Proper nutrition is essential during pregnancy and breastfeeding. Unfortunately, morning sickness, time constraints, and exhaustion often make this a difficult goal. In this section I will cover some ways to better your nutrition to give your child the best possible outcome.
Disclaimer: we have no affiliation with any product we recommend on this website. Our recommendations are based on our research and personal experiences with various products.
Everyone is already aware of prenatal vitamins. The primary reason why they are so important is folic acid: the CDC “urges all women of reproductive age to take 400 micrograms (mcg) of folic acid each day, in addition to consuming food with folate from a varied diet, to help prevent some major birth defects of the baby’s brain (anencephaly) and spine (spina bifida).” There are many prenatal vitamins on the market with varying levels of nutrients, varying quality of ingredients, and varying levels of bioavailability.
I generally recommend a two-tier approach to prenatal supplementation. Step one is for women of childbearing age who might become pregnant (if you start supplementing when you discover your pregnancy it may be too late!):
Nature Made Prenatal + DHA Softgels: ~$23/150 count (1 per day).
These offer a balance of low cost, acceptable bioavailability, and product availability (massive bottles can be found at retailers like Costco for less than they are sold for on Amazon!).
Step two is for women who believe they are pregnant or have tested positive:
Zahler Mighty-Mini Prenatal + DHA: ~$30/90 count (1 per day).
These are slightly more expensive, but they offer much greater bioavailibility and ingredient quality than the Nature-Made vitamins. These are rarely available in brick and mortar stores, but worth every penny to order. An added benefit of these vitamins is that they truly are “mini”: when you’re gagging due to morning sickness, the last thing you’ll want to do is choke down a giant horse-pill (or three!).
Omega-3 Fatty Acids
There are many sources of omega-3 fatty acids on the market. These vary in their levels of heavy metal content (be warned: many attest to purity levels that private testing prove to be incorrect!). The typical American diet is greatly lacking in omega-3 fatty acids. These fatty acids—found in highest quantities in fish—are critically important in the neurological development of your child, and are also used in the production of breast milk and important hormones related to pregnancy maintenance and childbirth. Research has confirmed that supplementation of omega-3 fatty acids has a positive effect on the visual and cognitive developments of babies, and is linked to a reduction in allergies in infants. Furthermore, omega-3 fatty acids have been shown to reduce the risk of pre-term labor and delivery, preeclampsia, and post-partum depression.
It should be noted that “vegetarian” sources of omega-3 fatty acids (such as flaxseed) contain ALA, as opposed to the EPA and DHA that have been proven to have these beneficial effects. Fish and other seafood sources are the best source of EPA and DHA available. IT is recommended that adult women take 500 mg of EPA/DHA daily (minimum 220 mg EPA, 220 mg DHA). Pregnant and lactating women should increase their daily DHA intake to 300 mg per day.
Most straight fish-oil products taste revolting, and often have heavy metal contamination. Of encapsulated/gelcap products, many cause “fish burps” which women find unpleasant or are extremely large and hard to swallow. Our recommended product for omega-3 supplementation is as follows:
NatureMyst SuperiorRed Krill Oil 1250 mg: $16/60 count (2 per day).
These provide 339 mg EPA and 202 mg DHA per 2 gelcap serving and are small and easy to swallow even when nauseous. The additional DHA per the above recommendation? That comes from the mighty-mini vitamin. You’re all covered!
This may be something you haven’t heard of before. Every cell in your body is enveloped in a cell membrane made out of what are known as phospholipids. This goes for your child, as well, and in no cells are there higher demands for phospholipids than in their nervous system, where some of the individual cells stretch from their brain to far-flung areas of their bodies. Phospholipids are made up of two fatty acid tails, and a head made up of a phosphate group and a choline molecule. Studies have shown that in the US, the majority of the population (over 94% of women!) achieve adequate choline intake through their diet, and choline demands rise dramatically during pregnancy and breastfeeding.
Studies have correlated maternal choline supplementation with increased childhood intelligence, lower risk of mental illness, and lower risk of neurological impairment.
Not all choline is made equal, however, and understanding the differences between them can help you save money while providing greater nutritional support to your child. The most common (and cheapest) form of choline is choline bitartrate, a fishy-smelling powder that is often found encapsulated. Generally speaking, 50% of the supplement weight is actual choline ion, so if you are seeking to supplement 450 mg (the general evidence-based recommendation), you would need to take two 500 mg capsules of choline bitartrate. Choline citrate is another option, though is much harder to find and about 50% more expensive than choline bitartrate. Choline citrate has a citrus flavor, and powdered choline citrate can easily be mixed into orange juice or Tang, sparing you from swallowing capsules.
Choline supplements such as CDP choline and Alpha-GPC should be avoided. These supplements are not only expensive, but are designed specifically to deposit choline in the brain. Citicoline has additional pharmacological effects that should be avoided during pregnancy! These supplements are generally used by individuals to enhance their memory and alertness while pregnant and breastfeeding women are looking specifically for nutritional support.
Morning sickness (a misnomer, as it can occur at any time—or all times!—during the day) can become a barrier to women getting proper nutrition, particularly during the first trimester when many vitamins and nutrients are critical for their children’s early brain development. There is as much advice on how to deal with this problem as there have been pregnant women: this was our preferred solution.
Each day upon waking we would make a shake containing 1 cup milk, 1/4 cup 5% fat Fage greek yogurt, 1/2 cup frozen blueberries, 1 large banana, 30g hydrolyzed whey protein, 15g micellar casein protein, and a pint of water in a blender. This was provided at the bedside each morning in three large glasses, and proved to stabilize nausea. Since the shake is designed to be quickly absorbed and quickly moved through the stomach, most of the nutrients are maintained even if some of it is later “lost” once you get up.
If you go this route, we recommend you use a source of protein powder such as True Nutrition. Most sources of protein powder are packed with fillers, undesirable protein sources such as soy isolate, preservatives, and have untested amounts of heavy metals. True Nutrition, and many other services catering primarily to bodybuilders, generally have excellent track records for product testing and quality, and often are significantly less expensive than other sources. In our experience, a ~$65 supply of the powders in the recipe above (3 Kg hydrolyzed whey, 1 Kg micillar casein) is an ample supply for the first trimester when it is useful. We recommend you do not add flavor to the powder (it’s unnecessary and often tastes awful).