Pregnancy comes with a host of joys, fears and decisions, many of which seem to revolve around what you can and can’t eat. For most women, there’s no other time when diet comes under as much scrutiny. And it’s with good reason—your baby’s health completely depends on the essential nutrients you are supplying. The formation of organs, the growth of cells and tissues and the development of body systems all happen during specific windows of opportunity in the prenatal period. By eating and supplementing wisely, you can maximize these opportunities. 

Eating a diet rich in calcium and other minerals, protein and vitamins is a good first step, but it’s hard to get optimal levels of certain nutrients solely from food. Adding prenatal vitamins and a few other well-chosen supplements is a smart precaution, given the stakes. 

Remember, eating for two does not amount to simply eating more. It’s eating strategically to ensure the best health for your baby, ideally—as in the case of folic acid—before he or she is even conceived. Here are our three top supplement picks to ensure that your baby has the best chance for healthy development. 

Folic acid

There’s no underestimating the importance of taking folic acid while pregnant—consider it non-negotiable. “I recommend folic acid for all women,” says Shelley Wroth, MD, an integrative medicine physician at Duke Integrative Medicine in Durham, N.C. Folate, a B vitamin critical for cell production and division, is crucial for preventing neural tube defects such as spina bifida. Folate levels are hard to maintain solely from food sources, so make sure your prenatal vitamin contains adequate levels, or take it as a stand-alone supplement in addition. 

A study published in the May 2000 issue of the Journal of American Nutrition suggests that poor dietary folate intake is associated with an increased risk of adverse birth outcomes. Since the neural tube forms in the fourth week of gestation, shoring up your internal folate reserves even before pregnancy is a smart, proactive decision. The U.S. Department of Public Health suggests between 400 and 800 mcg of folic acid every day throughout pregnancy.

Fish oils

“More and more studies confirm that omega fatty acids are important for babies in terms of their healthy, normal development,” Wroth says. Fish oil with omega-3 docosahexaenoic acid (DHA) is linked to preventing preterm labor and delivery and boosting infant brain power, visual acuity and gross motor skills. Plus, says Wroth, “supplementing with omegas has no risk, except for one important caveat: If a woman has a condition that prolongs bleeding times or is taking a medication to decrease the risk of blood clots, omegas are often contraindicated.” (As with any supplement, consult with your healthcare provider before taking.)

Recent omega research points to even more reason to supplement. “Babies of mothers who supplement with omegas have less eczema and food allergies for their first year of life,” Wroth points out. A study published in the September 2009 issue of Acta Paediatrica, a Swedish journal, showed that maternal supplementation with omega 3s during pregnancy decreased the risk of food allergies for infants with a family history of allergic disease, as well as certain kinds of eczema. Wroth recommends 2.8 grams of fish oil with DHA daily.

Probiotics

While conventional doctors may consider taking probiotics during pregnancy controversial, a growing body of research suggests their efficacy for either preventing preterm colitis—an impaired gastrointestinal tract—or at least reducing its severity in preterm babies. Technically known as necrotizing enterocolitis, this gastrointestinal disease affects 10 percent of preterm babies who weigh less than 1,500 grams. “There’s now enough data on the benefits of probiotics for this issue that maternal supplementation with them should be routine,” Wroth advises. 

Probiotics come with a host of other bonuses. Like omegas, probiotics can reduce atopic dermatitis and food allergies. People may not realize that 70 to 80 percent of our immune system cells reside in the gut. That’s why Wroth says, “Keeping the bowel flora robust helps regulate the entire immune system.” A 2010 study published in the September 2010 issue of the British Journal of Dermatology suggests that mothers who consume probiotics from 36 weeks of gestation to three months postnatally reduce the incidence of atopic dermatitis in their infants. No specific FDA recommended dosage of beneficial bacteria currently exists.