Dietary supplements during pregnancy – to take or not to take?

Every expectant mother wants a healthy pregnancy and the best possible development for her child. For this reason, many pregnant women turn to special dietary supplements designed for mothers-to-be. However, not everyone is aware that these products can vary greatly in composition – and not all of the substances they contain are truly necessary during pregnancy.

So which dietary supplements are actually useful?

Which dietary supplements are recommended during pregnancy?

Professional societies and medical guidelines generally recommend getting micronutrients through a balanced and varied diet. Routine self-prescribed use of multivitamin supplements is not advised. Supplements should be used when there is an increased need, a diagnosed deficiency, or special circumstances that justify it – ideally after consulting a doctor.

Regardless, certain nutrients are considered particularly important for the healthy development of the child and the well-being of the mother. Especially recommended are: folic acid, DHA (an omega-3 fatty acid), iron, iodine, and vitamin D.

Folic acid

Folic acid plays a key role in the development of the unborn child’s central nervous system. Women who wish to conceive should ideally begin taking it about six weeks before conception. Some experts recommend it for all women of childbearing age as a general precaution.

The standard recommended dose is usually 0.4 mg per day. Timely supplementation can reduce the risk of so-called neural tube defects such as spina bifida by up to 70%.

Folic acid remains important during pregnancy itself – especially during the first 12 weeks, when organ development takes place. Continuing intake through the end of pregnancy and into breastfeeding is recommended, as the need remains elevated.

Folic acid can also be obtained from the diet, particularly from green leafy vegetables (e.g., spinach, Swiss chard, cabbage), legumes, whole grains, nuts, and beets.

DHA (docosahexaenoic acid)

DHA is a long-chain omega-3 fatty acid that is crucial for the development of the baby’s brain, nervous system, and vision. Adequate intake can also have a positive impact on the child’s psychomotor development. In addition, DHA may reduce the risk of postpartum depression in mothers.

A deficiency in DHA can increase the risk of preterm birth or preeclampsia (pregnancy-related high blood pressure).

DHA is naturally found in fatty sea fish and seafood. Because the consumption of certain fish species should be limited during pregnancy due to potential mercury contamination, supplementation with at least 200 mg DHA per day is often recommended. Those who eat little or no fish may consider higher doses – following medical advice.

Iron

During pregnancy, iron requirements increase significantly, as more blood is produced and the growing baby and placenta need to be supplied. Iron deficiency can lead to pregnancy-related anemia, which causes fatigue, difficulty concentrating, and increased susceptibility to infections.

However, iron supplementation is not generally recommended for all. It should be considered in cases of proven iron deficiency or low ferritin levels.

Iron can be obtained through diet – for example, from red meat, organ meats, legumes, whole grains, or green vegetables like parsley. Important: Plant-based iron is less readily absorbed than animal-based iron. Combining it with vitamin C-rich foods can improve absorption.

Iodine

Iodine is essential for healthy thyroid function and for the development of the baby’s central nervous system. During pregnancy, the need increases due to higher excretion through the kidneys and the baby’s own requirements.

Iodine deficiency can have serious consequences, including intellectual disabilities, hearing loss, or deafness in newborns.

Iodine is mainly obtained through iodized table salt, dairy products, eggs, and fish. Nevertheless, dietary intake alone is often insufficient. A daily intake of 150–200 micrograms of iodine is usually recommended during pregnancy – provided there are no thyroid disorders. For women with known thyroid conditions, supplementation should be done under medical supervision.

Vitamin D

Vitamin D is important for calcium and phosphate metabolism as well as a well-functioning immune system. The body produces vitamin D through skin exposure to sunlight, particularly UVB radiation.

In many parts of the world, sufficient production of vitamin D through sunlight is only possible from around March to September, and only with regular outdoor exposure without sunscreen. At other times – and especially with limited sun exposure – supplementation is advisable.

During pregnancy and breastfeeding, a daily dose of 1,500 to 4,000 IU of vitamin D is often recommended, depending on individual needs. A blood test can help determine the appropriate dose.