Ngā taiora me ngā kai āpiti Nutrients and supplements

Folic acid helps the body to make new cells. It is important because it can help to prevent birth defects of a baby’s brain and spine, such as spina bifida. Spina bifida can cause walking, bladder and bowel problems.

Folic acid and spina bifida — HealthEd   (external link)↗

How much to take and when

You should take a folic acid tablet (0.8 milligrams) every day for 4 weeks before you might become pregnant. Keep taking it to 12 weeks after becoming pregnant. If you are pregnant with more than 1 pēpi (multiple birth), you may need to keep taking it throughout your pregnancy.

If you find out that you are pregnant and you have not been taking folic acid, start taking it as soon as possible.

Where to get it 

You can buy folic acid tablets from pharmacies, but these will be free if they are prescribed by your midwife, doctor, or a nurse practitioner. Talk to them first.

Iodine helps the body to grow and develop, especially the brain. Because pēpi get iodine from their parent, pregnant and breastfeeding people need more iodine.

During pregnancy and while breastfeeding, choose foods that are high in iodine and take a tablet every day. Foods that are high in iodine include:

• well cooked seafood
• milk
• eggs
• some cereals and breads.

How much to take and when

Take 1 iodine tablet (150 micrograms) every day when you are pregnant and breastfeeding.

Where to get it

You can buy iodine tablets from pharmacies, but these will be free if they are prescribed by your midwife, doctor, or a nurse practitioner. Talk to them first.

Iodine and iodine deficiency — HealthEd (external link)↗

You need enough vitamin D to maintain healthy levels of calcium and phosphorus in your body. Vitamin D is needed for strong bones and joints, as well as healthy muscle and nerve activity.

Food sources of vitamin D include:

• eggs
• oily fish, such as tuna, sardines and salmon
• some types of milks, yoghurts and margarines.

It is difficult to get enough vitamin D from food alone. The best source of vitamin D is the sun, so try to get outside:

• before 10am and after 4pm between September and April
• around the middle of the day between May and August.

If you have lighter skin, you will need less time in the sun. It is important not to get sunburnt.

Some people have lower levels of vitamin D, called a vitamin D deficiency. You are at higher risk of vitamin D deficiency if:

• you have darker skin
• you spend most of your time inside
• you have liver or kidney disease and are taking certain medicines, for example, anticonvulsants.

Talk to your midwife, doctor or nurse practitioner if:

• you are worried that you do not get enough vitamin D
• you have a higher risk of vitamin D deficiency.

If you are pregnant with more than 1 pēpi, vitamin D supplements can help reduce the risk of high blood pressure and preeclampsia.

Multiple pregnancy

During pregnancy, your iron needs almost double. Lack of iron can result in anaemia making you feel more tired than usual.

• Iron — HealthInfo (external link)↗
• Anaemia — HealthInfo (external link)↗

Red meat such as lean beef and lamb are the best sources of iron. Other good sources include:

• chicken and fish
• legumes, such as chickpeas, lentils, kidney beans and baked beans
• nuts and seeds
• wholegrain breads
• iron-enriched breakfast cereals – choose a cereal with at least 3 mg of iron per serving
• dried fruit, such as apricots, raisins and figs
• green leafy vegetables such as silverbeet, spinach and watercress
• tofu and tempeh (fermented soybeans)
• spreads such as Marmite, Vegemite and peanut butter.

Liver

Although liver is a rich source of iron, you should only eat small amounts — no more than 100 g each week. This is because liver contains very large amounts of vitamin A, which can harm growing pēpi.

Vitamin C

Vitamin C helps us absorb up to 4 times as much iron from our food. You can get vitamin C from many fruits including:

• berries
• feijoas
• kiwifruit
• mandarins
• oranges
• rock melons
• tamarillos.

You can also get it from vegetables including:

• broccoli
• capsicums
• cauliflowers
• tomatoes.

Try to include fruit or vegetables with every meal, especially if you're vegetarian.

How to get your daily iron — HealthInfo (external link)↗

Iron supplements

If you cannot get enough iron from your diet, you may need to take an iron supplement. Your midwife or doctor will advise what is most appropriate for you.

Taking iron supplements — HealthInfo (external link)↗

Some drinks, foods and medications make it harder for your body to absorb iron. Take iron supplements 1 hour before or 2 hours after having:

• tea or coffee
• milk, yoghurt or cheese
• calcium supplements
• antacids, such as Mylanta and Quick-Ez.

Essential fatty acids help form your baby's nervous system and other tissues.

To increase your essential fatty acid intake:

• eat 30 grams of oily fish such as salmon, tuna, sardines, either fresh, canned or frozen, once or twice a week
• eat a small handful of raw nuts and seeds every day, such as walnuts, almonds, peanuts and sunflower seeds
• use sunflower, canola or olive oils
• choose margarine over butter
• regularly choose eggs as a convenient cheap meal or snack
• eat plenty of vegetables every day, particularly dark green types, such as spinach, broccoli, green peas and green beans.

Calcium is important for the formation of your baby's bones, particularly in the last months of pregnancy when your pēpi is growing rapidly. You need 1000mg of calcium per day.

How to get calcium in your diet

You can get this by eating a varied diet and including at least 3 servings of milk and milk products each day. A serving is:

• 250 ml of milk
• ¾ cup of yoghurt (200g), or
• 2 slices of cheese (40g).

Milk and milk products such as cheese, yoghurt and custard are the best sources of calcium. Other good sources of calcium include:

• calcium-enriched almond, rice or soy milk
• canned fish with soft edible bones, such as salmon and sardines
• nuts and seeds
• dark green leafy vegetables
• tofu.

If you cannot get enough calcium from your diet or you are having more than 1 pēpi, you may need to take a calcium supplement. Talk to your LMC or GP for advice. The best calcium tablets are those that contain around 600mg of calcium per tablet, such as Caltrate.

Zinc is an essential nutrient found in a variety of plant and animal foods, along with supplements. 

Zinc is essential for your baby's growth. The best sources of zinc are:

• lean red meat
• chicken
• wholegrain breads and cereals
• legumes
• nuts
• seeds
• dairy products.

If you are eating well and choosing daily from the 4 food groups, you should not need to take a multi-vitamin supplement. But you may need one if you have had severe morning sickness and have been vomiting often.

Morning sickness

If you take a multi-vitamin supplement, choose 1 that is designed especially for pregnant people. Regular multi-vitamin supplements may contain too much vitamin A and this can harm your pēpi.

Thiamine helps your body turn food into energy. Food sources include wholegrains, meat and fish.

If you were vomiting a lot in early pregnancy, you may have been prescribed thiamine. Keep taking this until you are eating normally again, and the vomiting has stopped.

Vitamin B12 helps keep your body's nerve and blood cells healthy. It helps make DNA, the genetic material in your cells. It also helps prevent a type of anaemia that can make you feel tired and weak.

B12 is only found in animal foods or specially fortified foods, such as Marmite, So Good soy milk and Special K breakfast cereal.

If you eat little or no animal foods, talk to your Lead Maternity Carer (LMC) or GP. You will need to have a blood test to check your B12 levels. If your level is low, you willl need a vitamin B12 supplement or vitamin B12 injection.