Food supplements: can we take them during pregnancy?

Vitamins, minerals, plant extracts… The food supplement market is exploding! During pregnancy, the needs of a mother-to-be change. Can she take some of these products to prevent the risk of deficit or even deficiency?

Folic acid, vitamin D… What food supplements and vitamins to take before conception or while pregnant?

In principle, a balanced and diversified diet provides the body with everything it needs. The College of French Gynecologists-Obstetricians (CNGOF) and the High Authority of Health (HAS) only recommend systematic supplementation of two vitamins during pregnancy: B9 (folic acid) and the D. Numerous studies have shown that vitamin B9 is essential for the proper development of the fetal nervous system. A deficiency increases the risk of malformations, particularly neural tube defects (NTDs), called spina bifida.

While B9 is found in many foods, such as green leafy vegetables (spinach, cabbage, chicory, etc.) or in eggs and cheese, approximately 25% of pregnant women do not achieve the recommended daily intake. Doctors therefore recommend that all future mothers take a supplement of 400 micrograms per day of folate. It is even recommended to take it at least two months before conception, because it is from the start of the first month of pregnancy that the embryo's nervous system is formed. For those with a history of AFTN, the dose is also multiplied by 12.5. Despite these recommendations, only 50% of future mothers benefit from this boost during the first trimester.

The other vitamin officially recommended by doctors is vitamin D. It is also essential during pregnancy. It contributes to the good development of the baby's skeleton. Various studies seem to indicate that an insufficient level plays a role in the occurrence of pre-eclampsia, gestational diabetes, or even intrauterine growth retardation (IUGR). Taking vitamin D by pregnant women may also reduce the risk of low birth weight and premature birth. However, when vitamin D and calcium are combined, the risk of premature birth is increased. For this reason, it is extremely important tocommunicate regularly with the healthcare professional who accompanies us during our pregnancy, in order to carry out the necessary analyzes before taking any supplements and never give in to self-medication.

Some foods contain a little vitamin D, including sardines, salmon, tuna and fortified dairy products, but the majority is synthesized by the skin under the action of ultraviolet B rays. Suffice to say that for women who live in regions with little sunlight or who give birth between the months of March to June, it is often lacking. nearing the end! This is why doctors often advise expectant mothers to take a dose of vitamin D in the 6th or 7th month of pregnancy.

Can you take vitamin C or iron while you are pregnant?

For other vitamins or minerals, including vitamin C or iron, it is only after measuring a deficiency and on prescription. Indeed, needs increase considerably during pregnancy, not only to allow the development of the placenta and fetus, but also due to the increase in blood volume. It may therefore be relevant to consume food supplements, but we must first ensure that it is useful for us and our baby.

And the taboos of pregnancy, do we talk about them?

What food supplements can you take during the postpartum period?

After the birth of her baby, the patient may suffer from baby blues, a temporary state, which is due to the sudden drop in hormones and strong emotions. It can be characterized by mood swings, irritability, sleep disorders as well as anxiety. Although these disorders can be confusing, they do not last. The baby blues completely disappears in two weeks.

In order to help the young mother, food supplements may be recommended. Products based on selenium, vitamin C and E may in particular be indicated because of their action against oxidative stress. However, it is better to consult your doctor, gynecologist or midwife before taking these products, and especially if symptoms persist for several weeks.

Beware of the dangers of food supplements during pregnancy

According to the NutriNet-Santé study, conducted in the summer of 2013, nearly 75% of future mothers take food supplements during the 3rd trimester of pregnancy. In response, in 2014, experts from The National Agency for Food, Environmental and Occupational Health Safety (ANSES) calls for the greatest caution in this regard.

Over three years of implementing its Nutrivigilance system, the Agency received nearly 1,200 reports of adverse effects directly linked to food supplements. If slimming products are involved in 15% of cases, followed by hair supplements, anti-cholesterol then vitality/tone, “special pregnancy” cocktails are not spared. They represent 5% of reports, including nine serious cases and two medical terminations of pregnancy.

In front of the severity of certain side effects in pregnant women, ANSES has decided to take action in order to assess the risks of additional intake of vitamins and minerals during pregnancy. In an opinion published in June 2017, the organization warns against the multiplication of sources of vitamins and minerals, in the absence of established needs.

ANSES reminds pregnant women to do not consume food supplements without the advice of their healthcare professional and recommends that they report to their doctor, pharmacist or midwife the taking of any product (medication or food supplement), whether delivered on prescription or taken as self-medication.

For the attention of health professionals, the Agency reminds that:

  • The consequences of a hypercalcemia on the health of the newborn, in the event of hypersensitivity to vitamin D, require the implementation of appropriate preventive measures. In the event of confirmed hypercalcemia, the origin should be investigated through appropriate examinations and the relevance of supplementing pregnant women with vitamin D should be reconsidered;
  • In newborns, unexplained hypercalcemia could be linked to genetic hypersensitivity to vitamin D. It will therefore be appropriate, in the event of unexplained hypercalcemia, to look for a possible mutation in the gene predisposing to hypercalcemia in children and to take appropriate measures;
  • Simultaneous exposure to multiple sources ofiodine (from medicines or food supplements) increases the risk of thyroid disorders in the newborn and should therefore be avoided during pregnancy;
  • It is essential to do not accumulate sources of vitamins and minerals without regular biological monitoring.

Finally, it alerts healthcare professionals to the importance of declaring to the nutrivigilance system any adverse effects brought to their attention, which may be correlated with the consumption of food supplements.

Food supplements: what are the risks during pregnancy?

Too high doses of vitamins, iodine or other molecules can be problematic, because many of these substances pass the placental barrier. So, Maternal overconsumption of vitamin A exposes the baby to malformations. However, nearly 6% of future mothers take it in the 3rd trimester of pregnancy, according to the Journal of Clinical Endocrinology & Metabolism.

The high number of pregnant women who supplement with vitamin E is also worrying: it is around 30% during the 2nd trimester. However, if a vitamin E deficiency is dangerous for the fetus, levels that are too high are just as dangerous. THE use of these supplements must therefore be supervised by the medical profession.

As for food supplements based on plantsaround 11% of future mothers consume it, while some active ingredients can be toxic. This is the case of red yeast rice, psynephrine, present in the peel of the bitter orange, and caffeine. ANSES particularly advises against the ingestion of these supplements for pregnant women, and warns against the cocktail effect of all these products.

To avoid the occurrence of these undesirable or even serious effects, it is therefore recommended to only take what is really useful and prescribed by the practitioner following your pregnancy. No more no less !

Food supplements for pregnant women: respect the dosage and duration of treatment

Some expectant mothers are at greater risk of lack of iron. This is the case if you had very heavy periods, if you eat little or no foods of animal origin, if you are expecting twins or have had closely spaced pregnancies… If a blood test reveals an iron level that is too low, the doctor may prescribe iron tablets, while you replenish sufficient reserves. But, here again, be careful: it We have to respect the dosage and duration of treatment to avoid overload.

Likewise, our doctor may prescribe iodine. This trace element is essential for the proper development of the baby's brain. For mothers at risk of deficiency (geographic areas, closely spaced pregnancies, smoking, veganism, etc.), a daily supplement is offered throughout the pregnancy. For others, it is simply advisable to boost your intake by consuming products rich in iodine (cooked shellfish, sea fish, iodized salt, cooked eggs and dairy products).

Beyond these specific cases, always validated by a doctor, a pregnant woman who eats normally does not need supplements.

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