Most doctors recommend starting taking prenatal vitamins with a minimum amount of folic acid at least three months before trying to conceive. Strong research evidence supports the value of consuming a minimum of 400 mcg of folic acid daily, alone or in combination with a multivitamin to prevent neural tube defects, miscarriages and even some forms of cancer in newborns. The new study shows that women who take multivitamins during pregnancy can significantly lower their children’s risk of nervous system cancer known as neuroblastoma, most common tumor diagnosed in infants and is usually diagnosed in children under age 3, by 30 percent to 40 percent (Prenatal multivitamin supplementation and rates of pediatric cancers: a meta-analysis. Goh YI, Bollano E, Einarson TR, Koren G. Clin Pharmacol Ther. 2007 May;81(5):685-91.)

Another 2007 study shows that vitamin use during pregnancy seems to help protect against childhood leukemia and brain tumors (Vitamin and mineral supplements in pregnancy and the risk of childhood acute lymphoblastic leukemia: a case-control study. Dockerty JD, Herbison P, Skegg DC, Elwood M. BMC Public Health. 2007 Jul 3;7(147):136.)

Dr. Andrew F. Olshan, professor of epidemiology at the UNC School of Public Health and a member of the Lineberger Comprehensive Cancer Center, says that among nutrients that might reduce the incidence of childhood cancers are folic acid, vitamins C and A. In addition, regular adequate folic acid intake can lower your own risk of some cancers, including breast cancer, and heart disease.

Doctors suggest that the best effect results from a diet rich in folic acid sources, such as fortified grains and dark green leafy vegetables, coupled with a daily supplement containing 400 mcg (0.4 mg) of natural folic acid.

There has been much debate whether isolated, synthetic vitamins do any good. The recent research shows that certain vitamins can actually shorten your lifespan. Antioxidant supplements such as vitamins A and E, and beta-carotene appeared to raise, not lower, the risk of early death. Findings by Copenhagen University scientists are nothing short of shocking: beta-carotene produced an approximate 7 per cent increased risk of early death, vitamin E a 4 per cent increase and vitamin A, a shocking 16 per cent increase.

This is certainly not good news for the future mom!

One explanation may be that while antioxidants are eliminating the molecules called “free radicals” which are said to cause the oxidative stress, this might actually interfere with a natural defense mechanism within the body. Naturopaths say that synthetic vitamins are not absorbed by human body and in fact do more harm than good because the chemical structure of synthetic vitamins is not the same as of the real thing.

And by all means the study is not conclusive. It studied the effect of vitamins on ill people with heart disease and diabetes, and in fact, the very authors of the study said there was “no convincing proof of hazard” for taking vitamin supplements.

While the jury is still out, it may be wise to abstain from taking isolated supplements of antioxidant vitamins A, C, and E. For example, a bottle of ascorbic acid caplets is a classic example of isolated synthetic vitamin.

Organic vegetables and herbs contain vitamins in natural form, in just the right amounts in the way nature made your body to use them, not from some isolated or man-made chemical source. Food contains a complex matrix of different components which could not be replicated by supplements. To boost your intake of vitamins and minerals, make it a habit to consume superfoods: barley grass, chlorella, spirulina, sea vegetables, wheat grass, “greens” powders, quinoa, flax oil, extra virgin coconut oil, soy milk and tofu, green tea, and various spices. Organic milk is very rich in natural vitamin E, essential fatty acids, calcium and antioxidants.

Our diets, no matter how hard we try, are often lacking in essential nutrients, and well-formulated supplements can help bridge the nutritional gap for many moms-to-be. To patch things up, whole food vitamin supplements are indispensable.   

Any vitamins are only good if they are able enter your bloodstream. When choosing a multiple vitamin in pill form, try the simple Tap Test. Shake the bottle vigorously. Does it sound like maracas? If the multivitamins sound like a bunch of rocks, they are most likely very hard for your body to digest and absorb. Capsules seem to be a better alternative to pills and liquid vitamins seems to have the highest absorption levels. According to the Physician’s Desk Reference, more than 85 percent of nutrients in liquid supplements are absorbed in 22 to 30 seconds.

Some vitamins are bio-available only in certain forms. Check the bottle of the multivitamins to answer the following questions:

Is vitamin C buffered or esterified? Does the formula contain bioflavonoids, which work synergistically with vitamin C.?

Is the vitamin E in your multivitamin natural or synthetic? Does the formula contain several types of tocopherols?

Does your multivitamin contain few or many forms of antioxidant nutrients? Generally the more different kinds and forms the better. However, certain antioxidants are not recommended for use during pregnancy. Some of the expensive ingredients not proven safe for use during pregnancy and lactation include selenium, coenzyme Q10, L-glutathione, n-acetyl cysteine, and ginseng. Why should you pay for something you aren’t going to use?

 Does your multivitamin contain the full complement of B vitamins, in proper ratios? Does it contain more than 1 mg of folic acid?

Does your multivitamin contain food enzymes? Digestive enzymes help the body to absorb and digest the supplements.

Do not be afraid to look at and compare labels. Remember, your goal should be to purchase the safest multivitamin, so go ahead and scrupulously compare the labels.

The rule of thumb is: if the source of the vitamin is a chemical name, then the vitamin is synthetic. If the food source is given, the vitamin comes in a natural form.

Here are the most common sources of natural vitamins:

Vitamin A: fish oils, lemon grass, carrot oil (synthetic: acetates, palmitates)

Vitamin B1: yeast (synthetic: thiamine mononitrate, thiamine hydrochloride)

Vitamin B2: yeast (synthetic: riboflavin) 

Pantothenic acid: yeast, rice bran or liver (synthetic: calcium D-pantothenate)

Vitamin B6 (pyridoxine): yeast (synthetic: pyridoxine hydrochloride)

Vitamin B12: liver, micro-organism fermentation, cobalamin

Folic acid: Yeast or liver (synthetic: pteroylglutamic acid)

Vitamin C: citrus, rose hips, acerola berries (synthetic: ascorbic acid)

 Vitamin D: fish oils, ergosteral (yeast) (synthetic: calciferol)

 Vitamin E: vegetable oils, wheat germ oil, d-alpha tocopherol (synthetic: dl-alpha tocopherol)

Vitamin K: alfalfa (synthetic: menadione).

Of course, in ideal world we would be obtaining vitamins only from natural sources. But we live in a real world, where even completely organic diet cannot fill the necessary vitamin quota. During my pregnancy, I used complete pregnancy multivitamins sold in a health food store and supplemented them with added chelated calcium and fish oil. My advice is simple: trust your maternal instincts, but whenever in doubt, take the vitamins to your doctor to get his approval (or else).