Women need a variety of nutrients both before they get pregnant and during pregnancy and lactation. But three to pay attention to are folic acid, vitamin D, and docosahexaenoic acid (DHA), an omega-3 fatty acid.
Folic acid is also known as vitamin B9. It’s important in preventing neural tube defects such as spina bifida and macrocytic anemia. These conditions can develop early in pregnancy, before a woman even knows she’s pregnant. That’s why all women of childbearing age, whether pregnant or not, should make folic acid part of their diet.
Here are guidelines on getting enough folic acid:
- Even before pregnancy, women should get 400 micrograms (mcg) of folic acid per day.
- During pregnancy, women should get 600 to 800 mcg of folic acid per day.
- During breastfeeding, women should get 500 mcg of folic acid per day.
- Women at high risk should get 4,000 mcg (4 mg) of folic acid per day.
The many dietary sources of folic acid include the following:
- half-cup lentils: 179 mcg
- half-cup spinach or asparagus: 130 mcg
- one ounce cold cereal: 100 to 400 mcg
- half-cup oatmeal: 80 mcg
- half-cup peas: 50 mcg
- half-cup broccoli: 39 mcg
- one slice of enriched bread: 37 mcg
- half-cup orange juice: 37 mcg
- one cup strawberries: 26 mcg
Vitamin D deficiency and insufficiency are widespread among pregnant women. The National Academy of Medicine (NAM) (formerly the Institute of Medicine) estimates that 5 to 29 percent of pregnant women don’t consume enough vitamin D. For pregnant women, this is important because vitamin D may protect against preeclampsia. It also may inhibit diabetes and infectious disease.
NAM recommends that during pregnancy and lactation, women get at least 600 international units (IUs) per day of vitamin D. (One report from the American Academy of Pediatrics suggests that a higher intake than that may be needed to maintain mothers’ vitamin D sufficiency.) Experts agree that supplemental vitamin D is safe in dosages up to 4,000 IUs per day during pregnancy or lactation.
Vitamin D is produced by the human body in response to sunlight. Unfortunately, the reality of sunburns and skin cancer make sunlight a risky source. There are a few natural dietary sources of vitamin D. But given their limited number, most Americans must satisfy their vitamin D needs by eating or drinking foods fortified with it or by taking supplements.
Here are a few of the vitamin D–rich and vitamin D–enriched foods identified by the National Institutes of Health:
- cod liver oil, 1 tablespoon: 1,360 IUs
- swordfish, cooked, 3 ounces: 566 IUs
- salmon (sockeye), cooked, 3 ounces: 447 IUs
- tuna fish, canned in water, drained, 3 ounces: 154 IUs
- orange juice fortified with vitamin D, 1 cup (check product labels, as amount of added vitamin D varies): 137 IUs
- milk, vitamin D–fortified, 1 cup: 115 to 124 IUs
- margarine, fortified, 1 tablespoon: 60 IUs
The omega-3 fatty acid DHA has several health benefits, including these:
- Benefits for mothers: Prevention and/or management of perinatal depression, increase in gestational length and therefore potential reduction in preterm birth, and improved DHA content of breast milk
- Benefits for babies: Improved visual acuity; enhanced cognitive development leading to stronger motor, social, and communication skills and higher IQ; and possibly lower body fat in infancy and childhood
Fish is a rich source of DHA. The U.S. Department of Agriculture’s (USDA’s) dietary guidelines recommend seafood for women who are pregnant or breastfeeding, as follows:
- Consume 8–12 ounces of seafood each week from a variety of types.
- Limit albacore (white) tuna to 6 ounces or less per week.
- Don’t eat shark, swordfish, king mackerel, or tile fish.
Women who can’t (or don’t wish to) eat fish can take supplements: 200 milligrams (mg) of DHA per day during pregnancy is recommended. Up to 2,700 mg of omega-3 fatty acids (920 mg DHA and 1,300 mg of eicosapentaenoic acid, or EPA) has been used safely.