I Evaluated Six Popular Prenatal Vitamins (so you don't have to)

I often get asked which is the best vitamin to take for both pregnancy and postpartum. Optimal nutrition is vital to a healthy pregnancy, the healthy development of your baby, and for maintaining optimal function in the mother both during pregnancy and during lactation. Since perinatal nutrition is complex, I simplified it for you! I looked at the nutrient content of six popular pre/postnatal vitamins and evaluated them for optimal perinatal support. My thoughts are outlined below.

Nutrient Content of Each Supplement

	Ritual	Nature Made	GOL	Needed	Fullwell	WHN
Vitamin A		770 mcg (BC)	1300 mcg (BC)	1500 mcg BC & RP	1500 mcg BC&RP	1300 mcg BC &RP
Vitamin C		85mg 100%	150 mg 125%	300 mg 250%	275mg	120 mg
Vitamin D	2000IU	1000 IU	1000 IU	4000 IU	4000 IU	4000 IU
Vitamin E	7mg – 37%	15mg 100% preg	19mg 100% post	30 mg 158%	100 mg	19 mg
Vitamin K	90 mcg K2	90 mcg	90 mcg + 20 mcg K2	90 mcg K2	100 mcg K2	90 mcg K2
Thiamine B1		1.4mg – 100%	1.61 mg 115%	5mg 357%	5mg	1.4 mg
Riboflavin B2		1.4mg – 88%	1.84 mg 115%	20 mg 1250%	10mg	1.6mg
Niacin B3		18mg – 100%	20.7mg 115%	25mg 1250%	25mg	18mg
Pantothenic acid B5		6mcg – 86%	8.05 mg 115%	150 mg 2143%	150 mg	7mg
B6		1.9mg – 95% (PHCl)	9mg 450%	40mg 2000% P5P	20mg	2mg P5P
Biotin B7	150 mcg – 42%	30 mcg 86%	210 mcg 600%	350 mg 1000%	500 mcg	35 mcg
Folate B9	1000 mcg DFE (MTHF)	800 mcg FA ie 1330 mcg DFE	800 mcg DFE	918mcg DFE MTHF	1360 mcg DFE MTHF & Ca Folinate	600 mcg DFE MTHF
B12	8mcg 286%	5.2 mcg 186%	14 mcg 500%	200 mcg 7143%	150 mcg	2.8 mcg
Calcium		150mg – 12%		200 mg	400 mg	200 mg
Choline	55mg – 10%			400 mg	300 mg	320 mg
Iron	18mg – 67%	27mg 100%	27 mg	+	+	+
Iodine	150mcg – 52%	150 mcg 52%	290 mcg 100%	290 mcg	250 mcg	220 mcg
Mag	32mg – 8%	45mg 11%		200 mg	300 mg	100 mg
Zn		11mg 85%	13 mg 100%	25 mg	20 mg	6.5 mg
Cu				1mg	0.75 mg
Se			50 mcg 71%	200 mcg	200 mcg	100 mcg
Mn			0.75 mg 29%	5mg	5mg	1.3 mg
Mb				100 mcg	100 mcg	25 mcg
Cr			90 mcg 200%	120 mcg	120 mcg	45 mcg
Potassium				100 mcg	100 mg
Omega 3s	350mg	260mg		+	+	+
Myo Inositol					150 mg
Betaine HCl					150 mg
Boron	0.7 mg

My Rating:

Ritual: 2/10

There are several redeeming qualities about this prenatal vitamin. It uses methylfolate instead of folic acid, and in adequate amounts along with B12. It contains omega 3s, vitamin D, iron, and iodine, all of which are very important for pregnancy. Unfortunately, the downfalls outweigh the redeeming qualities here. The vast majority of the nutrients it contains are in truly negligible amounts, such as choline, magnesium, and vitamin E. Plus it doesn’t contain many essential nutrients at all. There is no vitamin A, vitamin C, or calcium to name a few. It cannot support the thyroid adequately when it is 70mcg and 140 mcg short in iodine for pregnancy and breastfeeding, respectively, nor does it contain any selenium, zinc, or several B vitamins required for your body to actually use thyroid hormones. Remember, the thyroid is our master metabolic hormone, and is greatly involved in maintaining a successful and healthy pregnancy as well as fetal development (1). Plus, the vitamin D it does contain is insufficient for many important processes, such as immune health and dental formation in your growing baby (2). It will unfortunately leave many major gaps in nutrition for the vast majority of women no matter how nourishing their diet.

Nature Made: 4/10

This multivitamin does contain many nutrients our body needs, but unfortunately it still misses the mark. It provides just under or at the RDA for pregnancy for all the B vitamins, but the folate provided is in the synthetic form folic acid, which many women cannot properly utilize. The vitamin A it contains is also in a precursor form, and bodies activate it at varying rates, likely rendering this inadequate. By the third trimester, it is almost definitely insufficient as even twice the RDA is found to come up short later in pregnancy for nearly ¼ of women (3). Along with bare minimum vitamins D and C, immune system support is lacking here. It also cannot support the maternal thyroid properly with inadequate iodine and zinc, and no selenium. It does, however, contain the RDA for iron, which is helpful in the second and third trimesters of pregnancy, as well as early postpartum. Overall, this vitamin is basic at best, but lacks support where it counts.

Garden of Life: 5/10

This prenatal multivitamin is a bit more comprehensive, containing at least the RDA for all the B vitamins, the full RDA for iron, and is thyroid-supportive with sufficient iodine for both pregnancy and postpartum, as well as adequate zinc and near-adequate selenium. It does only hit the minimum for Vitamins D and E, however, and is lacking magnesium, choline, and calcium, all of which are essential for a healthy pregnancy. Additionally, though it does technically contain enough Vitamin A to be considered adequate for lactation needs, it is only in the form of beta carotene which may not be activated sufficiently for many women. Its baseline support doesn't make it a bad option, just not an optimal one.

Needed (8/day option): 9.7/10

This prenatal vitamin is a fantastic option all around. It uses methylated folate instead of folic acid and uses both the precursor beta carotene and the active retinyl palmitate for vitamin A, making both of these nutrients more usable in the body. Its B vitamin profile is robust, with all exceeding the RDA, and is supportive for calcium, choline, and magnesium needs. This multi is also very thyroid-supportive, with sufficient iodine, zinc, and selenium. It also contains an optimal amount of vitamins C, D, and E. Iron can be added on separately, which is helpful for varying needs across trimesters and across women. Omegas can also be added separately as well, which is helpful to ensure these sensitive fats do not go rancid. I do wish it was a bit more supportive in calcium as many women do not consume enough, and the folate content would be more optimal if it utilized more than one type of active folate as some people are sensitive to methylated vitamins. The only slight downfall is that several moms have told me that they could not tolerate the taste.

FullWell: 10/10

When comparing the nutritional profile between Needed and FullWell, they are very similar in which nutrients they contain and the amounts, so I will discuss where this one differs. FullWell makes sure to use both methylated folate and folinic acid to be better utilized for a larger cohort of women and provides a greater quantity of folate overall. It also uses both precursor beta carotene and active retinyl palmitate for vitamin A. I also appreciate that it contains a more supportive amount of calcium since many women consume insufficient amounts, though neither supplement reaches the RDA here. It is 40 mcg short in iodine for postpartum lactation needs, but this is easily made up in the diet if you are consuming milk or seafood regularly and is otherwise very thyroid-supportive with zinc and selenium. It offers iron and omega 3s as a separate add-on as well. The quantity and quality of nutrients provided in this multivitamin are robust, making it an excellent option for both pregnancy and postpartum, and I have not heard any complaints regarding taste for this brand. It is one I personally use and highly recommend.

**A note about both Needed and FullWell: Yes, they do both require 8 pills per day. However, that is for a reason. They both contain more nutrients than most prenatal multivitamins, and that takes up space. Choline itself is considered a “bulky nutrient”, but it is involved in methylation, brain health, and the prevention of midline deficits (like spina bifida), so it is important to include. Neither of them contain adequate calcium or optimal choline, likely due to the volume it would require, but provide a good boost to help you get there with the support of a healthy diet. Both brands utilize capsules that can be opened and the powder added to smoothies or applesauce if pills aren’t your thing right now. You will never get an optimal prenatal in a one or two pill per day format.

We Heart Nutrition: 6/10

This option is more comprehensive than the first two brands, but provides the minimum in well-rounded support for pregnancy and postpartum. It meets the RDA for all the B vitamins, though it does use the methylated form of folate. For vitamin A, it meets pregnancy and postpartum needs with both the precursor and active forms utilized, and it has an optimal vitamin D quantity as well. It is somewhat supportive for the thyroid with iodine content sufficient for pregnancy (but is 70mcg short for postpartum lactation needs) and optimal selenium content, but zinc does not meet recommended amounts. I can appreciate that it is supportive for calcium, choline, and magnesium, but wish it was more robust in these nutrients. In all, this is not a bad option, and may be more doable as it is just four pills per day, but it would still require you to consume a very nutrient dense diet to reach optimal intake for most nutrients.

Generally speaking, the best prenatal vitamin is the one you will actually take. I do hope I've provided some guidance on what is important in a supplement and where the gaps are so you can choose what's best for you.

References:

1.      https://www.niddk.nih.gov/health-information/endocrine-diseases/pregnancy-thyroid-disease

2.      Hollis, B. W., Johnson, D., Hulsey, T. C., Ebeling, M., & Wagner, C. L. (2011). Vitamin D supplementation during pregnancy: double-blind, randomized clinical trial of safety and effectiveness. Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research, 26(10), 2341–2357. https://pmc.ncbi.nlm.nih.gov/articles/PMC3183324/

3. Gannon, B. M., Jones, C., & Mehta, S. (2020). Vitamin A requirements in pregnancy and lactation. Retrieved from https://www.sciencedirect.com/science/article/pii/S2475299122120779