be harmful. Folic acid bioaccumulates in the body and un-metabolized folic acid can be harmful - it “sits” in the body's folate receptors without properly activating them, potentially causing a folate deficiency.

In addition, in many cases an optimal nutrient needs other nutrients to work best in the body. A great example of this is Vitamins D3 and K2. Vitamins D3 and K3 are both the active forms of their respective nutrients. One of the roles of Vitamin D3 is to increase calcium absorption from the gastrointestinal tract. Vitamin K2 should be consumed alongside Vitamin D3 in order to direct the calcium deposition into the bones and teeth, rather than in the arteries or kidneys.

Are the nutrient forms that "your body can best absorb and use" naturally harvested or synthetic? 

It depends! At Needed, we take a “nature first” approach, believing that proper nutrition starts with nutrient forms found in nature. In our view, this does not only include nutrients sourced directly from plants, food, or other naturally harvested material. In some cases synthetic nutrients, meaning they are synthesized in a lab or through other commercial processing, can be the better choice. The synthetic nutrients we like we call “mindfully-made” are nutrients found in nature, meaning their molecular structure is not a man-made creation (not always the case in the supplements industry), that is made through high quality processing. These mindfully made nutrients can offset some of the downsides of naturally harvested nutrients including:  

  • Naturally harvested, especially plant-based, nutrients are often not in their active forms. Synthetic nutrients can be made in the form ready to be used by the body like Methylfolate mentioned above. 
  • Naturally harvested ingredients can often have other unwanted ingredients in them including toxic metals like arsenic, lead, or mercury. For this reason, we source our Omega-3 powder from sustainable microalgae grown in fermentation tanks, removing the exposure to heavy metals often found in Omega-3 sourced from fish. 
  • It can be challenging and wasteful to get high dosages of a specific nutrient when it is extracted from naturally harvested material. For example, there are considerable sustainability questions around the common vegan source of Vitamin D3, lichen. Lichen is a moss-like organism that exists as a composite of fungus and algae. It is an important part of the Arctic tundra ecosystem and grows "extremely slowly", less than a millimeter per year. For this reason, we prefer a “mind-fully made D3.”

How do I know what the right amount of a nutrient is? 

Getting the right dosage of a nutrient is important. Getting too little (or in some cases too much of a nutrient) can be detrimental. 

In our view, most prenatals do not supply enough of the nutrients that mama and baby truly need. 

This is due to a number of factors including: 

  1. Most prenatals are designed to meet minimum nutrient requirements to avoid fetal complications like spina bifida, not to optimally nourish mom (levels far too low). Read more about why Recommended Daily Allowances often aren’t enough.
  2. There are trade-offs between product quality and pleasantness of taking.
  3. OB-GYNs aren't informing their patients to demand different products, because they lack fundamental nutrition training.

At Needed, we select nutrient forms and dosages to fully nourish both mama and baby. In doing so, we think it’s important to also consider:

  1. Nutritional amounts available in food, i.e., what you are likely to get outside of a supplement
  2. Relevant peer reviewed, published research 
  3. The clinical practice of health practitioners who regularly test the nutrient levels of mamas and mamas-to-be
  4. The physiological mechanisms of nutrient usage, meaning how a particular nutrient form is actually used and stored by the body
  5. Traditional healing practices used across cultures for thousands of years 

What are unwanted additions?

As we have seen in other industries, such as the beauty industry, there are often “unwanted” additives, binding agents, fillers, chemicals, and processing agents, present in supplements. Some are intentionally added, while others are residual heavy metals and process contaminants or byproducts. Common additions to avoid include stearic acid, magnesium stearate, potassium sorbate, silicon dioxide, titanium dioxide, carrageenan, artificial colors and flavors, and corn maltodextrin.

Some of these are very difficult to avoid. As discussed earlier in the article, it’s potentially impossible to avoid heavy metals in many naturally harvested ingredients as they are now so prevalent in our environment. Though, many companies do make more of an effort than others to “clean-up” their supplements. 

Can you trust that what it says on the label is actually in the supplement?

Supplements do not require pre-market approval, meaning neither the FDA, nor any other government body, approves the launch of a new supplement. All supplements are required to be manufactured in accordance with FDA guidelines, the current Good Manufacturing Practices (cGMPs), which help ensure quality and safety. However, not all companies follow these guidelines. The FDA can go after any offenders, but they do not have capacity to chase down everyone. This is where consumers HAVE to trust the company behind the product. You cannot just assume that every product is equal, or assume that what is on the label is actually in the pill or powder (both to begin with and overtime with shelf-life stability). Third party testing helps. We also recommend that you contact the company to learn more about their products directly. We at Needed love hearing from you

Does the form of the supplement matter, i.e. pill vs. gummy vs. powder?

The form of the supplement may impact your ability to make a daily habit of taking a supplement. Unfortunately, there are often trade-offs between product quality and pleasantness of taking. In general, the tastier the product (e.g., gummy vitamin), the better the chance that it’s missing critical nutrients that it has dosages that are way too low. Two examples include: 

  1. Minerals are often missing or dosed very low in gummy vitamins as they don’t work well in a gummy matrix. 
  2. Choline is a nutrient where not a single prenatal meets the RDA. It is a “bulky” nutrient, meaning tons of pills. 

Especially during pregnancy, it’s important to find a product that both works in your body AND fits your daily life. We've designed our prenatal to do both.

When should I start taking prenatal supplements? 

It’s never too early to optimize your nutrition, but at a minimum, we recommend starting six months before conceiving. This will help you detoxify, support greater fertility and overall vitality, and build-up nutrient reserves to support a healthy pregnancy. This last point can be especially important as many serious birth defects originate in the first eight weeks of pregnancy when the baby’s organs are forming and when many mamas i) may not know they are pregnant yet, and ii) cannot stomach much of anything given first trimester nausea.

Okay I get it. I need a better Prenatal. Where can I find the optimal one for me?

When we were looking for a high quality prenatal, we researched hundreds of products and could not find one that fully met our needs (read what we are using in the meantime). 

So, we’ve spent the last 3 years designing one from the ground-up that optimally nourishes mamas, going well beyond meeting bare minimum requirements

In the meantime, take our quiz to learn if you are deficient in Omega-3, and check-out our Omega-3 tailored for a mama-to-be that’s 5x better absorbed than a standard pill.
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