Supplementation needs for mother and baby

From the moment of conception until roughly 6 months of age, a breastfed infant is entirely dependent on the mother for nutrition. More and more research indicates that preconception, prenatal and postnatal nutritional status has an impact on both maternal and foetal health. Supplementation during conception, pregnancy and lactation may be necessary to meet the additional nutritional demands.

Here we outline the current Australian recommendations for supplementing some key nutrients for general health throughout the gestational period. Folate and iodine are particularly important. Due to the differences in dosing between pregnancy supplements, patients should at a minimum be advised to seek products in line with Australian recommendations.

Useful URLs

RANZCOG at tinyurl.com/okclvvj

NHMRC at tinyurl.com/o366ynv.

Nutrient Who and when Rationale Dose
Folate ≥1 month preconception and during first 12 weeks of pregnancy Prevention of neural tube defects (NTDs)
  • ≥0.4 mg daily
  • 5 mg daily for known risk of NTD (eg, anticonvulsant use; diabetes mellitus, previous child with NTD
    or family history, BMI >30)
Iodine All women considering pregnancy, pregnant, or breastfeeding Even mild deficiency can result in suboptimal neurological development, particularly lower IQ  150 mcg daily in addition to dietary intake
Vitamin D During pregnancy
  • Deficiency in neonates/infants associated with impaired skeletal development and increased incidence
    of hypocalcaemic seizures
  • Level should be ≥50 nmol/L in pregnancy and lactation (may need to be 10-20 nmol/L higher at end
    of summer to maintain levels in winter)
1000 IU daily
Iron3
  • Haemoglobin level should be checked at first antenatal visit and ~28 weeks
  • Not recommended in pregnancy or lactation unless iron deficiency anaemia is present
  • Iron deficiency anaemia should be investigated and treated
Expanded red cell volume, blood loss around time of delivery, and demands of the developing foetus and
placenta
  • Ensure women meet RDI (27 mg/day for pregnancy; 9-10 mg/day for lactation)
  • Note that ferrous bisglycinate causes less constipation and nausea than some other forms of iron
    such as ferrous sulphate
Omega-3 fatty acids Low intake of seafood Essential for healthy development of foetal brain, nervous system and retina 500 mg/day of combined DHA and EPA