Why do I need my Prenatal Pills?

Vitamins

By the end of this lesson you will be able to:

•	Understand why vitamins and minerals are so important during pregnancy.
•	Learn why the need for iron and calcium increases during pregnancy.
•	Identify the importance of folic acid and some good sources of this vitamin.
•	Know what pica is and why some women and children experience it.

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Activity 1:

1. Do most Americans eat a healthy diet?	Yes	No
2. Is folic acid, a B vitamin, more important during pregnancy?	Yes	No
3. Are the minerals calcium and iron needed during pregnancy?	Yes	No
4. Do you think it is important to take a prenatal during pregnancy?	Yes	No

Vitamins are important for the health of both the mother and baby. The food a pregnant woman eats provides the nutrients needed to begin and maintain the growth and development of her fetus.

Three nutrients that are very important during pregnancy are iron, folic acid, and calcium. These vitamins and minerals are important all the time but even more so during pregnancy because of the increased needs of the fetus.

Because most Americans don’t eat a variety of foods included on the food guide pyramid or eat too much from one food group, ignoring the others, many pregnant women may be deficient or low in calcium, iron or folate when they become pregnant.

Now let's see why there is a need for more nutrients during pregnancy and what can happen if you don't receive them.

Why Do I Need Prenatal Supplements?

• The fetus gets all of its' nutrients (including vitamins and minerals) from the mothers diet, nutrients stored in the mothers bones and tissues and some nutrients made in the placenta. The placenta aids in transferring nutrients, hormones and other substances from mother to baby. Nutrients found in the food consumed by the mother are needed for the placenta to perform these transfers.

• The increased needs of the mother and fetus sometimes make it difficult to obtain enough of the required vitamins and minerals from the diet alone.

What's is a Prenatal?

Prenatal Vitamin Contents

Folic acid	400 micrograms (mcg)
Calcium	250 mg
Iron	30 mg
Magnesium	320 mg
Vitamin A	800 mcg (8,000 I.U.)
B6	2.2 mcg
Vitamin C	65 mg
Vitamin D	10 mcg
Vitamin E	10 mcg
Zinc	15 mg

Why Do I need Iron?

•	Low iron stores in the blood, causes iron deficiency anemia. Iron deficiency in the early stages of gestation may increase the risk of having a low-birth weight or pre-term baby.

The women who are at most risk:
• May have poor nutrition because they eat the wrong kinds of food or not enough iron-rich foods
• Are unable to eat because of nausea and vomiting
• Are carrying multiple fetuses (twins or triplets)
• The need for iron increases during pregnancy and is even more important during the third trimester. The third trimester is when the fetus is storing iron for use after birth.
• The extra iron helps carry oxygen and nutrients to the fetus. Normally we absorb about 10% of the iron consumed in the diet. During pregnancy, iron absorption increases to 20%. This is important because a pregnant women's blood volume increases as much as 50%. Because of the increased requirement during pregnancy, iron is often hard to get through diet alone. The health care professional often recommends an iron supplement to help supply enough iron to meet the fetus and mother's needs.

Activity 2:

1. Name 2 reasons iron is important during pregnancy.
a.
b.

2. Name one way that you can increase iron.

Why Do I need Calcium?

•	Calcium is required for normal growth and development of bones and teeth. Calcium also helps with muscle contraction and blood clotting.
•	Bone formation begins in childhood and increases through adolescence, continuing until about 25 years of age. Daily calcium intake helps maintain bone health after age 25.
•	If there is not enough calcium in the diet, the body takes it from the bones. Calcium is taken from bones, carried in the blood and used for other body functions.
•	According to the National Institute of Health, a large percentage of Americans fail to meet the current recommended guidelines for calcium intake. As many as 50% of children and adults in the United States get less than the daily requirements for calcium.

How much Calcium do I need?

•	Calcium intake varies according to a person's age, sex and ethnicity. Other factors affecting calcium absorption are vitamin D intake, medicine and food that block calcium availability.

Calcium requirements

AGE GROUP	mg CALCIUM
4-8 years	800 mg
9-18 years	1,300 mg
Pregnant or Lactating teens	1,300 mg
Adults 19-50	1,000 mg
Adults 51+	1,300 mg
Recommendations based on the Dietary Reference Intakes for Calcium, National Academy of Sciences, 1997

•

Vitamin D is an important part of bone health. Without it, we could not get the calcium to our bones. Vitamin D increases the transport of calcium from the digestive tract to the blood stream. Our bodies can produce vitamin D with the aid of sunlight but limited exposure to sunlight will reduce production so drinking vitamin D fortified skim milk is an excellent way to ensure we get an adequate amount of both Vitamin D and calcium.

Activity 3:

1. Calcium is important for bone growth.	True	False
2. Calcium helps with muscle contraction.	True	False
3. You need more calcium during pregnancy.	True	False
4. Vitamin D is important for bone health.	True	False
5. Your body can make vitamin D.	True	False

Why Do I Need Folic Acid?

•

Folate, also called Folic acid, is a B vitamin and is important for both men and women. However, it is even more important for women of childbearing age or women planning to have a baby.

•

Folic acid is important for many body processes and is very important during the first trimester of pregnancy. At this time the baby's spine and brain form. Folic acid is crucial in cell multiplication and red blood cell formation. A diet deficient in folic acid has been linked to birth malformations know as neural tube defects. These defects in the fetus include:

•	Anencephaly: Part or all of the fetal brain is missing
•	Spina Bifida: The neural tube that encloses the spinal cord fails to close properly (this may result in paralysis).

•

The mother can develop a severe folate deficiency called megaloblastic anemia in the third trimester of pregnancy. The mother’s heart, spleen and liver may become enlarged, endangering both her and the fetus.

•	Recent research suggests that taking folic acid supplements may also significantly decrease the risk of having a baby with congenital heart defects.
•	Folic acid is found in all prenatal and most 1-a day vitamins. The recommended daily allowance of folic acid is 400 mcg per day.
•	Folic acid is also found in enriched flour, bread, rolls and buns. It is also fortified in the cereals that WIC provides.

Many women of childbearing age consume much less than the 400 mcg of folic acid per day that would prevent neural tube defects. The U.S. Public Health Service suggests ways to increase folic acid in the diet:

•	Improve dietary consumption
•	Fortify the U.S. food supply
•	Use daily supplements of folic acid for women of childbearing age.

•In 1998, the FDA's folic acid fortification program became effective. Manufacturers are required to add more folic acid per pound to enriched flour, bread, rolls, buns, farina, corn grits, cornmeal, rice and pasta products. The FDA also recommends eating natural sources of folate. Green leafy vegetables, legumes, citrus fruits and juices. Also, it is recommended to take a dietary supplement containing folic acid.

Activity 4:

1. A diet high in folic acid can reduce the risk of neural tube defects.	True	False
2. Even if you don't plan on becoming pregnant you should take a folic acid supplement.	True	False
3. Prenatal vitamins are the only source of folic acid.	True	False
4. Citrus fruits are a good source of folate.	True	False

What is Pica?
• Pica is a word that comes from the Latin word for Magpie, a bird that eats anything and everything. Pica is a craving for non-food items. The most common are:
     • Dirt
     • Clay
     • Paint chips, chalk, plaster
     • Laundry starch
     • Cornstarch
     • Baking soda
     • Coffee grounds
     • Cigarette ashes, buttes and burnt match heads
     • Rust and other items, such as leaves, grass and non-food items

Who gets Pica?

•	Pregnant women
•	Children (10-20% of children have pica during part of their childhood?)
•	People who are deficient of certain minerals
•	Individuals that are developmentally delayed or impaired

Pica can cause dietary deficiencies because the non-food item eaten can block absorption of necessary minerals in the intestine.

Pica can be dangerous if the craved substance is contaminated (intestinal infections and parasites) or toxic. If the non-food substance blocks the intestine, it can lead to a medical emergency and even death.

Activity 5:

1. Why can pica be dangerous?

2. Are children the only ones that may have pica?

Yes

Calcium, iron and folate are just a few of the nutrients we need everyday. But during pregnancy they become even more important. Protein, carbohydrates, fats, and all the other vitamins and minerals are equally as important. Following the recommendations on the food guide pyramid ensures a variety of nutrients needed for growth, good health and development.

What do you think...

Why is it important to take prenatal vitamins during pregnancy?

Which WIC Office do you go to?

AK Regional Hospital
Eagle River
L Street
Providence Hospital

Where are you taking today's lesson?

Activity 1:	1. Yes 2. Yes 3. Yes 4. Yes
Activity 2:	1. Blood volume increases, fetus needs additional iron during last trimester, carries oxygen to mom and fetus, helps carry nutrients to mom and fetus 2. Increase intake of foods containing iron, take prenatal.
Activity 3:	All true 1. Calcium is important for bone growth, bone maintenance, muscle contraction and blood clotting 2. Additional calcium, is needed during pregnancy to support the needs of the developing fetus and provide adequate amounts for moms bone growth or maintenance 3. Vitamin D aids in transporting calcium into the body 4. All milk is fortified with vitamin D and our body makes it.
Activity 4:	1. True 2. True 3. False 4. True

Activity 5:

1. Pica can cause dietary deficiencies because the non-food item eaten can block absorption of necessary minerals in the intestine.
2. No

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Revised: 06-13-2008