So, you're pregnant... here's a to-do list! (part one)
Early pregnancy is so exciting. It's also a bit scary - you may find yourself holding your breath until your first ultrasound that proves it's real, when suddenly, you feel like you’ve been hit by a Mack truck. As early as 6 weeks, nausea peaks and fatigue will have you waking up from a 12 hour sleep and crawling right back into bed.
On top of it all, you have bloating and round ligament pain in lieu of a cute (and validating) baby bump. People rarely appreciate the amount of “pregnant” that you are, and “When you’re really pregnant…” becomes a phrase you hear whilst fighting the urge to vomit at family gatherings (despite your properly timed intake of saltines and ginger ale).
That being said, I have some recommendations for you.
Yes, more to add to your plate!
I want you to approach these early pregnancy to-dos with lots of grace for yourself and understand that, while starting early IS more beneficial, starting once the nausea cools off is also great. Please understand that the following are simply suggestions, and I trust you to know what is reasonable for your situation and financial standing. These are things I recommend for my own clients as a licensed midwife in Kentucky & Tennessee, but they may not be the best choice for you! That said, this is not medical advice and should be taken as information for entertainment purposes only. Please bring this information to your health care provider to make an informed decision for yourself!
FIRST, grab a vitamin.
There's some discourse on the wellness side of the internet about whether or not you really need a prenatal vitamin if you're getting lots of healthy whole foods.
You do.
We all need the extra nutrients, and buckling down on whole foods for nine months can't undo a lifetime of eating produce grown in nutrient-depleted soil. Our food isn't the food of our ancestors, and, honestly, they could have used a supplement as well, considering the rickets. Your sweet baby will take the fat from your brain and the calcium from your bones. If you plan to breastfeed, this continues. If you plan to have future children, they will get the leftovers. A good food-based prenatal fills the gaps prenatally (when it matters most).
This isn't a breakdown of the many prenatal vitamins on the market. I have some opinions on the matter, but that's a whole other post entirely. I recommend a food-based prenatal, so for now, consider checking out Lily Nichols' recommendations for current brands.
Other Supplements
Choline!
We now know it is as important in early pregnancy as folate (what you may know as folic acid) for supporting neural tube formation in the brain and preventing conditions like spina bifida. Its benefits continue through late pregnancy, where it helps develop your baby's memory centers in the brain and manages inflammation throughout your body. During lactation, you lose choline through your breastmilk as your baby is gobbling it down to support their own faculties. Animal products and eggs are an excellent source of choline, but you would need to eat six eggs a day (every single day) to get the recommended amount for pregnancy. Popular prenatal vitamins are now adding choline to their labels, because they know it's something health conscious families are looking for; however, the amount of choline needed doesn't fit in a single capsule. This means the amount these brands are adding is insufficient and mostly for show. Look for a standalone choline supplement with around 550 mg per serving and plan to continue taking it while lactating and pick it back up prior to trying to conceive in the future.
Omega-3s
The benefits prior to conception through breastfeeding and beyond are so numerous from mental health benefits to less risk for preeclampsia. Rather than go through all of the reasons to include it with your daily supplements, I'm linking to the American Pregnancy Associations post where they are outlined! I personally reach for a brand that is third-party tested to ensure the oil isn't old or rancid. I like to get over 1,000mg (1g) of omega-3s daily, but ~ 2 grams is a suitable dose during pregnancy.
Ask your provider before beginning omegas as they may have a blood thinning effect at higher doses, but they're safe for most people.
Food based sources of omega-3s, such as sardines and low-mercury tunas, are ideal if you can stomach them as their high protein content rounds out the health benefits.
Choose light tuna from reputable sources and limit your intake. Safe catch tuna is my fav for a brand that mercury tests each fish, but you still should be mindful of factors that contribute to mercury consumption such as type of tuna and how frequently eat it. Consumer Reports has a good article where they ultimately recommend avoiding tuna during pregnancy, but it remains highly nutritious and we know that one can a week is safe - more depending on the fish. Sardines are the highest in omegas while being extremely low in mercury! Unfortunately, they smell and taste like sardines. For that, I recommend adding hot sauce.
Vitamin D3 + K2
Here's another supplement with an array of benefits that may prevent gestational diabetes, preeclampsia, and have lasting effects for your child. For instance, maternal intake of D3 may lead to stronger tooth enamel for your baby, which protects against childhood cavities (but only when taken during pregnancy). It's also great for supporting your mood and immune system.
Daily intake of vitamin D3 in pregnancy should be about 4,000 IU (units). There is no agreed upper limit for K2, but many combination supplements like this one I like from NOW*, have 45mcg. If you take four capsules to meet the vitamin D3 intake, you're still at 180 mcg of K2, which is a safe amount for daily consumption. There are liquid and gummy forms for those who have trouble swallowing pills.
I find that even my outdoor loving clients who are getting daily sunlight can still be seriously deficient in vitamin D. Vitamin D (which might be more like a hormone than a vitamin) isn't found in many foods, and the supplements are usually inexpensive at about $10-$20 a month at my recommended dosage. Vitamin D3 rather than plain D is more bioavailable - meaning your body can absorb it more easily - while the added K2 helps direct calcium to your bones rather than arteries and other tissue.
*I personally look for the NOW or Solaray brand because they are more affordable options while still being a quality line of supplements that offer some degree of third party testing.
These Specific Probiotics
A probiotic blend with L. reuteri RC-14 and L. rhamnosus GR-1 may be preventative of Bacterial Vaginosis (BV) and Group B Strep (GBS), which is a big deal during pregnancy! The science is very mixed, but we know they support a healthy vaginal pH and microbiome for your gut and reproductive tract.
Those two strains are often included in a women's probiotic, but check the back of the label to make sure you see them there. I, personally, think we should be treating our partners with these probiotics as well, though these strains are commonly found in women's probiotics only - unless you buy them as stand alone products where the price seems to be wildly inflated.
So, how does it work? Healthy bacteria throughout your body (your microbiome) are helpful for preventing infections during pregnancy like BV or yeast. This means taking the probiotics may keep you from needing an antibiotic, if they can stave off the infections entirely. Antibiotics can kill off dangerous bacteria once they arrive, but they eliminate all the good stuff, too. Your baby benefits from the healthy bacteria in your body as it seeds them with the bacteria they need for a healthy immune system for life!
Preventing GBS means not worrying about taking IV antibiotics in labor: the recommended treatment for the 1 in 4 pregnant women who will test positive for it at their 36 week screening. Repeated or late pregnancy exposure to antibiotics has long term health consequences for our kids. At times, taking them is unavoidable - they can be life saving - but focusing on preventative health measures, like probiotics, shouldn't be underestimated in health care.
That's all for this post!
Part Two includes professionals to hire in pregnancy and adjustments to make within your life (and with your partner). If you enjoyed this post, share it with your friends! Feel free to comment below any feedback, thoughts, or suggestions for early pregnancy.
Consumer Report Mercury in Your Tuna https://www.consumerreports.org/health/food-safety/how-worried-should-you-be-about-mercury-in-your-tuna-a5041903086/
Vitamin D in Pregnancy
Vitamin K
Effective probiotic regimens for bacterial vaginosis treatment and recurrence prevention: A systematic review
Thank you for this thorough post! I enjoyed reading & learning about the various supplements important during pregnancy 🙏🏼