Sarah Remmer: The Non-Diet Dietitian


How To Choose The Best Prenatal Multivitamin

Be pro-active with your health prior to pregnancy—know what to look for in a prenatal multivitamin

Be pro-active with your health prior to pregnancy and look for these seven things in your pre-natal multivitamin.

During the months leading up to conception, make sure that your body is primed to grow a healthy, thriving baby. There are a few things that you'll want to consider before trying to conceive. Reaching a comfortable and healthy weight for you, making sure that your diet is healthy and balanced for the most part, and including some enjoyable physical activity into your routine (if you haven't already) are all important goals to have in mind when you start getting "baby fever." 

While improving your nutrition at ANY stage of pregnancy is great (research suggests that an expectant Mother’s eating habits directly effect her baby’s health and food preference during infancy and beyond), it’s better to start adopting healthy habits before a positive pregnancy test. 

What’s most important is that you’re eating healthfully most of the time, making sure to include lean sources of protein, calcium-rich foods, whole grains, veggies and fruits in your diet (with a treat here and there, of course). But because your nutrient requirements increase during pregnancy, it’s important that you start taking a prenatal multivitamin before you become pregnant to fill any nutritional gaps. Even if you are a very healthy eater, it’s nearly impossible to meet all of your requirements with food alone. This doesn’t mean that you have to go out and spend a lot of money on expensive vitamins from the health food store. In fact, I often suggest against buying these (they tend to provide too much or too little of the important nutrients that you need during pregnancy and at times are not government regulated) and instead, opt for a good quality pre-natal multivitamin from your local pharmacy (or one that your Doctor has prescribed). 

Here’s what to look for in a pre-natal multivitamin:

Folic Acid:

Folic acid is the synthetic version of folate, a B vitamin naturally found in foods like lentils, beans, and leafy greens. Because it is difficult to get enough folate naturally in your diet (especially in the first few months due to potential nausea), it's important to ensure that your multivitamin contains enough (which most do). Folic acid is extremely important to help protect your baby against neural tube defects (which turn into brain and spinal cord defects) in those first days and weeks after conception when many women are not aware that they are pregnant yet and is essential to normal development of the spine, brain and skull of the fetus. Unless you've previously had a baby with a neural tube defect, or your Doctor suggests that you take a higher dose of folic acid, what’s recommended is 400-1000 micrograms (mcg) per day.


Iron is an important mineral, especially during pregnancy, that is naturally found in meats, poultry, fish, eggs, beans, lentils, and some vegetables. It plays an important role in transporting oxygen throughout your body and it also helps to reduce your risk of pre-term birth as well as low birth weight. When you become pregnant, your iron needs triple (think about all of that extra blood that you have circulating in your body!). It’s hard to obtain this extra iron from diet alone, so what’s recommended is 16-20 mg per day (many prenatal multivitamins contain 27 mg, which is ok). If you notice that you're unusually tired and weak, you may have low iron (iron-deficiency anemia), which is not uncommon during pregnancy due to the huge increase in blood volume that occurs. Your Doctor, Dietitian, or Midwife may recommend an additional Iron supplement in this case. 


Milk, yogurt and cheese are the gold standards when it comes to calcium content, but you can also obtain it from canned salmon (with the soft bones), sardines, anchovies, certain vegetables such as spinach and collard greens, almonds and molasses. It's important that you're consuming 1000 mg of calcium per day through diet and/or supplement form, not only to support your own bone health, but also to help to build strong, healthy bones and teeth for your baby. Most prenatal multivitamins only contain about 250-300 mg of calcium, therefore will not support all of your calcium needs. That why it’s important that you’re also including calcium-rich foods in your diet (about two to three servings a day). 

Vitamin D: 

Make sure that your multivitamin contains extra vitamin D (most contain 200-400 International Units).  Vitamin D helps with calcium absorption which is essential for bone health. It also helps to prevent Rickets (which can lead to birth deformities), delays in physical development and abnormal bone growth. If you’re lacking vitamin D during pregnancy, your baby may fall short of the vitamin at birth. The Dietary Recommended Intake (DRI) of Vitamin D for pregnant and breastfeeding women in Canada is 600 IU per day (I usually recommend 1000 IUs per day though). Make sure to top up with an additional vitamin D3 supplement if your prenatal vitamin does not supply this amount and if you aren't getting enough vitamin D in your diet. You can find dietary sources of vitamin D in cow's milk, fortified milk alternatives, eggs yolks, red meat and many kinds of fish.

Don’t overdose in Vitamin A: 

You also want to make sure that you’re not getting too much of any nutrient. More specifically, you don’t want to overdose on vitamin A, because it may cause birth defects in your baby. Limit your vitamin A supplementation to no more than 5000 IUs per day. Most regulated prenatal multivitamins will not exceed this amount.

Omega 3

Prenatal multivitamins typically do not include omega 3 fatty acids, but it's important to make sure that you're getting enough prior to and during pregnancy, as your requirements are higher. During pregnancy, omega-3 fatty acids travel through the placenta to your baby to help grow his or her brain and tissues. The best way to ensure you're getting enough, is to consume at least two standard servings (three ounces cooked is a serving) of fatty, low-mercury fish per week such as salmon, canned light flaked tuna, or trout. If you don't like fish, you should consider taking an omega-3 supplement. 

Make sure that your supplement is government-regulated: 

Look for proof of government regulation on your prenatal multivitamin container. You should notice an NPN# or NHP# (natural health product number). This basically means that your supplement contains what it says it contains, it is in a safe dose if taken as directed and is of high quality. It also means that the supplement has also been tested for things like heavy metals (in the case of fish oil supplements), pesticides, and toxins. 

If you found this post helpful, you may also want to learn what The Six Most Important Nutrients For a Healthy Pregnancy are as well as How To Manage Pregnancy-Related Digestive Issues