Studies have consistently shown that pregnant women across the world are lacking in vitamin D. Why is this the case and what are the risks of such deficiency? Should mothers-to-be take vitamin D when they are sometimes advised against taking supplements during pregnancy?
All responsible scientific organisations recommend taking vitamin D during pregnancy. The reason is simple: around 35% of expectant mothers are vitamin D-deficient at the start of their 3rd trimester when it occurs in spring and winter (1). And the majority of the remainder have inadequate levels. According to recommendations established recently by the American Society of Endocrinology, and Institute of Medicine (IoM), pregnant women should take 600IU of vitamin D a day, though several studies suggest this dose is arguably too low to reach the target of 30ng/mL.
In terms of which supplement to take, there is a choice of oil-based capsules (such as Vitamin D3 1000 IU) to be taken daily to mimic natural intake, a single ampoule containing 100,000 IU, usually recommended in the seventh month of pregnancy, or two 50,000 IU ampoules, one to be taken at the 6th month and one at the 7th.
Certain mothers-to-be are at higher risk and need to be even more careful:
To minimize the risk of deficiency, vitamin D supplementation can be initiated before the first trimester, when a woman is trying to conceive.
Vitamin D deficiencyis not something to be taken lightly: it is associated with several risks and problems for both mother and fetus, and later for the baby:
As we know, vitamin D supports normal immune system and muscle function, and healthy bones and teeth. All physiological functions that develop in the fetus in the early months of pregnancy.
The latest studies show that for good health, we need to have more than 50 nmol/L of vitamin D circulating in our blood at all times. For the most part, this comes from our bodies’ production: under the effects of the sun’s UVB rays, the skin produces vitamin D from cholesterol and the body stores any excess in the liver. We also obtain it via dietary sources though these are rare (oily fish, dairy products, fortified drinks) and only provide 100-200 units a day (5) when we need 400-800. So in the absence of supplementation, regular exposure to the sun is essential if we are to avoid deficiency.
The problem is that our sedentary lifestyles and clothing habits reduce our exposure to sunlight, especially between October and May, as does pollution in major cities and the use of sunscreen. Some of us will already have negligible reserves in autumn. In pregnancy, the risk is increased tenfold because the body ‘diverts’ the mother’s reserves toward the fetus which needs an increasing amount of vitamin D for skeletal mineralization.
The safe upper level (SUL), established by the IoM (2011) and EFSA (2012), is fixed at 100 µg/jour (4000 IU). The risk of exceeding this amount is zero if you stick closely to the recommendations of the authorities and even those suggested by certain scientific studies. However, some health professionals may recommend higher intakes of vitamin D, depending on your situation (age, sex, ethnicity, latitude, etc.)
If you are pregnant and want to take a supplement (for example, Vitamin D3 1000 IU), you should always consult a health professional for advice on the right dose and best time to take it depending on your chosen supplement (he or she will advise which month to start your vitamin D supplementation, or when to take a single vitamin D ampoule, etc.). This is also an opportunity to consider taking other supplements, such as folic acid (pre- and during early pregnancy) and prenatal multivitamins (vitamin C, vitamin A…)
If you’re pregnant and want to breastfeed your baby, be sure to continue supplementing with vitamin D once you’ve given birth: breastmilk contains very low levels of vitamin D (just 20-60 IU per liter). Here again, seek advice from a health professional.
References
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