Pregnant women are well aware when they reach for that tub of ice cream or jar of peanut butter that they're eating for two. But they should remember that means they're also taking in nutrients for two.

Women often don't get enough essential nutrients in their own diets. But deficiencies become even more problematic when a woman is trying to conceive, becomes pregnant or is breast-feeding, because the baby relies solely on her for all of his food. Supplements can help women maintain the right level of vitamins and minerals for themselves and their babies.

"Obviously every couple wants to have a healthy child," says Michael Schwartz, founder and president of Michael's Naturopathic Programs in San Antonio, Texas. Schwartz notes that the human body is like any machine, and without the right nutrients, "you end up with a manufacturing facility that is oper?ating with malfunctioning equipment."

Before conception
The most important nutrients for women trying to get pregnant are folic acid, calcium, iron and fatty acids.

Folic acid is the one that women need to start taking the earliest—as soon as they start thinking about becoming pregnant—because it's most important in the earliest stages of pregnancy, usually before a woman even realizes she's pregnant. This vitamin is crucial to ensure proper development of the fetus' brain and spinal cord, and a deficiency can lead to severe birth defects like spina bifida.

Public campaigns like the March of Dimes have raised awareness among women about the importance of getting enough folic acid, so consumers are usually well educated on this front, says Marci Clow, senior director of technical services for Santa Cruz, Calif.-based Rainbow Light. Her company's two pre-natal products include 800 milligrams of folic acid.

Folic acid from vitamin supplements and fortified foods is more readily absorbed and made available for use by the body than natural folate from food, according to the March of Dimes Web site. The body absorbs about only 50 percent of food folate, while taking in 85 percent of the folic acid in fortified foods and 100 percent of the folic acid in a vitamin supplement.

Throughout pregnancy
Women need calcium to build strong bones, and so do their babies. Anthony Almada, president and chief scientific officer at the natural products consulting company IMAGINutrition in Dana Point, Calif., tells women to think of it as having a calcium reservoir in their bloodstream. The reservoir needs to stay at a certain level. And if that's not done through diet or supplements, then it will be leached from the mother's bones to provide it to her baby. The need for extra calcium continues through breast-feeding to continue to build the baby's bones.

Iron creates red blood cells in the baby, so women need to take extra iron during pregnancy because much of it is going to the baby for its development needs. The need tapers off during breast-feeding because most nursing women don't menstruate and so don't lose iron through blood, and the baby doesn't need extra iron from the mother at this point.

A common pregnancy complaint—constipation—is a result of boosting iron intake. Almada says a form of iron supplement called bisglycinate is less prone to causing constipation, and is included in many prenatal supplements. Since constipation is the only significant downside to moderate iron supplementation, women are generally encouraged to continue taking their prenatal supplements, even if they include extra iron, after they give birth, because the baby still needs all the other nutrients.

Fatty acids, and omega-3 docosahexa?enoic acid in particular, have been growing in popularity as studies show their importance in fostering good cognitive and visual development in babies. "More and more studies are showing the benefit without any known negative downsides," says Douglas Kalman, director of nutrition and applied clinical research at Miami Research Associates.

Staying healthy all along
Women should think as well about other nutrients besides folic acid, iron, calcium and fatty acids.

For example, high levels of calcium and iron can reduce zinc absorption, Almada says. He recommends that pregnant women take a separate zinc supplement as many hours away from the time they take their calcium and iron as possible. So, if they take their calcium and iron at 8 a.m., they'd be best off taking a zinc supplement at 8 p.m. Additionally, vitamin D aids in calcium absorption. And fiber supplements may help women who have just given birth and have problems with hemorrhoids.

The best way to get any of these nutrients is from a healthy diet. But pregnant women often have a hard time keeping food down. This can make supplements even more valuable, especially if they are formulated to be easy on the stomach. Rainbow Light, for example, uses ginger and plant-source enzymes to this end.

"You need to purchase a product that you're going to take," says Clow, who has a master's degree in nutritional science. Some women, herself included, don't mind popping six pills a day. But others simply won't remember, so a one-a-day is better for them.

Another important point to keep in mind when stocking your supplement shelves with products for pregnant women is customer sensitivities. "People are pretty cautious when they're pregnant or trying to become pregnant," Clow says.Seven years ago, Rainbow Light launched a line of condition-specific supplements for pregnant women, such as a cold and flu remedy, an energy booster and a digestive aid. But they discontinued all of them because they weren't selling well.

"They were too nichey for the market?place," she says.

Emily Stone is a Chicago-based freelance writer.

Natural Foods Merchandiser volume XXVIII/number 9/p. 95-96