Overall vitamin, iron and mineral requirements increase by 15 per cent throughout pregnancy. Women who eat carefully planned, varied meals with sufficient nutrients do not need supplementation; that is, if they eat five servings of fruit and vegetables, four servings of dairy products, two portions of protein and two to five teaspoons of fat/oils daily.

However, various dietary surveys have shown sub-optimal nutrition in a number of individuals particularly as regards iron and, therefore, it is common for supplementation in pregnancy.

Pre-conception – that is before pregnancy – all women should supplement with folate, which has been shown to reduce the risk of neural-tube defects (NTDs). The dose most commonly found in over-the-counter preparations reduces NTDs by 60 per cent. While 400 micrograms a day is recommended, some experts recommend up to 5 milligrams (5,000 micrograms) daily during pregnancy. Larger doses are safe.

Supplemental vitamins and iron are definitely required in pregnant women with conditions like epilepsy, particularly if they are on antiepileptic medication. They are also required for women with multiple pregnancies (twins), who are HIV+, who continue to drink alcohol, and who suffer from haemoglobinopathies and hypertension.

Vegetarians who consume cheese, milk and eggs, fish and poultry rarely need supplementation. More restrictive vegetarians (eg vegans) often need vitamin B complex, calcium and iron.

Omega 3 and 6, found in fish oil, is thought to be integral to brain and spinal column development. It is now regularly being used to treat and supplement the nutrition of young children. A number of studies has advocated omega oil supplementation in pregnancy, especially if a limited quantity of fish is being consumed in pregnancy.

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