Getting an A+ in Your Vitamin A Intake for Pregnancy
We all know that getting enough vitamins and minerals is key for a healthy pregnancy – to help both the mom and the growing baby. But in the case of vitamin A intake, getting too much can cause more harm than good.
Vitamin A is an essential micronutrient. You and your baby don’t make it on your own, so you have to consume it in order to avoid any deficiency side effects and diseases.
But consuming too much – especially while pregnant – can lead to toxic results and even death.
This delicate balancing act is why many mothers are fearful of the nutrient. Instead of worrying, it’s so important for mothers-to-be to understand what vitamin A does, how much they should be getting, where to get it, and how to prevent toxicity.
Read on for all the must-know vitamin A details.
What’s so Wonderful about Vitamin A
Before we touch on the ways vitamin A can hurt, let’s be sure to focus on the ways vitamin A helps. After all, it is essential for life!
Vitamin A plays an important role in many human functions, including:
- Immune function
- Cell health
Vitamin A is also an antioxidant that can help ward off free radical problems that lead to diseases like cancer.
Why Pregnant Women Should Love Vitamin A
In pregnancy specifically, the right doses of vitamin A are vital for maternal health and positive newborn outcomes. The effects of vitamin A include:
- Supporting fetal growth
- Supporting fetal development: organ, skeleton, body system, etc.
- Helping repair a woman’s tissues postpartum
- Keeping mom and baby healthy by supporting both immune systems
- Keeping mom’s and baby’s vision strong
- Metabolizing fat
Some studies highlighted by the National Institutes of Health have shown that adequate vitamin A during pregnancy can reduce the child’s risk of type 2 diabetes, improve their pulmonary function, and even lead to better school performance later in life.
How Much Vitamin A Should a Pregnant Woman Have?
For many nutrients, daily intake needs go up significantly for pregnant women. Because a woman’s body needs to care for her own needs and also care for the developing fetus, it makes sense that you’d need significantly more vitamins, minerals, amino acids, and enzymes.
Vitamin A is a different story. A fully grown non-pregnant women should typically have around 700 mcg RAE of vitamin A per day. But as you can see, that need doesn’t go up very much during pregnancy.
Here are the Recommended Dietary Allowances (RDA):
- A pregnant woman 19-years-old or older should have 770 mcg RAE (or 2,500 IU) per day
- A pregnant teenager should have 750 mcg RAE (or 2,565 IU) per day
Interestingly, the need for extra vitamin A does go up quite a bit for breastfeeding. That’s because your body’s vitamin A goes out through the milk to provide adequate nutrition for your baby:
- A breastfeeding woman 19-years-old or older should have 1,300 mcg RAE/4,300 IU per day
- A breastfeeding teenager should have 1,200 mcg RAE/4,000 IU per day
Experts recommend focusing more on these numbers as an average for a whole week instead of forcing the exact amount each and every day.
Can You Have Too Much Vitamin A?
Just enough vitamin A, and you’re in great health. Too much vitamin A, and you’re in trouble.
Vitamin A is a fat-soluble vitamin, meaning all the excess gets stored in your body instead of coming out in your urine. Most is stored in your liver as retinyl esters. Retinyl esters transform into retinol, then retinal, and finally retinoic acid, the active form of the micronutrient.
Until then that transformation and release, all that standby A adds up to toxic amounts. Having too much vitamin A can lead to:
- Liver damage
- Thinning of the bones
- Skin problems
- Birth defects
These side effects are why it’s vital to know the upper limit (AKA: the very most you can take without harm). This includes what you consume from vitamin A supplements, animal sources, and fortified foods.
- Women who are over the age of 18 should never get more than 3,000 mcg RAE (or 10,000 IU) each day.
- Teenagers should never get more than 2,800 mcg RAE (or 9,333 IU) each day.
For this reason, it is essential to never take extra doses of your prenatal multivitamin. You should also never take added vitamin A supplementation unless your health care practitioner prescribes it.
Can You Have Too Little Vitamin A?
Because so many different foods contain vitamin A, it is extremely rare to have a vitamin A deficiency in the United States and other developed countries.
In developing countries where access to healthy food is greatly limited, vitamin A deficiency is a serious public health problem.
The World Health Organization explains one of the main deficiency concerns in these countries is night blindness – the inability to see when the light is dim. In these cases, extra vitamin A supplementation is necessary, but should still be monitored closely by their healthcare provider.
In regard to the baby, low vitamin A often leads to weakened immune systems and heightened morbidity and mortality.
If there is some reason that you are concerned about your vitamin A intake being too low, simply have your doctor check your levels. Never assume you are low and treat it yourself.
Top Food Sources of Vitamin A
There are two different types of vitamin A found in foods: provitamin A carotenoids and preformed vitamin A. The first can be eaten without caution; the second should be watched more carefully.
1. Produce = Provitamin A Carotenoids
Carotenoids are safe to eat in abundance. They are not as potent as preformed vitamin A, so the body can handle them in high amounts. Never think you shouldn’t have a sweet potato for lunch since you had one for dinner last night.
These fruits and vegetables will not cause birth defects no matter your trimester of pregnancy.
Interestingly, many of the foods in the carotenoid category are orange. That’s due to their plant pigment, beta-carotene. Our bodies actually convert beta-carotene into vitamin A.
The only reason veggies like spinach and broccoli are green is because their high chlorophyll masks the beta-carotene.
Top sources of beta-carotene include:
- Sweet Potato
- Butternut Squash
- Collard Greens
- Bell Peppers
2. Animal and Fortified Products = Preformed Vitamin A
These are the foods containing vitamin A that can be stored up into toxic levels. With the exception of liver, these foods can still be consumed safely in regular amounts. The true toxicity will come more from overdoing the vitamin A supplementation.
Liver, on the other hand, is such a high dose of vitamin A it is often recommended to avoid it or only have it once a month.
- Fortified cereal
- Fortified milk
Vitamin A Supplements
The only vitamin A supplement a pregnant woman should have is what can be found in her prenatal vitamin.
Finding the perfect amount of vitamin A supplementation in your prenatal can be confusing between the years 2019 and 2021. The FDA is in the process of requiring supplement companies to start showing the amount of vitamin A in “mcg RAE” instead of the old IU.
The reason is simple: scientists use “mcg RAE.”
In 2020, large companies have to switch over. In 2021, small companies have to switch over.
In 2019, you’ll notice most prenatal vitamins still show IU (international units). Since the upper limit is 10,000 IU, most prenatal vitamins will be under 5,000 IU to leave plenty of room for food sources.
If you happen to eat many foods high in vitamin A, you may want to choose a prenatal with a lower dosage and vice versa. If you are unsure the perfect amount of vitamin A for your prenatal, just ask your doctor!
What About Topical Vitamin A (AKA: Retinol)?
Topical vitamin A is a common ingredient found in popular anti-acne and anti-aging skincare treatments you can get over-the-counter and with a prescription. Common options are retinol and Accutane.
While some studies show low to no risk, The National Institutes of Health says the retinoid tretinoin caused four officially-reported cases of birth defects.
Due to these reported cases, most health care professionals believe women should get off retinol and other vitamin A skincare treatments during the duration of their pregnancy.
This is often a frustrating aspect of pregnancy for women. Since these medications are keeping them free of breakouts and wrinkles. If this is the case for you, check out this systematic review of various skincare products during pregnancy.
Staying Healthy with the Right Amount of Vitamin A
Don’t let the toxicity possibility of vitamin A scare you. The solution is very simple:
- Take a high-quality prenatal multivitamin with a moderate dose of vitamin A that stays near the recommended daily allowance
- Eat plenty of fruits and veggies – they’re packed with so many other micronutrients important for pregnancy too, like folic acid
- Stop eating liver (or greatly reduce it with permission from your doctor) to prevent problems from dietary intake
- Get off your retinoids and other topical A gels and creams
- Avoid all other vitamin A supplements or medications unless prescribed by your doctor
Then keep it up throughout your breastfeeding time as well. These simple steps will ensure you and your baby are getting the ideal intake of vitamin A – not too much, not too little.