Table of Contents
Pregnant and Breast-feeding Women. Women who are pregnant or who are breast-feeding generally need additional vitamins. Folic acid and vitamins B6 and B12 are particularly important. Women who are vegetarians must be sure to avoid vitamin B12 deficiencies, which can harm their babies. Folic acid reduces the risk for neural tube defects and possibly facial abnormalities, such as cleft palate. Studies also show that low folate levels during pregnancy are associated with low birth weight, a risk factor for the development of cardiovascular disease in adulthood. A woman's best approach is to take extra folic acid plus multivitamin supplements (which have additional benefits), starting them before becoming pregnant.
Pregnant women with healthy diets may have low folate levels and need to take supplements. Requirements are as follows:
- The recommended dietary allowance (RDA) for folic acid prior to conception is 400 mcg, and during pregnancy it is 600 mcg.
- During breastfeeding 500 mcg is recommended.
Some women have low vitamin A reserves in their liver. It is important to note, however, that too much vitamin A significantly increases the risk for birth defects. Daily amounts of 10,000 international units (IU) of vitamin A in supplements and food can pose a danger. Experts recommend that pregnant women get no more than 2,500 IU/day and avoid eating liver.
Infants and Children. Infants who are breast-fed by healthy mothers receive enough vitamins except, in some cases, vitamins K and D. Human milk has low levels of vitamin K, and the newborn's immature intestinal tract may not produce enough of the baby's own supply. Most babies are given an injection of this vitamin at birth. Infants being breast-fed by malnourished women or those who lack sufficient exposure to sunlight may be deficient in vitamin D. In these cases, supplements of 200 - 300 IU are recommended.
Formulas are required to contain enough vitamins and minerals. Beyond infancy, most American children receive all the vitamins they need from their diet, unless they are living in severely deprived circumstances. However, recent research suggests that many healthy children ages 1 to 11, especially African-American and Hispanic children, are not getting enough vitamin D.
Smokers. Smoking interferes with the absorption of several vitamins, importantly vitamins C and D. Smoking can interfere with the metabolism of vitamin D, resulting in poor muscle function.
Taking high doses of antioxidant vitamins, especially beta-carotene, is harmful to smokers. Instead of taking supplements, smokers should be sure their diets are rich in fresh fruits, vegetables, and whole grains. Of course, smoking cessation is the most important intervention of all.
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Review Date: 10/08/2010
Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine,
Harvard Medical School; Physician, Massachusetts General Hospital.
Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M.,
Inc.
A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)
