Folic acid and key vitamins and minerals in pregnancy: a short guide

During pregnancy your body needs more of certain vitamins and minerals. A balanced diet covers a lot, but for some nutrients your doctor may suggest a supplement. This is not a list of doses; it is a calm overview of why each nutrient matters.

Folic acid: why is it talked about so early?

Folic acid (the supplement form of vitamin B9) supports the development of your baby's nervous system in the first weeks. For this reason health authorities generally recommend folic acid for people planning a pregnancy or in early pregnancy.

If you did not start before conceiving, do not worry; talking to your doctor as soon as you notice is enough. Your doctor decides the right amount; a different plan may be needed if you have had a pregnancy with a neural tube defect, have diabetes or take certain medicines.

In food it appears as folate: leafy green vegetables, pulses, oranges and other citrus fruit, and fortified grains.

Vitamin D

Vitamin D helps your body absorb calcium and matters for your baby's bones and teeth. It is made in the skin with sunlight, but where you live, the season, clothing and skin tone can change this. Food sources are limited: oily fish, egg yolk and fortified products.

Your doctor decides whether you need a supplement and how much; they may also check your blood level.

Iron

Because blood volume increases in pregnancy, iron needs go up. Red meat, chicken, pulses and dark green leafy vegetables are good sources. Iron deficiency and anaemia have their own article; the key point here is that iron supplements should be taken under medical supervision, based on blood tests.

Calcium

Calcium is needed for your baby's bones and teeth. It is found in yoghurt, milk, cheese, canned fish with bones, sesame, almonds and dark green vegetables. If you do not get enough, your body can draw on its own bone stores, so paying attention to your diet matters for you too.

Iodine

Iodine takes part in making thyroid hormones and is important for your baby's brain development. Dairy products, fish and iodised salt are key sources. Using iodised salt in moderation may be enough for many people; if you have a thyroid condition, ask your doctor about supplements.

General notes on supplements

• Supplements do not replace a balanced diet; they complement it.
• When choosing a pregnancy vitamin, review the contents with your doctor rather than going by brand.
• High amounts of vitamin A may be unsuitable in pregnancy, so do not add multivitamins or herbal products on your own.
• If you feel nauseous, taking a supplement with food or at another time of day can feel easier; you can ask your doctor.

What can you do?

1. At your first appointment, tell your doctor about all vitamins, herbal products and medicines you use.
2. Try to eat leafy greens and pulses a few times a week.
3. Take small steps to bring oily fish and dairy into your menu.
4. Link your supplement to a daily habit, such as brushing your teeth.
5. If you miss a dose, do not blame yourself; simply continue the next day.

When to contact your doctor

• If you have constant nausea, constipation or vomiting after starting a supplement.
• If you notice allergic signs such as itching, rash or breathlessness.
• If you feel very tired, look pale or have palpitations; a test for anaemia may be needed.
• If you eat vegetarian or vegan, or have had weight-loss surgery.
• If you had a pregnancy with a neural tube defect before, or take medicines for a condition such as epilepsy.

For sudden breathlessness, swelling of the face or chest pain, call 112.

This article is for information only; your doctor's advice comes first on which supplement to take and in what amount.