Are prenatal supplements really necessary in this day and age? It is a conundrum I have debated back and forth over the past several years since I began following the tenets of the Weston A. Price Foundation. While the foundation recommends that pregnant women obtain all their nutrients from food alone, it has been my own experience, as well as knowledge on the modern world, that I have come to the conclusion that taking prenatals are necessary.
My motivation for writing this post was the miscarriage I experience during the summer of 2018. After it had occurred and despite the reassurances of my obstetrician, when I questioned the possibility that my lack of prenatal use was not a contributor to the event, I began researching the available evidence on the necessity of certain vitamins and minerals needed during pregnancy. From what I gathered, not only are certain vitamins and minerals extremely necessary, but they are also very difficult to incorporate even with a fortified Weston A. Price diet. I am currently pregnant again, and in addition to a hormone fortifying protocol I am following a strict prenatal intake regimen to ensure that I will not miscarry again.
For clarification, the Weston A. Price Foundation recommends the following items in the list below.
Diet for Pregnant and Nursing Mothers
“Cod Liver Oil to supply 20,000 IU vitamin A and 2000 IU vitamin D per day, which is provided by 2 teaspoons high vitamin cod liver oil.
1 quart (or 32 ounces) whole milk daily, preferably raw and from pasture-fed cows
4 tablespoons butter daily, preferably from pasture-fed cows
2 or more eggs daily, preferably from pastured chickens
Additional egg yolks daily, added to smoothies, salad dressings, scrambled eggs, etc.
3-4 ounces fresh liver, once or twice per week
Fresh seafood, 2-4 times per week, particularly wild salmon, shellfish and fish eggs
Fresh beef or lamb daily, always consumed with the fat
Oily fish or lard daily, for vitamin D
2 tablespoons coconut oil daily, used in cooking or smoothies, etc.
Lacto-fermented condiments and beverages
Bone broths used in soups, stews and sauces
Soaked whole grains
Fresh vegetables and fruits”
At first glance it is easy to see why many women complain about the exorbitant amount of food listed above. I can personally attest to this. Even when not suffering from morning sickness, I found it difficult to eat this much food in one day. It is worth noting that I do not restrict my calories. I let my stomach be my guide for how much food I should eat. In that respect, I would like to discuss why getting enough nutrients into our bodies, while we are pregnant, is very difficult through food alone and why prenatals are necessary to take in our modern world.
One obvious reason why pregnant women need to take prenatals is because the soil, in which we grow our food, is depleted. Due to modern agricultural practices, the plants we grow to consume have far less nutrients than they did decades ago (Source). Since we have an increased need for nutrients during pregnancy, nutrient deficient foods impede the healthy development of a growing baby.
Most of us are aware that folate is a critical nutrient during pregnancy. A deficiency in folate can lead to a condition known as spina bifida, a disorder that affects the spine. However, I have recently learned that folate affects much more than spinal cord development. Consuming an adequate amount of folate, during pregnancy, prevents neural tube defects, which are neurological conditions. In addition to these birth defects, consuming enough folate before and during pregnancy can prevent tongue/lip ties and cleft lip/palate.
Dr. Ben Lynch’s website has a ton of great information on the MTHFR gene mutation. People with the MTHFR gene mutation have impaired methylation, a process that takes place in the metabolism of folate, hormones, neurotransmitters, and waste products.
In each of my pregnancies, I have experienced severe morning sickness. For a while, I was unable to consume many of the nutrient dense foods in the Weston A. Price Foundation’s dietary recommendations for pregnant women. Many of those foods made me ill to even think about, which is common with many pregnant women.
Even if you ate perfectly, or the way the Weston A. Price Foundation recommends before you conceived, you would not have a sufficient buildup of nutrient stores to get you through the first trimester (assuming you could only handle eating junk food or less nutrient dense food during that time).
I have not seen the Weston Price Foundation address this topic – what if a woman can’t eat all those nutrient dense stores much less keep it down? They do recommend getting to the root cause of morning sickness, but what if that takes weeks or even longer to resolve as in my case?
While I haven’t conducted any scientific studies on the diets of pregnant women, nor have I researched on the extent to which women intake enough nutrients from diet alone, most of my basic investigating has determined that your average woman is not ingesting all the nutrients she needs from a low protein, high carbohydrate diet. Many pregnant women who suffer from morning sickness report mainly being able to eat high carbohydrate or high sugar foods, which are not particularly nutrient dense. This is another reason that I believe that prenatals are necessary during pregnancy.
Even when I’m not pregnant and suffering from morning sickness, life can get in the way of my planning. I will not meal plan far enough in advance, and when it comes time for a meal sometimes, I am too tired to make the meal completely balanced.
Yes, for many meals I try to have a meat/fish with a vegetable and a starch, but sometimes I didn’t plan well enough. Other times I am too tired to cook and we get pizza, take out or go out to eat (we strive to eat at farm to table/real food restaurants in those instances). That food isn’t always balanced, especially if it is pizza, pasta or something starchy.
This is my realistic view of what happens on a daily or weekly basis in many peoples’ families. Sometimes you are simply too tired to make liver or other nutrient dense foods, especially when you are pregnant. This is yet another reason I think that prenatals are necessary for most pregnant women.
Some Nutrients Are Hard to Fit In
The following are the top nutrients I know that are hard to get into your diet on a regular basis.
The RDA or the Recommended Dietary Allowance of folate during pregnancy is 600 mcg according to the National Institute of Health (NIH). The top 3 sources they list for folate are beef liver (3 oz, 215 mcg), spinach (1/2 cup, 131 mcg) and black eyed peas (1/2 cup cooked, 105 mcg). There are a number of other foods listed with smaller amounts of folate, but after reading their chart, I realized just how difficult it would be to consume 600 + mcg of folate per day while pregnant.
I don’t know about you, but even when I am consuming organ meats on a regular basis, I don’t consume liver every day and certainly not 3 oz per day. You would have to eat at least a few cups of greens per day, plus liver, plus beans to get enough. This just isn’t realistic for me. I would recommend taking this prenatal along with these dessicated liver capsules (use my code healthbysarah for an extra 10% off).
I used to believe that only whole food sources for vitamins were acceptable, even in our modern world. However, I have read some of the research of Linus Pauling and Dr. Fred R. Klenner and I have come to believe that most people are not getting nearly enough Vitamin C in their diets.
The advice is to take Vitamin C, or ascorbic acid, to bowel tolerance. This means that continue to increase your dose of Vitamin C (whether you are well or sick) until you see loose stools. It is even safe to do so during pregnancy. In the FAQs of this website, it links to sources talking about the myth that Vitamin C can cause miscarriages (which it doesn’t).
When we are getting lots of sunshine, especially during the summer months, our bodies are most likely producing an adequate amount of Vitamin D. Because some people may have impaired absorption, it is important to work with your doctor or practitioner to see if your levels are adequate. However, those who live far away from the equator or have indoor jobs and do not get enough sunlight exposure, may have a hard time synthesizing Vitamin D.
The Weston A. Price Foundation has an article with a table of food sources for Vitamin D here. However, beware that the table shows the levels for cod liver oil taking 1 tablespoon daily, which I definitely don’t recommend. For adults, it is good to take about 1 teaspoon daily. This brand is very high quality along with this brand. Vitamin D can also be obtained through emu oil – this is the brand my family and I take.
The following foods contain higher amounts of Vitamin K2: goose liver, natto, dark chicken meat and hard cheeses. Goose liver and natto both have very high amounts of Vitamin K2. The problem is that those foods are not commonly eaten or found in our country and the last 2 I listed, you have to eat high amounts of them to get close to the daily recommended intake.
Vitamin K2 is important for heart, kidney, bone, dental and metabolic health along with cancer protection. Getting enough Vitamin K2 during pregnancy and throughout your child’s development can ensure that they have proper bone development and could prevent them from needing braces! This is the evidence Dr. Price found in the indigenous populations he studied eating plenty of fat soluble vitamins (A, D and K).
Emu oil is one of the highest sources of Vitamin K2 in the world. This is reason my family and I are supplementing with emu oil. This is the brand we use.
In an ideal world, we would live as our ancestors did by picking fresh foods from gardens, farms, and butchers each day. But as the world turned and modern western society moved away from rural settings, so did the way we obtained our food. People get their food from grocery stores, eat out at restaurants/fast food establishments. Modern living has traded farm fresh for scientifically preserved. This is further compounded by the fact that longevity has been the central focus of modern food science. Food sitting in refrigerators, freezers, or pantries for days, weeks, months or even years on end, depending on the product, has become the norm.
This norm ignores the established fact that food begins to lose nutrients soon after harvest. In this paper, nutrient stability of specific vitamins is discussed and mentions that Penn State researchers studied the effects of food storage on the nutrient content of fresh spinach. What they found was that the spinach only retained 53% of its folate content after 8 days.
Folate is one of the most important nutrients in fetal development, so we need to choose our food and supplements carefully for good prenatal health.
After much research, I have concluded that prenatals are necessary for the majority of women to take before, during and after their pregnancies to not only maintain optimal health for themselves, but for their babies.
The prenatal I have been taking for several months is Seeking Health. I have tried a number of prenatals and I didn’t take this one for a while simply because of the price. I am sorry I waited because it is the best one I have found out there. It not only has all the standard vitamins and minerals recommended in prenatals, but it has methylfolate, methylcobalmin, adenosylcobalamin, chromium, inositol, CoQ10, red raspberry leaf, ginger extract, milk thistle extract and betaine HCl among other nutrients.
Dr. Lynch talks about how his product has more than the minimum RDA of nutrients and how it goes above and beyond what is the minimum. For example, a daily serving has 200 mcg of selenium, which is very difficult to obtain in your diet. I was especially intrigued to try this prenatal because it was recommended by my doctor to supplement with 200 mcg of selenium daily to support my thyroid health (I had thyroiditis and hyperthyroidism after my miscarriage).
Since I believe prenatals are necessary to take for most women, I will not take the chance again of not supplementing. The following are my recommendations to take before, during and after pregnancy and what I am currently taking in my pregnancy. As always, be sure to check with your doctor first before adding or changing your supplementation.
- Cod Liver Oil
- Emu Oil
- Non-GMO Vitamin C (ascorbic acid) to bowel tolerance
- Dessicated liver capsules (use my code healthbysarah for an extra 10% off)