Vitamin A in Pregnancy: Benefits, Overdose Risks, Safety Limits, Foods

You cannot underestimate the importance of vitamin A for your pregnancy. I have explained below why it is so essential and how you should satisfy its required intake.

However crucial this vitamin is especially at such a time, it is most necessary to curb its consumption within the recommended limits.

Chronic and excessive overdose, especially during early pregnancy, increases the risk of its toxic effects on the pregnant woman and birth defects in the growing fetus. This is a glaring example of how a small thing can have a disastrous impact on a life and too, of your loved one.

About vitamin A

Vitamin A is a vitamin, which is fat soluble and therefore, requires fat to be metabolized. It is an essential vitamin stored in the liver. It is of two types:

Preformed Vitamin A is the most common form and can be directly used by the body. It is called retinal or retinoid and is found in foods of animal origin like milk, eggs, and liver.

It is this animal form of vitamin A that can be directly used by the body and which is toxic beyond the recommended doses.

Provitamin A carotenoids or beta-carotene is converted inside the body into retinol, the usable vitamin A. You find it n red, yellow, orange, and dark green fruits and vegetables. This plant-derived form of vitamin A is not toxic.

If an adult stopped having vitamin A in his diet, it would take about 2 years for signs of vitamin A deficiency to manifest. This speaks highly of vitamin A stores in the body (liver).

Recommended vitamin A dosage during pregnancy

  • In a pregnant woman under 18 years of age, the recommended daily allowance (RDA) is 750 mcg (micrograms)
  • In pregnant women 19 years and above, the RDA is 770 mcg.
  • In breastfeeding mothers, the RDA increases and is 1200 mcg in pregnant woman under 18 years
  • In women above 19 years, the RDA is 1300 mcg
  • In a non-pregnant woman, the RDA is 700 mcg.

The above figures are the average requirements and you don’t have to consume this amount of vitamin A on a daily basis. Just make sure you average out this intake over a few days, say per week.

Vitamin A safety limits

The Food and Nutrition Board of the National Academy of Sciences has set the upper limit of vitamin A consumption per day as follows:

Pregnant and breastfeeding women, aged 19 years and older should not consume more than 3,000 mcg (or 10,000 IU) of preformed vitamin A from all sources including supplements, animal food sources, and fortified foods each day.

For women age 18 and younger, the upper intake limit is 2,800 mcg (9,333 IU).

This limit is set for preformed vitamin A, which is derived from foods of animal origin and dietary supplements as palmitate, acetate or fish liver oil, and which can cause toxicity to the pregnant woman and her growing baby.

Again, according to the World Health Organization recommendations, a daily supplement during pregnancy should not exceed 10 000 IU (3000 RE) and a weekly supplement should not exceed 25 000 IU (7500 RE). One microgram (mcg) of retinol (preformed vitamin A) is equal to 1 mcg RE.

Why you require vitamin A in pregnancy? Benefits

In pregnancy, the mother and the growing baby both require vitamin A. It is required for the growth of the baby’s lungs, heart, eyes, bones, and for the integrity of the body cells.

It also helps in the development of the nervous and circulatory systems of the fetus. It promotes fat metabolism and the resistance to fight infection.

Similarly, it also helps to have good vision, promotes tissue repair after giving birth and increases the immunity of the mother.

Should you take vitamin A supplements during pregnancy?

A normal pregnancy diet gives you sufficient amount of vitamin A and usually, there is no need to have exclusive vitamin A supplements.

Your diet of meat, dairy, fish, eggs, and fortified cereals contains enough of preformed vitamin A or retinol. It is also present in most fruits and vegetables mostly in the form of carotenoids, which the body converts into the usable retinol.

It is therefore, not necessary to increase your vitamin A intake with supplements as too much of vitamin A can cause birth defects and liver toxicity.

A pregnant woman or a woman planning to conceive should not take vitamin A supplements such as isotretinoin (brand name Accutane) prescribed for treating acne or some skin conditions.

Even topical creams such as tretinoin (Retin-A) prescribed for skin conditions should be avoided.

If you are taking such supplements, you should make sure that you do not get pregnant while you are on them.

When pregnant, make sure to read the label before taking any prenatal supplements, and see if those supplements contain vitamin A or not. However, small doses are of no concern.

Ideally, stick to what your doctor has prescribed. Most over the counter multivitamins and some fortified foods contain a significant amount of preformed vitamin A, which can be toxic.

Vitamin A toxicity risks in pregnancy

Vitamin A toxicity cannot arise from consuming vitamin A from your diet. It can arise if you are taking too much of preformed vitamin A through supplements or eating too much of liver and fish liver oils. The liver is a high source of vitamin A and you should avoid this food during pregnancy.

Too much preformed vitamin A during pregnancy significantly increases the risk of toxicity to the mother and the growing fetus. The higher the doses consumed, the greater is the risk.

Research indicates that babies born to women who ate up more than 10,000 international units of vitamin A daily were 2.4 times more likely to be born with birth defects than babies exposed to 5,000 international units or less.

Furthermore, babies of mothers exposed to 20,000 international units during the first three months of pregnancy were about four times as likely to be born with defects that included cleft lip, cleft palate, hydrocephalus and heart malformations.

 

Your normal diet gives you enough of beta-carotene, which does not act in the same way as preformed vitamin A and therefore, having such foods keeps you safe from vitamin A toxicity.

On the baby

High levels of vitamin A especially during the early first trimester (first 12 weeks) of pregnancy can seriously harm the baby. It can cause birth defects and can affect the eyes, brain, face, the bones and the intellectual development of the baby. Liver toxicity is also a major side effect. Care should also be taken during breastfeeding as breast milk contains fats and this will easily allow the fat soluble vitamin A to pass through the breast milk to the baby.

Care should also be taken during breastfeeding as breast milk contains fats and this will easily allow the fat soluble vitamin A to pass through the breast milk to the baby.

On the mother

Vitamin A toxicity can cause nausea, vomiting, headaches, dizziness, hair loss, confusion, blurring of vision, bone loss and loss of muscle coordination.

Signs of Vitamin A Deficiency

Your physician may prescribe supplements if he finds that you are deficient in vitamin A.

The symptoms and signs of vitamin A deficiency include night blindness or impaired night vision, lowered immunity and xerophthalmia (abnormal dryness of the conjunctiva and cornea of the eye with inflammation)

Headaches, cracked and decaying teeth and joint pains are other symptoms of vitamin A deficiency.

Vitamin A food sources

Fruits

Carrots
Watermelon
Mango
Tomato juice
Pumpkin
Prunes

Vegetables

Broccoli
Spinach
Sweet potatoes

Animal foods

Liver from  beef and chicken
Kidneys
Fish liver oils
Eggs

Dairy foods

Cow’s milk
Cheese
Ice-cream

Other food sources

Fortified cereals
Butternut

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