Friday, December 23, 2016

Ranking the best prenatal vitamins of 2016 (review)

If you’re pregnant (or even considering it) and worried about your baby’s health, taking a prenatal vitamin might be something you want to think about to ensure you’re getting all the vitamins and minerals your baby needs to develop properly.

Here are the best prenatal vitamins on the market, ranked.  Afterwards, we’ll look in more detail about how a prenatal vitamin can help you.

1.  Garden of Life Vitamin Code Raw Prenatal

prenatal-1The well-selling prenatal vitamin from Garden of Life focuses on deriving its vitamins and minerals from natural sources, and providing them in chelated forms whenever possible.

The ingredients have everything you’ll need in a prenatal vitamin: 80 mg of folate, 2 mg of vitamin B6, and 6 mcg of vitamin B12.

The amount of vitamin B12 may need to be higher, as some scientific sources advocate for raising the recommended B12 intake, as low blood levels of B12 are associated with birth defects.

Garden of Life Vitamin Code lives up to its “raw” namesake with the inclusion of its fruit and vegetable blend as well as its sprout blend.  These include the extracts of dozens of different fruits, vegetables, and sprouted seeds.  These are included to shore up any deficiencies in dietary intake of fruits, vegetables, and other healthy plant sources of nutrients.

There is also a blend of ginger root and active bacterial culture to aid the morning sickness and stomach troubles that sometimes accompany pregnancy.

Garden of Life Vitamin Code Raw Prenatal does pretty well on independent testing of the quality of its ingredients.  Though four of its vitamins were off from their label stated amounts by over ten percent, the worst of these (folate) was only off by about a third, and it was an excess, not a shortage.

Especially if you are drawn to the fruit, vegetable, and sprout concentrates, Garden of Life Vitamin Code Raw Prenatal is a great choice for a prenatal vitamin.

2.  New Chapter Perfect Prenatal Vitamins

“Perfect” might be a high bar to meet, but New Chapter’s prenatal multivitamin scores pretty well.

It’s got all the essentials in reasonable amounts: 100-300% of your recommended daily intake for most vitamins and minerals, plus extra vitamin B12 (500% of your daily needs) and a small enough amount of calcium so that iron absorption is not inhibited.

The vitamin includes an herbal blend too, with concentrates from brown rice, oats, berries, dandelion, rose hips, and a few other plants.  Additionally, several live culture probiotics are included for digestive health.

A few extracts from sprouted seeds are included too.  These ingredients draw from natural foods that would be a normal part of your diet, so there’s less of a risk of harming yourself or your baby with an untested and unknown herbal extract from an exotic plant.

3.  MegaFood Baby & Me

This best-selling and highly regarded prenatal is based around a philosophy of deriving its primary ingredients from natural instead of synthetic sources.

The vitamins and minerals in MegaFood Baby & Me come from carrots, cabbage, oranges, brown rice, and a species of yeast called S. cerevisiae.

Its label helpfully provides the recommended daily values for healthy adults and for pregnant and lactating women—these often differ substantially, as the Food and Drug Administration sets different standards for the nutritional needs of women who are pregnant or nursing.

Among the most important vitamins and minerals, MegaFood Baby & Me contains 18 mg of iron, 80 mg of folate, and 4 mg of vitamin B12.

In each of these cases, the amount of these vitamins and minerals is at or above 100% of the recommended daily intake.  Wisely, MegaFood Baby & Me keep the calcium content low, so as not to upset the absorption of iron from the supplement.

The supplement also includes a small fruit and vegetable extract blend, which includes orange, berries, ginger, chamomile, dandelion, and spinach.  It also comes in a vegetarian cellulose capsule, which is good news if you don’t eat animal products.

In terms of analytical testing, MegaFood Baby & Me had an average score.  Five of its ingredients had actual amounts more than ten percent off their label-stated amount; the folic acid content was 60% higher than the label claimed it to be.  It did pass all purity tests with flying colors.

4.  Thorne Research Basic Prenatal Multivitamin

From a quick glance at the nutrition label, Thorne Research’s prenatal vitamin formulation looks pretty unremarkable, until you take a closer look.

While most of the standard vitamins and minerals are present in the expected 100-250% of your recommended daily intake, the vitamin B12 content is through the roof at 3,333% of your recommended daily intake.

This aside, metal mineral content is pretty unremarkable: 45 mg of iron (on the high end), 200 mg of calcium (could inhibit iron absorption somewhat), and moderate amounts of other minerals.

Why such a high amount of vitamin B12 specifically?  It is one of the key vitamins for preventing neural tube defects, a very serious birth defect that can occur when intake of these vitamins is low.

Further, scientific research has called into question the levels of the recommended daily intakes for vitamin B12, since some research has found that increased risk occurs with levels of vitamin B12 intake not usually termed deficient (1).

Though Thorne Research’s own marketing literature does not go into detail on this outlier ingredient, it’s likely their motivations have to do with increasing blood levels of vitamin B12 as rapidly as possible during pregnancy, especially since neural tube defects can occur within the first few weeks of conception.

5.  Rainbow Light Prenatal One

As a top-selling traditional multivitamin manufacturer, it only makes sense that Rainbow Light would also sell a prenatal vitamin.  Its formulation is fairly traditional, using a tablet form and delivering mostly-normal amounts of the standard vitamins and minerals.

The B-complex vitamins are delivered at a higher than usual dose; vitamin B1 is provided at almost 600% of your recommended daily intake (10mg), vitamin B2 comes in at 500% (10 mg), and B6 comes in at 600% of your daily intake (15 mg).

The folic acid content is right where it should be, at 80 mg of folate, which is 100% of your daily needs.

Calcium content is moderate at 200 mg (15% of daily needs), which should help prevent malabsorption of iron.  The iron in Rainbow Light Prenatal One is delivered in the form of an amino acid chelate, which might help prevent gastrointestinal issues and also aid with absorption.

Like many other prenatal vitamins, Rainbow Light Prenatal One includes a blend of food powder isolates from raspberry, ginger, and spirulina, to make up for any deficits in fruit and vegetable intake.

Uniquely, it also includes a battery of enzymes to aid digestion and a culture of probiotics to improve GI tract health.

On quality testing, it comes in middle of the road:  Seven different ingredients differed from their label-stated amounts by over ten percent, but the worst of these was only 37% off its label claimed amount.

6.  Zahler Prenatal Vitamin + DHA

Zahler’s prenatal vitamin formulation is a serious supplement that delivers a concentrated dose of many of the critical vitamins and minerals for pregnant women.

With regards to the B-complex vitamins, it reads almost more like a sports supplement—the various forms of vitamin B are provided at anywhere from eight to sixteen times the recommended daily intake for pregnant women.

Fortunately, this is for the recommended serving size, which is actually two softgels, not one.

In pretty much every case, the essential vitamins and minerals are provided at 200% of their daily intake or more, so there is no reason you can’t go with only one softgel and still hit your daily needs.

Virtually all of the minerals are supplied as amino acid chelates or easily absorbed salts, so the bioavailability of the ingredients in this product should be very good.

The inactive ingredients communicate a commitment to purity and simplicity: the capsule is made from gelatin (an animal product, so vegetarians take note), two oils, and natural coloring.

One unusual aspect of the formulation is the decision to include the omega 3 fatty acid DHA in an amount of 250 mg.  It’s known that omega 3 fatty acids may help improve maternal mental health during pregnancy (2), but omega 3 fatty acids are usually delivered in higher doses than the 250 mg of DHA present in Zahler Prenatal Vitamin + DHA.

7.  Deva Vegan Prenatal Multivitamin

If you are a vegetarian or a vegan, it can be especially hard to make sure you are getting the right amount of the essentials for having a healthy baby.

The B-complex vitamins, as well as iron, are sometimes rare in vegetarian and vegan diets.  For cases like this, Deva Vegan Prenatal Multivitamin is a good way to shore up any deficiencies in your micronutrient intake.

As the name suggests, all of the ingredients are derived from non-animal sources.  The iron content is good (21 mg) and the vitamin B12 content is quite high, at 10 mg (1666% of your recommended daily intake).

The other B vitamins are also supplied in amounts ranging from two to six times your daily needs.

Deva Vegan also includes a number of herbal extracts.  Among these are cinnamon, apple pectin, alfalfa leaf, chamomile, rose hips, and acerola extract.

Usually you can assume herbal extracts at least do no harm, but in the case of prenatal vitamins, you should be extra vigilant—many herbal extracts are poorly understood and not well-studied, so their effects on your baby’s health are unknown.

If you’re serious about taking this prenatal vitamin, do your homework to make sure you are okay with all of the herbal extracts present in Deva Vegan’s formulation

8.  Vitafusion Prenatal Gummy Vitamins

Delivered in a chewable gummy format, Vitafusion’s prenatal offering might appeal to people who don’t like to swallow pills on a regular basis.  The active ingredients are mostly standard.

There aren’t any of the extras you might get from competitors, like fruit and vegetable powders or herbal extracts.

One serious disappointment about Vitafusion Prenatal Gummies is their complete lack of iron.

Given that iron is one of the most critical nutrients during pregnancy (since the increase in demand for iron to make blood cells taxes the mother’s iron stores heavily), it’s very unfortunate that Vitafusion does not include iron in this formulation.

It might have made sense to abandon iron to deliver a large dose of calcium, but there isn’t any calcium in the supplement either!

To top it off, Vitafusion does very poorly on independent laboratory testing for purity and quality.  Eight of its nutrients were off from their label-claimed amounts by at least ten percent, and the analytically-determined amount of folate was three times as high as it should be.

All of this together means there’s no good reason to be taking Vitafusion Prenatal Gummy Vitamins—there are just too many other good options on the market.

9.  One a Day Women’s Prenatal Vitamin with DHA

The prenatal vitamin offering from One a Day is one of the brands you’re likely to find at your local pharmacy, drug store, or big box retailer.

Unfortunately, as these low-cost vitamins tend to be, One a Day Women’s Prenatal Vitamin with DHA leaves a lot to be desired.

The daily values for its ingredients are all at 100%, giving the impression that the supplement’s designers simply wanted to check off all the boxes without putting much thought into the specific formulation.

The sources of the vitamins and minerals tend to be cheap compounds with poor bioavailability—metal oxides that can exacerbate an upset stomach, for example, instead of the more bioavailable and easily digestible amino acid chelates or soluble salts found in better-quality supplements.

On top of this, there are several ingredients you’d rather not see in a supplement you’re taking while pregnant—Red #40 dye, Yellow #6 dye, and titanium dioxide.  If ever there was a time to set aside, questionable coloring agents, it would probably be with a prenatal vitamin.

10.  Centrum Specialist Prenatal Multivitamin

Another one of the common brick and mortar store brands, Centrum Specialist Prenatal Multivitamin carries many of the same unfortunate markers of a cheap vitamin.

Centrum is worse than One a Day, because many of its vitamins and minerals don’t even reach 100% of your recommended daily value.

Most troublesome is the low level of vitamin B12—only 2.6 mcg, less than a third of your daily needs.  And this is for one of the most critical ingredients!

Centrum Specialist is an even more flagrant user of questionable ingredients.  Not only are many of the metal mineral sources cheap metal oxides, the formulation includes the preservative sodium benzoate and BHT—somehow, most other supplement companies find a way to make prenatal vitamins that don’t need to contain these synthetic compounds.

Even though you may see it on shelves everywhere, steer clear of this one.

Part 2: What can a prenatal vitamin do for you?

Prenatal vitamins are special supplements designed with the intent of helping your soon-to-be-born baby to be as healthy as possible.

The focus with prenatal vitamins is to provide nutrients that have been scientifically connected with better fetal development.

In an ideal world, your prenatal supplement is only one facet of ensuring your baby is as healthy as possible—staying healthy during pregnancy in other ways, like getting exercise and eating a well-balanced diet, is part of the equation too.

Given the name, you might think you should start taking prenatal vitamins once you know you are pregnant.  However, this is a mistake! Many critical developmental steps that rely on proper nutrition happen very early on during pregnancy—in the first few weeks.

Once you start considering having a baby, you should already start taking a prenatal vitamin.  The good news is that there is no real downside to taking a quality prenatal vitamin—they provide pretty much the same benefits as a regular multivitamin if you don’t get pregnant.

Benefits of prenatal vitamins

As the science of nutrition took off during the 20th century, scientists began to realize how important proper nutrition is during pregnancy.

As a baby develops, it is very vulnerable to nutritional deficiencies, and a deficit of a few critical vitamins and minerals are known to cause problems.

There is a substantial body of science that connects low levels of vitamin B9 (folate) and vitamin B12 (cobalamin) with an increased risk of neural tube defects, a birth defect that affects the spinal cord as it develops.  Neural tube defects often have very serious medical consequences for the baby.

According to a scientific article published in 1993 by P.N. Kierke and other researchers at the Health Research Board in Dublin, Ireland, blood levels of both folate and vitamin B12 are directly and independently linked to prevention of neural tube defects in infants (3).

The authors followed over 56,000 pregnant women throughout their pregnancy and after childbirth, tracking blood levels of folate and vitamin B12.

The authors then used statistical methods to search for an association between the blood levels of these two vitamins and the probability that the woman’s child would end up with a neural tube defect.  Indeed, the vitamin levels in the blood were strongly correlated with a reduced risk of this type of birth defect.

Moreover, many of the women whose folate and B12 intakes were up to normal dietary standards still had low levels of folate and B12 in their blood, which caused Kierke and co-authors to call for revisions to dietary intake standards.

This research, and other papers like it, spurred the United States Food and Drug Administration to create new standards for fortifying processed foods with folic acid (another form of folate) and vitamin B12 in order to prevent neural tube defects.

As a result, the average blood folate levels in pregnant women more than doubled, but some women still have low levels of folate (4).

During pregnancy, your iron needs are also quite high, since you are producing blood for two people instead of one.  According to a 2000 article by Thomas H. Bothwell published in the American Journal of Clinical Nutrition, the total added iron needs during pregnancy sum to over 1000 mg (5).

Much of this required iron comes during the second and third trimester, and many women do not have enough bodily iron reserves to support this demand for iron.

Bothwell writes that, for many women, especially those with a subpar diet, fortification of their food or supplementation of their diet with an iron supplement.  For this reason, almost all prenatal vitamins include iron as a part of their formulation.

The format of the iron supplied varies from product to product—though many different types of iron are absorbable, amino acid chelates tend to be better-tolerated.

Another important consideration is that calcium inhibits iron absorption.  This phenomenon is well-described in a brief by Leif Hallberg published in the American Journal of Clinical Nutrition in 1998 (6).

The interaction is strong enough that most high-quality prenatal vitamins have barely any calcium in them at all.  You should check your prenatal vitamin’s label to make sure there isn’t too much calcium in it.

However, it’s also important to get calcium during pregnancy too! The best strategy to avoid problems is to take a calcium supplement or eat calcium-rich food at least a few hours apart from taking your prenatal vitamin.

Recommended dosage

Fortunately, the recommended dosage is taken care of by the supplement designers in a quality prenatal vitamin.  You should examine the nutrition facts label to check the levels of four key ingredients, though: vitamin B9 (folate/folic acid), vitamin B12, iron, and calcium.

The Mayo Clinic recommends that you consume at least 400 micrograms (mcg) of folate per day before and during pregnancy, and vitamin B12 and iron should be supplied in amounts close to or exceeding 100% of your daily needs (8).

The calcium content, as mentioned before, should be limited, otherwise you’ll be interfering with your iron absorption.

Side effects prenatal vitamins

Since they are specifically designed with safety in mind, a quality prenatal supplement should not have any major side effects.  Some women find that consuming high levels of iron (especially in inorganic forms) can cause mild gastrointestinal problems (7).

Still, it’s important to keep your body’s iron stores high during pregnancy, so if this occurs, you can try switching to a prenatal vitamin that supplies iron in a chelated form, or spreading the dosage out throughout the day.


A prenatal vitamin supplement can be a great way to ensure that you are on the right track for ensuring your baby develops in a healthy way.  Making sure you get enough folate, vitamin B12, and iron are key aspects of a prenatal vitamin.

Remember, if at all possible, you should start taking a prenatal vitamin before you try to get pregnant, as the first few weeks of pregnancy involve some critical development of your baby’s nervous system and spinal cord.

Especially when it comes to choosing a prenatal vitamin, talking to your doctor is a good idea, as you might have some specific individual needs that need to be taken into account when deciding on a prenatal vitamin supplement.

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