Pregnancy vitamins: what to take and when (a UK guide)

The two you should be taking (NHS)

Start here. The NHS recommends both of these for everyone in pregnancy.

Folic acid, 400 micrograms a day, from before conception until the end of week 12. Taken at that intake, from at least a month before conception through the first trimester, folic acid raises maternal folate status, and low maternal folate status is a risk factor in the development of neural tube defects, such as spina bifida, in the developing foetus. Those first weeks are often before you even know you are pregnant, so the advice is to start when you begin trying. If your pregnancy was not planned, start as soon as you know. Some women are advised to take a higher 5 milligram dose, on a GP's prescription, if they have certain risk factors. Your midwife will tell you if that applies to you.

Vitamin D, 10 micrograms a day from early October to late March, in pregnancy and while breastfeeding. Take it all year if you are rarely outdoors or cover most of your skin when outside, and consider taking it all year if you have black or brown skin. Between October and March there is not enough sunlight in the UK to rely on your skin, so a daily supplement is the sensible route.

What a prenatal adds, and whether you need one

You do not have to take a pregnancy multivitamin. You can take folic acid and vitamin D on their own, and that covers the NHS recommendation. What a good prenatal adds is convenience and a few nutrients where a supplement can help in pregnancy: iodine and the omega-3 DHA. Our prenatal uses folate as methylfolate, an active form of folate, alongside iron, iodine and the rest.

Nutrient by nutrient

• Folate. The essential one. 400 µg folic acid to 12 weeks. More on folic acid versus methylfolate in the folate guide.
• Iron. Needs rise in pregnancy, but iron is not recommended for everyone as standard, only if a blood test shows you are low. See the iron in pregnancy guide.
• Iodine. It contributes to normal cognitive function and to normal thyroid function, and it is easy to fall short of if you avoid dairy and fish. See the iodine guide.
• Choline. Widely recognised as important in pregnancy, and easy to overlook, since the UK sets no formal figure. Food first, eggs especially. See the choline guide.
• Omega-3 DHA. Maternal intake of DHA contributes to the normal brain and eye development of the foetus and breastfed infants, at a daily intake of 200 mg DHA on top of the usual 250 mg of omega-3. If you do not eat oily fish, an algal DHA is the plant-based way to get it. See the omega-3 guide.

What to avoid

What you leave out counts here too.

• Vitamin A as retinol. Too much can harm the baby. Avoid supplements containing retinol, and avoid liver and cod liver oil. Beta carotene, the plant form, is fine, and is what a good prenatal uses.
• High-dose single supplements you have not discussed with your midwife.
• Herbal products, unless your midwife has said they are safe. Any addition is worth a quick check.

When to start and how long

Ideally start folic acid and vitamin D before you conceive, and if not, as soon as you know. Folic acid runs to the end of week 12. Vitamin D continues each day from October to March through pregnancy and while you breastfeed, and all year for some. A prenatal is generally taken across pregnancy, and many women continue a postnatal version afterwards, which we cover in the new mum guide.

Your pregnancy routine

Our pregnancy routine is built around the prenatal, and you can add an algal DHA if you do not eat oily fish. It only includes what applies to you.