Preconception, Pregnancy, Postpartum and Breastfeeding: Wellness and Supplements

Scope and a note on sources

This page covers nutrition and supplements across the stages around pregnancy: planning, pregnancy, after birth, and breastfeeding. Most dosing advice here comes from the UK's NHS because it was the clearest readable source we could verify; US guidance can differ in details, so confirm with your prenatal care provider. It is educational and not medical advice. Evidence labels: established recommendation, promising but limited, insufficient evidence.

Before pregnancy (preconception)

Folic acid. The NHS recommends taking 400 micrograms of folic acid a day when trying to get pregnant (ideally 3 months before) or as soon as you find out you are pregnant, through the first 12 weeks. Taking it longer will not harm your baby. [1] It is difficult to get enough from food alone, and folic acid lowers the chance of neural tube defects such as spina bifida. [1] A Cochrane review found a protective effect of daily folic acid, with high-quality evidence. [2] MedlinePlus says getting enough before and during pregnancy can prevent major birth defects of the brain or spine. [3] Established recommendation.

A higher dose is advised in some situations, such as a personal or family history of neural tube defects, diabetes, a blood condition such as sickle cell, or taking epilepsy or HIV medicine. This is prescribed by a clinician. [1]

Fertility supplements. For antioxidants taken by women with subfertility, a Cochrane review of 63 trials judged the evidence very low quality and was uncertain whether they improve live birth. [4] For inositol in women with PCOS, a Cochrane review found low to very low quality evidence. [5] NCCIH says there is not enough reliable evidence to know whether chasteberry helps infertility, and it may be unsafe in pregnancy. [6] Insufficient evidence. We do not claim any supplement improves fertility. See PCOS.

During pregnancy

• Vitamin D: the NHS recommends 10 micrograms daily from early October to late March, and year-round for some people, and says not to take more than 100 micrograms a day. [1]
• Iron: levels are checked at routine blood tests, and iron is recommended if you are anemic. [1]
• Avoid: cod liver oil and supplements containing vitamin A (retinol), since too much vitamin A can harm development. [1]
• Herbs: some herbs are unsafe or untested in pregnancy; for example NCCIH says black cohosh and red clover may be unsafe. [7][8] Read pregnancy and breastfeeding safety before using any herb, tea or supplement.
• Warning signs: bleeding in pregnancy is not always serious but needs advice. Severe belly pain, shoulder pain, faintness or heavy bleeding need emergency help (call 911). [9] An ectopic pregnancy can be serious, and symptoms such as one-sided belly pain, bleeding and shoulder-tip pain call for prompt advice even before a positive test. [10]

After birth (postpartum)

Low mood after birth is common in the first days and usually passes within 2 weeks. If it continues, gets worse or you struggle to cope, get help. [11] Postnatal depression can start in pregnancy, soon after birth, or up to a year later, and partners can be affected too. [11] Treatment includes talking therapies and antidepressants, and many antidepressants are safe while breastfeeding. [11] If you are having thoughts of harming yourself or your baby, call or text 988 (US) or 911. [11] See pelvic floor health for recovery, since a Cochrane review found that pelvic floor training during pregnancy probably lowers the risk of urinary leaks in late pregnancy. [12] Sleep: sleep in life stages.

Breastfeeding

You do not need a special diet while breastfeeding, though a varied healthy diet is a good idea. [13] The NHS suggests a daily vitamin D supplement for breastfeeding mothers, since it is hard to get enough from food alone. [14] Caffeine can reach your baby through breast milk, and there is not enough information to say how much is too much. [13] Check herbs and supplements with a clinician first: black cohosh, red clover and chasteberry may not be safe while breastfeeding. [7][8][6] See medication interactions.

When to get help

Seek care for bleeding in pregnancy, severe pain, or thoughts of self-harm. [9][11] See when to get help and nutrition for women.