Are prenatal vitamins really necessary?

The minute they discover they are pregnant, many mothers-to-be worry about whether they need to take extra vitamins and minerals to meet the increased nutritional demands of the growing foetus.

Two mums we spoke to say they went through their pregnancy without having to take supplements. Sharon, a 29-year-old mother of one didn’t take the recommended supplements at the most crucial time of her pregnancy, during the first trimester.

She says, “The first doctor I went to see prescribed them but I decided to not listen to her.”

Sharon got a new doctor whom she visited a few weeks into her second trimester. Her new doctor asked about her diet. She also tested her mineral levels. Sharon’s results showed she was OK – all she needed was iron and calcium supplements. She took one 30-day dose and that was it. She didn’t take supplements again.

She had a healthy pregnancy and gave birth to a baby girl weighing 3.9 kilogrammes. The baby will turn one year in August. Sharon says her baby hit the regular milestones all kids her age do without delays.

NECESSARY SUPPLEMENTS

Sharon believes that supplements are not necessary. Supplements make sense if the food you are eating lacks the necessary nutrients. And more often than not, whatever we consume is grown in fertile soils in the sun, so it still has a majority of its nutrients intact.

Another woman Janet, 28, didn’t take supplements at all during her pregnancy. She was 20 when she had her son. Janet says it was more to do with being young and naive than about making a conscious decision not to take the prenatal vitamins.

Janet visited the doctor twice – to confirm the pregnancy and at the time of giving birth. She had a natural birth, to a baby boy weighing 3.2 kilogrammes. Her son, now seven, turned out healthy.

Question is, are Janet and Sharon one of the outliers, one of those women whose babies who winged it by a prayer?

We consulted Nduta Wambura, a nutritionist at the Mater Hospital to find out. “The National Technical Guidelines for Micronutrient Deficiency indicate a schedule for which an expecting mother must take supplements at the very least. These supplements are folic acid and iron,” says Nduta. “Both supplements are to be taken daily throughout the pregnancy. Iron is particularly critical for the first trimester.”

Folic acid prevents birth defects to the baby’s brain and spine, while iron handles the increased blood volume the body demands. It takes the baby through pregnancy and six months after birth.

In addition to these two, Dr Sarah Ndegwa – a gynaecologist – says that calcium is also a crucial nutrient. Calcium builds your little one’s bones.

In response to whether all mums-to-be must take supplements, Dr Ndegwa says, “No, it depends on two things about her. First, what is her nutritional history at the time of her pregnancy? If she has been eating well and has been packing her body with these nutrients the pregnancy will need, then she will not need to take supplements.”

NUTRITIONAL DEMANDS

Doctors will run a test, an antenatal profile.

This antenatal profile shows the level of these crucial minerals in your body. It determines whether you need to take supplements or not. Most times, says Dr Ndegwa, if iron is low then it is likely the other two nutrients are low. The mum-to-be is immediately put on the iron, folic acid and calcium (IFAC) regimen.

Secondly, says Dr Ndegwa, the levels of these three nutrients are monitored closely throughout the pregnancy. Should any of them dip, then you need a supplement to fill that gap.There are mums-to-be who don’t need to take supplements at the start of the pregnancy, says Dr Ndegwa.

But as the pregnancy progresses, they are unable to keep up with the nutritional demands of their growing baby – its taking in more than they are able to give it in their diets. A supplement is necessary in such cases.  So in a nutshell, the good news is you may not need to supplement your diet during pregnancy. It’s advised and recommended, but it may not be a do-or-die situation for you.

The not-so-good news is that if you are not taking supplements then you need to keep track of what you are eating so you have all the crucial nutrients your baby needs during pregnancy. Any gaps you note you mindfully fill up – either with a supplement or through your diet.