Prenatal vitamins and breastfeeding support: labels, teas and herbs

A good prenatal vitamin comes down to a handful of nutrients on the label: folate, iron, iodine, vitamin D and, more and more often, DHA. Once the baby arrives, many nursing parents add a cup of Mother's Milk tea or a fenugreek blend, and a visit with a lactation consultant can make the first weeks a lot calmer.

There's no shortage of prenatal vitamins: Canada has dozens of good ones, so this guide sorts them by format and by label. Then come the herbal teas and lactation supplements people ask us about for breastfeeding and the postpartum period. When feeding concerns go beyond the shelf, our lactation consultants see families at our wellness clinic beside the Bedford store.

Nutritional needs: what should a prenatal vitamin have in it?

Nutritional needs rise when you're expecting and stay higher while you're nursing, and a prenatal multivitamin is built to help meet them. These are the daily amounts, counting food and supplements combined.

On the label, folate may read folic acid, methylfolate or L-5-MTHF (and the table counts it in dietary folate equivalents), iron is often bisglycinate or citrate, iodine is usually potassium iodide, and vitamin D is usually D3.

Folate helps form red blood cells, and so does iron. Iodine helps the thyroid gland work normally, and vitamin D helps the body absorb calcium, which goes into building the baby's bones and teeth. DHA is an omega-3 fat that supports the normal development of the baby's brain, eyes and nerves; some prenatals include it, and others leave it for a separate softgel. Zinc, B12 and calcium round out most formulas, and many use beta-carotene as their source of vitamin A. A prenatal is meant to sit alongside eating well, with protein, vegetables and whole grains, so the label amounts don't need to match the table on their own. Count what's in your prenatal before you add other supplements.

Folic acid or methylfolate?

Both are folate. Folic acid is the classic form, and methylfolate (often written L-5-MTHF or L-5-methyltetrahydrofolate) is the active form your body uses. Thorne, CanPrev and Naka use methylfolate, and Whole Earth & Sea pairs it with folic acid. Many people who know they prefer methylated B vitamins look for methylfolate and methylcobalamin B12 together. Either way, the usual guidance in Canada is a daily multivitamin with 0.4 mg (400 mcg) of folic acid for anyone who could become pregnant, and a prenatal with 16 to 20 mg of iron once you're expecting. If your midwife, doctor or another healthcare practitioner has suggested a particular prenatal, bring the name in and we'll find it.

Which prenatal format suits you?

Most of the choice comes down to how many pills you can face in a day, especially in the first trimester. Capsules and tablets usually mean two to four a day; a softgel or gummy can bring it down to one or two.

Capsules and tablets. Thorne Basic Prenatal uses folate as L-5-MTHF, methylcobalamin B12 and chelated iron, in moderate amounts taken with food. CanPrev Prenatal Multi carries 24 vitamins and minerals, including iodine, choline and a citrate form of iron, and it's vegan; CanPrev is a Canadian company. NFH Prenatal SAP comes in a 180-capsule bottle, and Whole Earth & Sea Women's Prenatal is a vegan, whole-food-based tablet with vitamin D3 from lichen, two small tablets a day.

One a day, gummies and methylated formulas. Platinum Naturals Prenatal Easymulti is a single softgel with 400 mcg of folate, 15 mg of bisglycinate iron, iodine and choline, plus 600 mg of fish oil that's 50% DHA. Suku The Complete Prenatal is a two-gummy serving with 800 mcg of methylated folate, 150 mcg of iodine and 1,000 IU of vitamin D3, made without sugar or sugar alcohols by a Toronto company. Naka Platinum Essential Prenatal uses methylated B vitamins and gentle iron bisglycinate in a vegetarian capsule; Naka is a Canadian maker based in Ontario. MegaFood Baby & Me 2 also uses methylated folate and B12, with choline and vitamin D.

For the queasy weeks themselves, Platinum Naturals Prenatal Anti-Nausea pairs ginger with vitamin B6 in a small softgel, and it helps relieve digestive upset such as nausea and lack of appetite.

Platinum NaturalsPrenatal Anti-NauseaGinger extract (equal to 312 mg of ginger) with 10 mg of vitamin B6 per softgel.Shop →

Do I need a separate DHA supplement?

Check your prenatal first. If it already has fish oil, like the Easymulti, you may be covered; read the DHA amount per day rather than the total oil. If your prenatal has none, a separate softgel is the simple fix. Plant-based options use algae oil instead of fish: Whole Earth & Sea Pure Food Marine DHA is a vegan 300 mg DHA softgel, and AquaOmega Plant-Based High DHA gives you EPA and DHA from algal oil with no fishy aftertaste.

The best prenatal is the one you can keep down and keep taking, every day, from before pregnancy through breastfeeding.

Which lactation supplements help with milk supply?

Lactation supplements are mostly natural herbs with a long history among nursing mothers. Fenugreek seed is the best-known herbal option, often paired with blessed thistle, and both are traditionally used in herbal medicine to help promote breast milk production. Many parents who want to increase milk supply use them alongside a feeding plan from a lactation consultant, because latch, feeding rhythm and how often you nurse or pump make a big difference to supply.

St. Francis Herb Farm, a family farm in Ontario's Madawaska Valley, makes certified organic Fenugreek-Blessed Thistle capsules and a fenugreek seed tincture you take in a little water, which many mothers find easier than several capsules a day. Its single-herb thistle tincture is also traditionally used to help promote milk production while breastfeeding. Rumina Naturals Milk Aplenty is an organic tincture blend made without fenugreek.

Does Mother's Milk tea help with breast milk?

A herbal tea is the gentlest way to try these nursing herbs, and it doubles as a reason to sit down with a new baby and drink something warm. Lactation teas count as lactation supplements too, just in a cup. Traditional Medicinals Organic Mother's Milk is built on fennel, anise, coriander, fenugreek and blessed thistle, herbs long used to help promote lactation, and mothers have reached for it for over four decades. Four O'Clock Nursing Mama blends organic chamomile, rosehip, fennel, moringa, holy thistle and anise with fenugreek extract, and is used in herbal medicine as a galactagogue, a herb that helps promote milk production. For single herbs, Celebration Herbals makes organic fenugreek seed and thistle teas. All four are made with organic ingredients.

Mother's Milk tastes sweet and slightly bitter, with a licorice note from the fennel and anise. A spoonful of honey helps, and Nursing Mama is just as good cooled over ice when you're too warm for a hot herbal tea. Many mothers keep a cup or a big bottle of water within reach at every feed.

What about raspberry leaf herbal tea in late pregnancy?

Raspberry leaf has been a favourite of women for generations, and this herbal tea has a long tradition of use in the last weeks before the baby comes. It brews robust and a little tannic, like a mild black tea, and it's naturally caffeine free. Traditional Medicinals Organic Raspberry Leaf is hand collected under FairWild certification; steep it covered and drink it between meals. Earth Mama Organics Raspberry Leaf Tea is a full-bodied single herb, with each bag individually wrapped for the hospital bag.

For the nursing basket, Earth Mama Organic Nipple Butter is lanolin-free and doesn't need to be washed off before feeding.

Earth Mama OrganicsOrganic Nipple ButterLanolin-free and 100% organic, with calendula. No need to wash off before nursing.Shop →

When should you see a lactation consultant?

Any time: before the baby arrives, in the first days home, or months in. Earlier is easier, but it's never too late, and it's just as useful with your first baby as your third. At our clinic in Bedford, Lindsay Spidell and Sydney Stewart are International Board Certified Lactation Consultants (IBCLC) and registered nurses. Our lactation consultants help with latch, low milk supply, how to pump and store milk, bottle and combination feeding, the transition back to work and weaning, in the clinic or virtually. Book a consult whenever early motherhood feels wobbly.

Questions we get a lot

Can I take a prenatal vitamin if I'm not pregnant?

Yes. Prenatals are made for the months before conception as well as while you're expecting and nursing, so many people start one while they're trying to conceive.

Should I keep taking my prenatal while breastfeeding?

Most people do. Thorne, CanPrev, Platinum Naturals and Whole Earth & Sea prenatals are all made for breastfeeding too, and the daily amounts for iodine and choline are higher while nursing than before the birth.

How do you make fenugreek tea?

The easiest fenugreek tea is a seed tea bag steeped in freshly boiled water, covered, for several minutes. Expect an earthy, slightly bitter cup with a maple scent; a little honey or lemon softens it.

How do I make Mother's Milk tea taste better?

Add a spoonful of honey, steep it a little shorter if the bitterness bothers you, or brew a pot and drink it cold. If licorice isn't your thing, Nursing Mama is milder.

Are lactation consultants covered by insurance in Canada?

Some extended health benefits plans cover visits with an IBCLC, so check yours. We give you a receipt to submit to your plan.

Prenatal vitamins are in the supplement aisle at both stores: 486 Starboard Drive in Bedford and 590 Portland Street in Dartmouth, open seven days. Nursing teas, herbs and balms are together in our lactation support section. In HRM, order by 11 am with Luminate Express for same-day delivery, or choose pickup. Anywhere else in Canada, orders over $80 ship free.

Sources: Dietary Reference Intakes: vitamins and minerals; Prenatal nutrition guidelines. This article is general information, not medical advice.