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Is a prenatal supplement enough for multiple pregnancy?

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By : Nurturing Life's Nutrition Team | Montreal Diet Dispensary
— Updated on :
supplement-prénatal-grossesse-multiple

No. To meet the recommendations of the Institute of Medicine (IOM) for a twin pregnancy, a supplement containing iron, copper and vitamin B6 should be added to the prenatal supplement.

Since it can be difficult to meet the needs for certain vitamins only through diet and that deficiencies are often observed, it is strongly recommended to take a supplement of vitamins and minerals during pregnancy, especially if it involves two fetuses. For multiple pregnancies, the Institute of Medicine, recommends the addition of:

  • 30 mg iron
  • 15 mg zinc
  • 2 mg copper
  • 2 mg vitamin B6
  • 250 mg calcium
  • 400 ug folic acid
  • 50mg vitamin C
  • 5 ug vitamin D

Taking a regular prenatal supplement (eg Materna®, PregVit®) is not sufficient to meet the needs of multiple pregnancy; adding extra vitamins and minerals including iron, copper and vitamin B6 is more essential. However, no supplement containing these three nutrients in a tablet is available on the market. At the Montreal Diet Dispensary, a Stresstab Zbec® is added to the prenatal multivitamin supplement. As it does not contain iron, food intake is closely monitored. In case of inadequate intakes of iron or anemia, individual iron supplements may be recommended by the doctor.

It is important to specify that a single prenatal/postnatal multivitamin supplement should be consumed per day even with a multiple pregnancy. Pre and postnatal supplements contain a high amount of vitamin A that can cause malformations in the fetus if taken in excessive amounts. It is therefore important to add the missing elements with the help of another supplement, free of vitamin A, such as Stresstab Zbec®.

For questions regarding supplements of vitamins and minerals, see a nutritionist.

References

  • Dietitians of Canada. Pregnancy – Multi-fetal. in Pen : practice-based evidence in nutrition. Last update : Nov 9, 2012. Access only by subscription.
  • Goodnight, W. et Newman, R. (2009). Optimal nutrition for improved twin pregnancy outcome. Obstetrics & Gynecology, 114(5), 1121-34.
  • Institute of Medicine. (1990). Nutrition During Pregnancy: Part I: Weight Gain, Part II: Nutrient Supplements. Washington, DC: The National Academies Press. http://www.nap.edu/catalog/1451/nutrition-during-pregnancy-part-i-weight-gain-part-ii-nutrient

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The views expressed herein do not necessarily represent the official views of the Public Health Agency of Canada.