Pregnancy nutrition supplements Good nutrition in pregnancy is vital for the healthy growth and development of your baby. You need enough nutrients to meet your baby’s needs, as well as your own. Eating well helps you get the nutrition you need for a healthy pregnancy. There are however some vitamins and minerals that are needed in higher amounts at this time. These can be difficult to get from your diet alone. That’s why experts recommend supplements of certain vitamins and minerals before pregnancy, during pregnancy and while breastfeeding. Folic acid (folate) Folate is an essential vitamin for a healthy pregnancy. It is needed for the growth and development of your baby, especially in the early stages of pregnancy. Folate is needed for the normal development of a baby’s neural tube in the spine, which occurs around 4 weeks after conception. Folate can be found in green leafy vegetables, fruit, breads and cereals, nuts and legumes. However, it’s difficult to get enough folate for pregnancy from your diet alone, so supplements (known as folic acid) are recommended for all women before and during early pregnancy. Taking folic acid supplements has been shown to reduce the risk of birth defects for all women, not only those with diabetes. Women with diabetes are advised to take a higher dose of folic acid than other women. This is because of a higher risk of neural tube defects. The amount recommended is between 2.5 milligrams and 5 milligrams (2.5–5mg) a day. This includes the amount contained in your folic acid supplement, plus any pregnancy multivitamins. You don’t need a prescription to buy folic acid, but make sure you tell the pharmacist you need to buy the 5mg tablet, not the usual 0.5mg tablet. Your doctor may suggest you take one 5mg tablet each day or every second day. Ideally, you would start taking your folic acid supplement three months before your pregnancy, and continue taking it for the first three months of pregnancy (the first trimester). Talk to your diabetes health professionals about folic acid supplements. What to take? High dose folic acid supplement of 2.5–5mg each day. When? 3 months before you become pregnant and until the end of your first trimester. Iodine Iodine is a mineral which is which is important for the healthy development of your baby’s brain and nervous system. During pregnancy and breastfeeding, women need more iodine than usual, but it can be difficult to get enough through healthy eating alone. All women who are planning for pregnancy, currently pregnant or breastfeeding are advised to take a supplement that includes 150 micrograms (150ug or 150mcg) of iodine each day. Ideally, iodine supplements should be started before you become pregnant. Pregnancy supplements containing iodine are available from your local pharmacy, but remember to check that they contain the recommended 150 micrograms of iodine. It’s also important to avoid kelp (seaweed) supplements as these may contain varying levels of iodine and may contain heavy metals such as mercury. Women with thyroid problems or Graves’ disease should see their doctor for advice before taking an iodine supplement. What to take? A supplement containing 150ug (or mcg) each day. If you have thyroid problems, talk to your doctor first. When? Before pregnancy, during pregnancy and while breastfeeding. Other vitamins and minerals Some women may be low in other important nutrients such as iron, vitamin B12, calcium or Vitamin D. This could be because of other health conditions, diet, lack of exposure to sunlight or certain medications. Your doctor may ask you questions about your usual eating patterns or arrange a blood test to check your levels of some of these nutrients. They can give you advice on how to get enough of these in your diet or through supplements. All pregnant women will have their iron levels checked during pregnancy and it is quite common to need iron supplements in the later stages of pregnancy. Your maternity health professionals will let you know when you will need your iron levels checked and if supplements are needed. Calcium supplements may sometimes be recommended by your doctor to help reduce the risk of high blood pressure in pregnancy and preeclampsia. Ask your doctor for more information. Healthy eating can help you get as many nutrients as possible from your diet. Talk to your doctor or dietitian if you are concerned about whether you are getting all of the nutrition you need. What to take? Additional nutrient supplements as recommended by your doctor. When? If the results of blood tests show that you are low in these important nutrients or on your doctor’s advice. Pregnancy multivitamins Pregnancy multivitamins are designed to contain a specific combination of vitamins and minerals based on the needs of women during pregnancy. Many women choose to take these supplements as most contain both iodine and folic acid. However, it’s important to check the amounts of these nutrients in the different supplements, and be aware that these do not contain the high dose of folic acid needed by women with diabetes. Ask your doctor for advice and if you choose to take a multivitamin, make sure it’s one for designed especially for pregnancy. Regular supplements and multivitamins can contain high doses (or megadoses) of some vitamins, and may cause harm to your developing baby. So, unless advised by your doctor, avoid supplements that are not designed for pregnancy. It’s also important to avoid using herbal preparations, without talking to your doctor first. Many of these may not be safe to use in pregnancy. If you are concerned about other nutrients, speak to your accredited practising dietitian about your usual diet and ask whether you need multivitamins or other supplements. Thank you to the NDSS Diabetes in Pregnancy Expert Reference Group and Robyn Barnes, APD/CDE for kindly reviewing this article. Research news Becoming a new mother: the experiences of women with diabetes Becoming a mother can be challenging at times for all women. Deakin researchers have found that women with type 1 or type 2 diabetes sometimes face particular challenges in the first year after giving birth. To help provide better healthcare for women in future, the researchers are developing a questionnaire about the wellbeing and support needs of women with type 1 or type 2 diabetes. They are seeking women who have had a baby in the past 12 months to take part in this research. This involves completing an anonymous, online survey (approximately 15 minutes). The survey will include questions about you, your baby, your experiences as a mother and your experiences of having diabetes in general. Participation is voluntary. All women who complete the survey will be given the option to enter a draw to win one of two iPads. Interested women can find out more here. Eye health and pregnancy Melbourne researchers have studied eye health in pregnancy among a group of women with type 1 diabetes and type 2 diabetes. Diabetes-related eye problems may appear or worsen during pregnancy and regular eye checks before, during and after pregnancy are recommended. In this study 85% of women had at least one eye check during pregnancy and about one quarter of women had damage to the small blood vessels at the back of the eye (diabetic retinopathy). It was found that women with type 1 diabetes, who were more likely to have diabetes for a longer time, those with higher HbA1c levels (average blood glucose levels over past 3 months) and existing kidney disease were more likely to have eye problems that could affect vision. The researchers called for extra attention to be given to ensure women have eye checks before, during and after pregnancy and regular follow-up of those at highest risk. You can read the research here.