April's Picks: Pregnancy Essentials
By April Segal, PharmD, BCPS, APh
Clinical Pharmacist + Founder
It has been such a crazy year! I hope you all have been able to find a secret pleasure to get you through all the quarantining, missed celebrations and missed vacations. I love hearing about the new activities and hobbies people have been picking up and the creative ways people are connecting with others. My husband and I have been blessed to have our own secret gem of happiness that has been keeping us sane through all the ups and downs of 2020. We are happy to announce that we are expecting a little boy (our first) on Halloween! We have been excitedly planning for his arrival with just three months left to go until we get to meet him.
If you have been to Remedy, then you know that we have a lot of products that are focused on women’s health. This includes products for various life stages that women go through, including pregnancy. Even though as a practitioner I am familiar with what to recommend to pregnant women, it has been different to experience it first hand! I found myself with a renewed vigor to deep dive into the best pregnancy products. You of course have the general things that all women should take (think prenatal vitamin and omega supplement), but you also have the unique needs that come up during every pregnancy. These may be health concerns unrelated to the pregnancy, like a pre-existing health condition that a mother can no longer take medication for (or who just wishes to use something more natural now that they are pregnant) or it may be related to the pregnancy itself. The one people are most familiar with is of course morning sickness but there are a whole slew of health issues that can come up at various stages, including anemia, leg cramps, joint aches, indigestion, and constipation. Whew! Sounds like fun right? Well despite all of that, it still is such an amazing time and I am still in awe at the entire process. Our bodies are so amazing!
So with that being said, I am going to go over my top picks for supplements to use during pregnancy! These products are the best of the best and I have recommended them to all my friends, family, and patients who are expecting.
So I could do a whole article on prenatal vitamins but hands down the MOST important thing is the type of folate (vitamin B1) in your prenatal. I can not tell you how disappointed I am in so many prenatal vitamins that use synthetic folic acid. This includes prescription-grade prenatal vitamins, which I would never recommend - these are some of the lowest quality prenatals of all. You should ensure that your prenatal says methylfolate on the label or that it is a whole-food-based prenatal, like my favorite by Innate Response. The MTHFR gene mutation is very prevalent and if you are a poor methylator your baby could be at risk of birth defects, and you could be at risk for higher rates of miscarriage if you do not take a prenatal with methylated folate. It's just not even worth chancing it. There is no downside to taking methylfolate. The other B-vitamins are important for you and baby as well. Vitamin B5 helps reduce leg cramps and promotes needed hormone production. Vitamin B6 helps reduce nausea and vomiting and can even be taken in higher strengths independently as a morning sickness remedy, but having it already in your prenatal is a win-win!
Another consideration is whether or not your prenatal contains iron. Iron can be one of the main reasons that a prenatal vitamin might make someone nauseous (or constipated for that matter). On top of that, not all women require extra iron supplementation or if they do, it might not be needed at all stages of pregnancy. I would suggest a prenatal that has a whole-food-based form of iron (you will see that the whole-food-based version is a trend here!) which is easier on the stomach. If you can't tolerate that, then it may be best to get an iron-free version and then supplement with high-iron foods or a supplement like Floradix, which is the iron supplement that I have seen have the best tolerability of all. Lastly, if your prenatal has a little bit of vitamin C in it, that will help you get the most out of your iron, as it helps with absorption, which is a notorious problem with iron.
Vitamin D, K, and Calcium are all important for healthy baby bone development. I prefer a prenatal that does not have calcium though. Mostly because it can interfere with the absorption of other nutrients. Secondly, most people can get enough of this in their diet, even if they are vegan!
Omega 3s (EPA and DHA)
The guidelines suggest that pregnant women should make sure to get at least 300 mg DHA, but I think that stops short. DHA is essential for both neurological and early visual development of the baby, but EPA has an important role too. EPA and DHA have also been shown to prevent preterm labor and delivery, lower the risk of preeclampsia, and increase birth weight. Omega-3 deficiency also increases the mother’s risk of depression. When picking your source of omega-3, it really should be marine or algae-based (for vegans). Plant-based sources like flaxseed or chia seeds typically only contain alpha-linolenic acid (ALA). ALA is not as active in our body and must be converted to EPA and DHA by your body. Unfortunately, our body’s ability to convert ALA is limited. Only about 5% of ALA is converted to EPA, while less than 0.5% is converted to DHA.
Omega 3 supplements should never smell or taste fishy if they do then do not take them - that is a sign that they have turned rancid. I have experienced this first hand when sampling lower quality supplements. If you get “fish burps” after taking omega 3 supplements, try keeping your supplement in the fridge. I also find that this can vary between products. I am a big fan of the tried and true Nordic Naturals brand. I love their quality standards related to mercury testing as well as their sustainable approaches (also, it is the one brand I have never had the “fish burps” on!)
Not every woman who is pregnant needs magnesium and I didn’t start taking this until the end of my second trimester, but boy do I love it now! It has helped so much with muscle tension, cramps, and also to help with sleep. I often find myself recommending magnesium glycinate to all types of people that come into Remedy because muscle aches/cramps + trouble sleeping are so common. My other go-to for both of these problems is CBD, but I don’t feel comfortable taking or recommending CBD for expectant mothers at this point, but thank goodness we have a super safe and effective option - magnesium! If you suffer from constipation during pregnancy you could try other salt forms of magnesium, such as magnesium oxide or a combo magnesium glycinate/magnesium oxide, which has the added benefit (in this case) of helping with bowel movements.
Sleepy Nights Tincture for Pregnancy
I have been a long time sufferer of insomnia. I have been on everything from Ambien to melatonin to CBD to herbal blends. Before I found out I was pregnant, I had my insomnia under control with the use of my Remedy Sleep Blend plus a nightly meditation. The sleep blend is actually Remedy’s most popular product, if you have issues sleeping I highly recommend it. It's a super-effective blend of Valerian Root, Hops, Skullcap, Passion Flower, Chamomile, California Poppy, and Melatonin. However, California Poppy, Hops, and Valerian really shouldn’t be used during pregnancy so I switched to Wishgardens’ Sleepy Nights for Pregnancy Tincture. I already loved this brand for all of their thoughtful blends and I wasn’t let down by this tincture! It is a beautiful blend of Milky Oat Tops, Linden, Passionflower, and Skullcap. It really works and I love that it is made especially for pregnant women so you can feel super safe to use it!
If you are expecting, congratulations! If you are trying to conceive, please stop in and talk to us, it is never too early to start thinking about pregnancy and what I like to refer to as trimester zero. We have lots of products that can help with the unique needs of women pre and post-birth! Women’s health is really one of my passions and it's evident when you look at our shelves :)