1. Charge Up the Calcium
Calcium is a mineral that deserves
special attention throughout a woman’s life, especially when it comes to
pregnancy. Calcium is important to strong bones and teeth, a healthy
heart, nerves, and muscles, and the development of normal heart rhythm
and blood-clotting abilities. Not consuming enough calcium and/or not
having good calcium stores will force the baby to use calcium from your
own bones. Consuming plenty of calcium before, during, and after
pregnancy can also help to reduce your risk for osteoporosis, or brittle
bone disease, later in life.
Intake Requirements
Whether pregnant or not, calcium
needs for teens (age fourteen to eighteen) is 1,300 milligrams (mg) and
1,000 mg for woman nineteen to fifty. Women older than fifty need 1,200
mg of calcium daily. The tolerable upper intake level for calcium is
2,500 mg daily.
The easiest way to get all the
calcium you need is to eat at least two to three servings of low-fat or
fat-free dairy foods each day. Other sources include green leafy
vegetables, calcium-fortified orange juice, calcium-fortified soy milk,
fish with edible bones, and tofu made with calcium sulfate. Reading the
nutrition facts panel (included on all packaged foods) is a great way to
spot calcium-rich foods. The amount on the panel is presented in terms
of “% Daily Value,” which is an approximation of the percentage of your
day’s calcium need supplied by one serving of that food.
Most prenatal supplements do not
provide all of the calcium you need daily. You may need to take a
calcium supplement, especially if you are not a milk drinker, are a
strict vegetarian, or are lactose intolerant. There are all types of
calcium supplements on the market today. Ideally, a calcium supplement
should also contain vitamin D for maximum absorption to occur.
Elemental Calcium
In a discussion of the amount of
calcium in supplements, it is important to understand the concept of
elemental calcium. Calcium occurs in combination with other substances,
forming compounds such as calcium carbonate, calcium phosphate, or
calcium citrate. What is really important is the “elemental” calcium, or
the actual amount of calcium in the compound. Some compounds contain
more elemental calcium than others. For instance, a calcium supplement
made from calcium carbonate might have 625 mg in each tablet, but the
amount of elemental calcium in each tablet is about 250 mg. When looking
for a calcium supplement, be sure to read the label carefully. Ideally,
the label will list how much elemental calcium is in each tablet. If
the label does not state elemental calcium, you can figure it out with
the following chart. Elemental calcium accounts for these percentages of
the following compounds:
• 40 percent of calcium carbonate
• 21 percent of calcium citrate
• 13 percent of calcium lactate
• 9 percent of calcium gluconate
How to Take Calcium Supplements
Supplements that contain calcium
citrate can be taken with or without food, whereas calcium carbonate
should be taken with food for optimal absorption. Many antacids, such as
Tums, contain calcium carbonate, which may be a more convenient and
less expensive way to take your calcium. If you prefer a chewable pill,
products such as Viactiv can be a good choice. Avoid the natural-source
calcium pills, such as those produced from oyster shell, dolomite, or
bone meal. These supplements may contain lead or other toxic metals.
When taking calcium supplements, it is best to take smaller amounts
several times a day for the best absorption. If you are taking a calcium
supplement and an iron supplement or a supplement with iron in it, take
them at different times of the day. They will each be better absorbed
alone.
Regular
exercise can have many healthy benefits for pregnant women, including
making the birthing process easier. It is a good idea to start an
exercise program before you become pregnant. This will give you time to
adjust and will help get your body ready for pregnancy. Women who are
already exercising before pregnancy can continue to do so, but they may
need to decrease the intensity. Women who are not exercising before
pregnancy can start, but they must start very slowly and should consult
their doctor first. Talk to your doctor about the amount of exercise
that is safe for you.
2. Pump Up the Iron
Iron is another essential mineral
that merits special attention as part of your diet before and during
pregnancy. Iron is essential to the formation of healthy red blood
cells, which are responsible for carrying oxygen through your blood to
the cells of your body. Almost two-thirds of the iron in your body is
found in hemoglobin, the protein in red blood cells that carries oxygen
to your body’s tissues. The increase in blood volume that takes place
during pregnancy greatly increases a woman’s need for iron. If you do
not get enough iron and/or do not have adequate iron stores, the growing
baby will take it at your expense. Iron deficiency during pregnancy can
cause anemia, extreme fatigue, a low birth-weight baby, and other
potential problems. The greater your iron stores before you become
pregnant, the better iron will be absorbed during pregnancy.
Intake Requirements
It is very difficult to get enough
iron from foods alone. Most multi-vitamin/ mineral supplements and/or
prenatal vitamin supplements will provide you with your pre-pregnancy
needs of 18 mg per day. If you have anemia before becoming pregnant,
your doctor may prescribe a much larger dose. During pregnancy, your
iron requirement climbs to 27 mg per day.
Again, as
with many other vitamin and minerals, too much iron is not always best.
Iron has a tolerable upper intake level of 45 mg. Foods that supply iron
include meat, poultry, fish, legumes, and whole-grain and enriched
grain products. Iron from plant sources (or “nonheme iron”) is not as
easily absorbed as that from animal sources (or “heme iron”).
Supplementing your meals with a food or beverage rich in vitamin C, such
as citrus fruits or juices, broccoli, tomatoes, or kiwi, will help your
body better absorb the iron in the foods you consume. The absorption of
iron from supplements is best absorbed on an empty stomach or when
swallowed with juice containing vitamin C.
3. The Scoop on Prenatal Vitamins
Prenatal supplements (PNVs) are
specialized vitamin and mineral supplements that women can take even
before pregnancy to get all of the essential nutrients they need during
pregnancy. Studies have shown that the use of prenatal supplements
before and throughout pregnancy can benefit a healthy baby.
Vitamins and minerals should never
replace a healthy diet. They are only meant to supplement a healthy
diet, not take the place of any one food or any food group. Foods
contain hundreds of vitamins, minerals, and phytonutrients. Only food
supplies the ideal mixture of these substances that are essential for
optimal health. Supplements can provide you with insurance that you will
receive everything you need, but they cannot do the entire job.
Prenatal vitamins come in many
formulations. Most PNV are distributed as samples to physician’s
offices, and it is a good idea to try multiple samples because some have
stool softeners and other binders, which you may or may not tolerate.
Finding one that you can tolerate will make it easier to take and
therefore easier to remember to take it daily.
The Ideal Prenatal Vitamin
The components all PNV supplements
should have in common are folic acid, iron, and calcium. Most PNVs have
only 100 to 250 mg of calcium— women need 1,000 to 1,200 mg daily, so
you should also take a separate calcium supplement. Except for calcium,
you should never take any additional supplements with your prenatal
supplement unless they are prescribed by your doctor. Since some
over-the-counter supplements contain too-high levels of vitamins and
minerals, it may be smarter to use a supplement such as a PNV that has
been specifically formulated for pregnant women and/or women trying to
conceive. PNVs are not recommended postpartum unless the mother is
considered to be at “nutritional risk.” Some women can benefit from
taking prenatal vitamins postpartum if they plan to become pregnant in
less than one year, but most experts recommend spacing pregnancy by at
least one year.
Who Should Take Supplements?
If you are a healthy woman who eats a
well-balanced diet and has no risk factors, your doctor may not feel
that you need to take a prenatal supplement. This is something that you
need to discuss with your doctor so together you can determine what is
right for you. No matter how healthily you eat, it is generally
difficult to get what you need each and every day, especially while
pregnant or trying to conceive, so a prenatal supplement can act as
insurance. All doctors do agree that a folic acid supplement is
necessary.
Women who have a history of poor
eating habits, who are on a restricted diet such as a vegan diet, or who
require a specific nutrient due to an existing medical condition will
definitely need to take some type of supplement.
Women who are expecting more than
one baby or have closely spaced pregnancies will need extra iron and may
require additional vitamin and mineral supplementation. Nourishing two
babies demands more from your body and therefore requires more
nutrients. After pregnancy, your body may be depleted of some nutrients.
If you are planning to become pregnant again soon, you may need special
supplements to restore those nutrients. Speak to your doctor before
starting any supplement program.
Are Your Prenatals Making You Sick?
Many women
have trouble taking prenatal vitamins once they become pregnant because
the iron content can exacerbate morning sickness. They are also known to
cause constipation and gas. If you are having problems, try taking your
prenatal vitamins with food or taking them right before bedtime. Also
drink plenty of water and include plenty of fiber in your diet. If that
doesn’t work, talk to your doctor about trying a different brand or
switching to a prenatal supplement without iron for the first trimester.
Many times these problems only last for the first trimester. In the
meantime, make certain your prenatal contains vitamin B6.
This vitamin has been found to help relieve nausea in some women during
pregnancy, a common discomfort during the first trimester.
