Q Is there a difference between over-the-counter and prescription prenatal vitamins?
Many doctors prescribe prenatal vitamins not because the prescription vitamin is better, but because it may be less expensive for the patient to pay the insurance co-pay rather than the over-the-counter cost.
There are no national standards for what should be included in a prenatal vitamin, since the FDA does not regulate what goes into vitamin and mineral supplements. Typically, over-the-counter prenatal vitamins contain 800 micrograms of folic acid, while prescription vitamins contain 1,000 micrograms. By comparison, the recommended daily allowance for non-pregnant adults is 400 micrograms. Either the 800 or 1,000 microgram dosage is fine for a healthy pregnancy.
There are many prenatal vitamin brands for you to select from — over the counter or by prescription. Check your insurance for your least expensive option.
Q Do I need to take fish oil or calcium supplements?
There had been a rise in interest in fish oil supplements in pregnancy after several epidemiologic suggested benefits in infant brain development, as well as improved maternal depressive symptoms and maternal lipid benefits. However, more recent, better-designed trials have been disappointing, and suggest that fish oil supplementation does not affect these issues.
Most prenatal vitamins have only about 200 to 300 milligrams of calcium, and the recommended intake in pregnancy is 1,200 milligrams. One can fit only so many vitamins and nutrients into a vitamin tablet, which is why there is not more. Depending upon the calcium content of your diet, a calcium supplement — either in the form of calcium citrate or calcium carbonate may be a good idea in order to reach the recommended amount.
Q Should I avoid eating canned foods, due to BPA exposure?
An enormous amount of attention has been placed recently on bisphenol A (BPA). BPA can be found in plastic food containers such as water bottles and plastic cling films, as well as in resins covering metal food cans. BPA is a xenoestrogen, a hormone that imitates the action of estrogen. Nearly 100 tons of BPA are released into the atmosphere yearly. Data from a large U.S. nutrition study suggest that more than 90 percent of the general U.S. population has detectable BPA in their bodies. The effects of this exposure are unclear. A 2011 study in Pediatrics
associated increasing amounts of BPA in maternal and infant urine with more anxious and depressed behavior and poorer emotional control. A recent review also noted behavioral abnormalities as well as earlier breast development among girls exposed to BPA.
There is a growing body of early data on BPA exposure and adverse pregnancy outcomes in animals and in humans, so some pregnant women may desire to limit exposure. The compound is everywhere, however, making it difficult to avoid.
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