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5 Prenatal Nutrients beyond Folate to Support Baby's Brain Development


When it comes to supporting baby’s brain development through nutrition during pregnancy, most people think of Folate (a natural, active form of folic acid) first. A cofactor in the synthesis of DNA and RNA, Folate is necessary for normal cell division and growth. It’s also a key methyl donor in DNA methylation, a process that regulates gene expression. 

As a part of a healthy diet, Folate supports the development of fetal central nervous system and helps prevent neural tube defects. This is why doctors recommend at least 600 mcg of Folate or folic acid for pregnant women. 

While Folate tends to be in the spotlight, it’s not the only key nutrient for the baby’s brain development. In your prenatal and postnatal period, make sure you are getting enough of these 5 others: Choline, Omega-3s, Iodine, Vitamin D and Iron.


Choline and baby’s brain health

Although not recognized as an essential nutrient until 1998, Choline is now considered just as important as Folate for early brain development and cognitive functions after birth. Choline supports baby’s brain health both structurally and functionally:

  • Choline is a component of a molecule called phosphatidylcholine. Phosphatidylcholine is a building block of nerve cells, including the brain. Without choline, nerve cells cannot develop or maintain their structure.
  • Choline is also a building block for acetylcholine. Acetylcholine is an important neurotransmitter that facilitates memory, mood regulation, muscle control and other functions of the brain. Studies have shown, for example, that an adequate maternal intake of choline during pregnancy and while nursing can support healthy development of the baby’s memory after birth.


Choline recommended daily intake during pregnancy and nursing

If you are pregnant, aim for at least 450 mg of Choline each day; while nursing, the recommendation goes up to 550 mg. Some recent studies have suggested that much higher amounts during pregnancy, as much as 930 mg, may help the baby’s cognitive development after birth.

Most women need Choline in their prenatal vitamins to meet the daily requirements. It's hard to get all of your choline from food alone. For example, eggs are one of the best sources of choline, but you’d need to eat 3-4 eggs each day to get to the 550 mg line.

It's important to choose the prenatal vitamins with a sufficient amount of choline, too. Most prenatal vitamins don't contain enough choline, if at all. As a result, a vast majority of women – over 90% of us, by some estimates – are not getting the necessary choline, even when they are taking prenatal vitamins.


Omega-3 and baby’s brain health

Omega-3 fatty acids, commonly known as the “healthy fats,” are components of phospholipids, which form cell membranes. Omega-3s, such as DHA, EPA and ALA, are found in oily fish, nuts and seeds.

Found in large amounts in the brain, Omega-3s have been suggested as possibly important for brain health, although study results are mixed. Multiple observational studies have found that adequate maternal omega-3 intake may be associated with healthy cognitive development of the baby in the early years, including behavioral regulation, motor control and communication.


Omega-3 recommended daily intake during pregnancy and nursing

For pregnant women, 1.4 g of omega-3 is recommended each day. A 3-oz portion of salmon can get you there. Flaxseed, chia seeds and walnuts are also a good plant sources of Omega-3 (ALA, to be specific). When nursing, the requirement is slightly lower at 1.3 g/day. Omega-3 supplements are also an easy addition to your prenatal/postnatal routine.



Iodine, T4 and baby’s brain health

Iodine is a building block of two thyroid hormones, T3 and T4. Aside from regulating numerous biochemical processes in the body (like metabolic activity and almost all aspects of female reproduction), these thyroid hormones are necessary for the proper development of the central nervous system of the baby during pregnancy and after birth.

In early pregnancy, when the baby’s thyroid gland is still “under construction,” the baby depends entirely on the T4 from the mom. This makes the maternal iodine intake crucial for the baby’s brain development. Studies have linked mom’s thyroid health during pregnancy to baby’s cognitive and behavioral health after birth. Maternal thyroid health may also be key to maintenance of pregnancy to term – another important factor in the baby’s brain health.


Iodine recommended daily intake during pregnancy and nursing

During pregnancy, aim for 220 mcg of iodine; when nursing, aim higher, for 290 mcg. Surveys indicate that a substantial portion of pregnant women in the US don’t have enough iodine in their body.

So, if you don’t use iodized salt, don’t eat bread and pasta made with enriched flour or don’t eat a lot of dairy (all good sources of iodine), make sure your prenatal vitamins contain enough iodine to cover your needs. Both American Thyroid Association and American Academy of Pediatrics recommend 150 mcg/day of iodine in your prenatal vitamins.


Vitamin D and baby’s brain health

Vitamin D is known mostly for its role in supporting Calcium absorption and bone mineralization – both crucial for the development and maintenance of healthy bone and teeth. Like Iodine, the baby relies exclusively on Vitamin D from the mom. Because some animal and human studies in adults have linked low Vitamin D levels to various neurological and cognitive problems, scientists have been looking into this fat-soluble vitamin’s possible role in baby’s brain and cognitive development.

These studies have seen mixed results, for many possible reasons – including problems with self-reported data, different timings of Vitamin D tests and cofounding factors like where participants lived, race/ethnicity and season of birth, all of which can affect the mom’s Vitamin D levels. However, a 2021 study did show a clear connection between the mom’s Vitamin D level in the second trimester and the baby’s IQ at ages 4-6.

Scientists don’t know why Vitamin D may help support baby’s brain health. Several theories have been suggested, including its role in normal structural development, regulation of cell cycles (i.e., development and death of cells) in the developing brain and gene regulation, but all of these remain hypotheses at this time.

omega-3s, choline, iodine and more support baby's brain development in pregnancy


Vitamin D may help the mom carry to term

Vitamin D may play a role in baby’s brain development from a different angle: Helping the mom carry the baby to term. Preterm birth is a major risk factor for impaired brain development, as well as cognitive and behavioral challenges after birth.

Babies who are born earlier have been known to have smaller brains, compared to those who are born at term. For example, study found that babies born before 38 weeks have 5% smaller brains than those who were born after 38 weeks. While the early babies’ brains grew quickly after birth, at 3 months after birth, they were still behind.

Evidence is mixed here and the potential mechanisms are still unclear, but a 2016 Cochrane review of 15 randomized clinical trials found that healthy maternal Vitamin D levels were associated with higher likelihood of full-term births. A 2017 study of over 1,000 mothers also found that those who had serum Vitamin D levels above 40 ng/mL were 62% less likely to have preterm births than moms whose D levels were below 20 ng/mL.


Vitamin D recommended daily intake during pregnancy and nursing

Because a large portion of our daily Vitamin D needs is covered by what’s synthesized in our skin when exposed to the UV rays of the sun, it can be a little difficult to know how much Vitamin D you should be getting from food.

The general recommendation is 15 mcg or 600 IU per day for both pregnancy and lactation, but some doctors recommend a much higher amount. It may be a good idea to ask for a Vitamin D test at your doctor. Knowing your level will help you and your doctor decide how much you should aim for, and whether you should add a Vitamin D supplement.


Iron, term birth and baby’s brain health

Iron is similar to Vitamin D, when it comes to its role in supporting the baby’s brain development: It’s a key nutrient that helps the mom carry the pregnancy to term. 

Iron is a building block of hemoglobin, the protein in red blood cells that carry oxygen throughout the body. In a normal pregnancy, the amount of blood circulating in the mom’s (and the baby’s) body increases significantly to support the mom, the placenta and the growing baby. The delta varies woman to woman, but it’s about 45% on average, with a similar increase in the number of red blood cells. Without sufficient iron, the mom’s body can’t keep up with this huge increase in demand for blood supply to maintain the pregnancy.


Iron recommended daily intake during pregnancy and nursing

The recommended amount of iron during pregnancy is 27 mg per day. Reflecting the drop in the need for more blood, iron requirement goes down to 9-10 mg per day when nursing. On average, women get only about half of the necessary iron each day, so OBGYNs recommend prenatal vitamins with iron to supplement. 

That said, Iron is also similar to Vitamin D, in that the amount you need in your prenatal routine may depend on how much of it you have in the body. Too much iron can cause stomach upset and make prenatal nausea worse. It can also interfere with absorption of other nutrients. So, it’s important that you are getting the right amount of iron for you, not more. Your prenatal checkup may include iron level test for this reason; if not, ask your doctor for one, and base your iron intake on the results.


Folate – last but not least

We cannot leave out Folate in any discussion of a baby’s brain health. Aim for at least 600 mcg of Folate each day during pregnancy and 500 mcg per day when nursing to ensure that you have sufficient amount of Folate to support the baby’s normal brain development and help prevent neural tube defects.

It’s also important to note that Folate matters the most in the very early stage of a pregnancy, when the baby’s neural tube (which will eventually become the brain and the spine) forms – so early that many women don’t know that they are pregnant yet. To make sure you aren’t deficient in Folate early on, doctors recommend starting on prenatal vitamins with 600 mcg of Folate (or folic acid) 3 months before you plan to start trying for a pregnancy.


Importance of nutrition after birth

The baby’s brain keeps growing at a remarkable rate after birth. Though the speed of growth slows down after the initial spurt, a study following 87 healthy babies found that the infant brain grows by a whopping 64% in the first 3 months. Their brains were about one-third of an adult brain at birth; by the time they are 3 months old, their brains were more than half the size of an adult’s.

So, the first few months after birth is still a key period for baby’s brain health. If you are breastfeeding, make sure to stay on your prenatal vitamins and any additional supplements. Sticking to your prenatal vitamins will help you meet the daily requirements for these 6 nutrients - and benefit the baby’s growing brain. The nutrients will also help the baby develop the cognitive and behavioral skills that will form the foundation for its lifelong health and happiness.

Please reach out if we can answer any questions about how to support your baby's brain health during pregnancy and after birth. We are with you.


Ovaterra provides reproductive health resources for general, educational purposes only. This content is not intended to replace medical advice from a qualified healthcare professional.



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