Most people have already spent a small fortune on a fancy prenatal vitamin before they come in for the first visit. Those that are labeled as prenatal vitamin and that are bought at a reputable store or pharmacy are generally going to be just fine. If they settle well, stick with it. (A generic version of Flintstones vitamins, two a day can also work!) My experience is that prenatal vitamins try to be a one size fits all and pack a lot of extra iron that may not be needed until the 3rd trimester. In the first trimester, too much iron can lead to constipation and increased nausea. 

Fish oil supplements that advertise omega 3 fatty acids or DHA and EPA are also popular and carry claims that they will help increase brain development. While there is good data that shows that eating fish high in DHA/EPA is beneficial for the newborn brain, there is no convincing data to date that taking a supplement form does any consistent good. It can often increase heartburn and halitosis.

After your initial labs come back, we may need to alter things slightly, but the above statements work generally for most patients.

Another common misconception is that prenatal vitamins have extra vitamins. Next time you’re at the store compare the nutrition facts between a prenatal vitamin and a women’s one-a-day vitamin. Actually, prenatal vitamins have substantially less of the fat soluble vitamins (vitamin A, D, E & K). These vitamins in excess can accumulate and lead to increased risk of malformations early on if too much is consumed. Less is really more in the case. This is why sticking with a labeled prenatal vitamin or children’s vitamin is generally safer.

Most nutritional supplements warn “talk to your doctor before taking if you are pregnant or think you might be pregnant.” This is probably good advice and we can review on a case-by-case basis.