Prenatal vitamins make me sick: Do I really need them?

I am 14 weeks pregnant. I have been taking prenatal vitamins since I was newly pregnant, but they make me feel sick. I experimented with taking them at different times of the day and with different meals, but nothing helps. Am I harming my baby by not taking the vitamins?

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Sue Gilbert

Sue Gilbert works as a consulting nutritionist. For many years she worked with Earth's Best Organic Baby Food, integrating nutrition and... Read more

If you are feeling well enough to eat a well-balanced, varied diet, and if you started your pregnancy in a very healthy state, then you may be able to limit your supplemental intake to a critical few nutrients. Pregnant women need more of some nutrients, particularly folic acid, iron and calcium.

A folic acid supplement of 400 mcg. each day is strongly recommended for women trying to conceive and pregnant women, particularly those in the first trimester. The folic acid in supplements is better utilized than the folacin (its counterpart) in foods, although both play the same role in your diet. Folic acid has been proven to reduce the risk of having a baby with a neural tube defect, such as Spina Bifida. If you can't tolerate a folic acid supplement, include plenty of grains that have been enriched and a generous amount of green leafy vegetables -- especially spinach. Also include wheat germ, legumes, orange juice, peanuts and occasionally liver.

Iron is another nutrient that is critical. Because your blood volume is expanding, extra iron is needed to carry the oxygen and nutrients to your fetus. Iron is particularly important for your baby during the last trimester, when he or she is accumulating it for use after birth. And iron is particularly hard to get through diet alone, even if you eat red meat. A supplement of 30 mg. each day is recommended for the last two trimesters. Good food sources of iron include beef liver, lean sirloin and ground beef, fortified breakfast cereal, pumpkin seeds, spinach, kidney beans, prune juice, lima beans and soybean nuts.

The need for calcium is most crucial during the last three months, when fetal bone formation takes place. If you can consume enough dairy products, or other calcium containing food, then you may be able to skip taking a calcium supplement.

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