1st Trimester Essentials

Last reviewed: August 2026

What to eat in the first trimester

Your baby's organs are forming in the first 12 weeks, so good nutrition is essential. Focus on a balance of protein, complex carbohydrates, healthy fats and essential micronutrients.

• Leafy greens (spinach, kale) for folate
• Oily fish (salmon, sardines) for omega-3 fatty acids
• Wholegrains for energy and fibre
• Eggs for choline and protein
• Dairy or fortified alternatives for calcium and iodine

The NHS pregnancy diet guide is a trusted starting point for food choices during pregnancy.

First trimester supplements: what to take and when

Even a well-balanced diet benefits from targeted nutritional support in early pregnancy, particularly if nausea or food aversions limit your intake. The recommended approach follows a simple three-tier structure.

Foundation: Vital Essence 1

Vital Essence 1 is the recommended trimester-one multivitamin, formulated specifically for the first 12 weeks of pregnancy. Each two-capsule daily serving provides:

• 400mcg active folate (Quatrefolic®) — the bioavailable form of vitamin B9, recommended by the NHS for the first 12 weeks to support neural tube development
• Iron — to support normal red blood cell formation and contribute to normal oxygen transport as blood volume increases
• Iodine — essential for foetal brain development and maternal thyroid function
• Vitamin D — supports immune health and foetal bone development
• B vitamins including B6, B12 and niacin — to support normal energy metabolism and nervous system function
• Choline — to support early brain and cell membrane development
• Zinc and selenium — antioxidant support for maternal and foetal cell health

If you were taking Vitafem before pregnancy: Vitafem is formulated for the preconception period. Once pregnancy is confirmed, switch to Vital Essence 1 as your foundation. Do not take both together.

Layer 1 companions: Vital DHA and vitamin D

Most women benefit from adding these two supplements alongside Vital Essence 1:

• Vital DHA — provides 500mg omega-3 DHA per daily dose to support foetal brain and eye development. Molecularly distilled and free from mercury. Does not contain vitamin A, making it suitable throughout pregnancy and into the postnatal period.
• Vitamin D Spray — the NHS recommends 10mcg (400 IU) of vitamin D daily throughout pregnancy. In the UK, sunlight is insufficient for vitamin D synthesis from October to March, making supplementation particularly important during these months.

Vital DHA

Provides 500mg omega-3 DHA per daily dose to support foetal brain and eye development. Molecularly distilled, mercury-free, and free from vitamin A, so it's suitable throughout pregnancy and postnatally.

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Vitamin D Spray

An easy-to-take oral spray delivering the NHS-recommended 10mcg (400 IU) daily dose, particularly useful October to March when UK sunlight is insufficient for natural vitamin D synthesis.

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Conditional add-ons: depending on your individual needs

The following supplements may be relevant depending on your circumstances. They are not recommended for everyone and should be discussed with your midwife, GP or a qualified nutrition practitioner before adding them to your routine.

Not sure where to start? Zita West offers free 1:1 product consultations with in-house nutritionists. Book a free consultation for a personalised first trimester recommendation.

Quatrefolic® Folate

Highly absorbable active folate for those who need a higher dose than the standard 400mcg — for example with an MTHFR variant or on clinical advice.

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Psyllium Husk

A soluble fibre source to support normal digestion and bowel regularity during pregnancy, particularly relevant alongside iron supplementation.

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NAC (N-Acetyl Cysteine)

An antioxidant sometimes used in high-risk pregnancies. Only relevant where specifically discussed with your healthcare provider — not for general use.

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Fertility Collagen Pro

Hydrolysed collagen peptides supporting skin, joints and connective tissue, for those wanting additional structural support during pregnancy.

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What supplements to stop or discuss with your midwife in the first trimester

Becoming pregnant changes your supplement requirements. Some supplements taken during preconception are not recommended once pregnancy is confirmed. Discuss your full supplement list with your midwife at your booking appointment.

Stop at confirmed pregnancy:

• Vitafem — designed for preconception. Switch to Vital Essence 1 as your trimester-one foundation.
• CoQ10 (including Kaneka Ubiquinol) — current guidance is to stop CoQ10 once pregnancy is confirmed due to limited safety data. Read more in the Zita West CoQ10 and pregnancy guide.
• High-dose standalone antioxidants — single-nutrient supplements taken at preconception doses are not necessarily appropriate during pregnancy. A trimester-specific multivitamin provides antioxidant cover at appropriate levels.
• Herbal supplements — many herbs used in preconception contexts have not been studied for safety in pregnancy. Do not continue any herbal supplement without discussing it with your midwife or GP.

Safe to carry forward:

• Omega-3 (Vital DHA) — safe and beneficial throughout pregnancy
• Vitamin D — continue at the NHS-recommended 10mcg daily
• Choline — safe to continue; particularly relevant if dietary intake is low

Always tell your midwife about every supplement you are taking at your booking appointment, including vitamins, minerals, herbal products and any prescription medications.

Omega-3 in the first trimester: why it matters

Omega-3 fatty acids, particularly DHA, support your baby's brain, eye and nervous system development from the earliest weeks of pregnancy. They are also commonly discussed in relation to maternal mood and pregnancy outcomes; speak to your midwife if you have specific concerns.

The Royal College of Obstetricians and Gynaecologists advises pregnant women on safe omega-3 intake. If you do not eat oily fish at least twice a week, an omega-3 supplement is worth considering. Vital DHA provides 500mg DHA per daily dose, is molecularly distilled to remove contaminants including mercury, and contains no vitamin A.

Choline in the first trimester

Choline supports neural tube formation, early brain development and cell membrane integrity. It is present in Vital Essence 1, and most standard prenatal vitamins include little or none.

For women with lower dietary choline intake — particularly those who avoid eggs or follow a vegetarian diet — a standalone Zita West Choline supplement (400mg per serving) can be taken alongside Vital Essence 1 to help meet the recommended pregnancy intake of 400-480mg per day. It is not a replacement for the multivitamin.

Read more in the choline in pregnancy guide.

Zita West Choline

400mg choline bitartrate per serving, taken alongside Vital Essence 1 for those with lower dietary intake, twin pregnancies, or wanting to reach the higher 400-480mg daily recommendation.

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Magnesium in the first trimester

Magnesium supports muscle relaxation, sleep and the body's stress response. It is included in Vital Essence 1 as part of the foundation formula. Some women find additional magnesium helpful for sleep or cramping; magnesium glycinate is a well-tolerated form. Consult your midwife or GP before adding a standalone magnesium supplement to avoid exceeding recommended levels.

Other first trimester lifestyle considerations

• Rest — fatigue is common in the first trimester; rest when you can
• Hydration — especially important if experiencing nausea or vomiting
• Caffeine — the NHS recommends limiting caffeine to under 200mg per day during pregnancy
• Exercise — gentle activity such as walking or prenatal yoga is generally safe unless advised otherwise
• Mindfulness — anxiety is common in early pregnancy; speak to your midwife if it is affecting your daily life

FAQs: first trimester supplements

What vitamins are recommended in the first trimester of pregnancy in the UK?

The NHS recommends active folate (400mcg), vitamin D (10mcg) and iron as core supplements in the first trimester. Omega-3 DHA is widely recommended for foetal brain development, and iodine is important for thyroid function and neurological development. A trimester-specific multivitamin such as Vital Essence 1 covers folate, iron, iodine, vitamin D, B vitamins and choline in one formula, with Vital DHA and a vitamin D spray recommended alongside it. Discuss your individual needs with your midwife at your booking appointment.

What supplements should I avoid or discuss with my midwife in the first trimester?

Stop CoQ10 at confirmed pregnancy due to limited safety data during pregnancy. Stop Vitafem or any preconception multivitamin and switch to a trimester-specific formula such as Vital Essence 1. Do not continue herbal supplements without midwife or GP approval. High-dose standalone antioxidants taken during preconception are not necessarily appropriate in pregnancy. Tell your midwife about every supplement you are taking at your booking appointment.

What is the difference between Vitafem and Vital Essence 1?

Vitafem is formulated for the preconception period, supporting hormone balance, egg health and fertility preparation. Vital Essence 1 is formulated for the first 12 weeks of pregnancy, with nutrient levels adjusted for the specific demands of early foetal development including higher iron, iodine and B12. Once pregnancy is confirmed, switch from Vitafem to Vital Essence 1. Do not take both together.

Can I take choline in the first trimester?

Yes. Choline is included in Vital Essence 1 and is safe throughout pregnancy. Women with lower dietary choline intake, those carrying twins, or those wanting to meet the higher pregnancy recommendation of 400-480mg per day may benefit from adding a standalone Zita West Choline supplement alongside Vital Essence 1. Choline is not a replacement for a trimester multivitamin.

How do first, second and third trimester pregnancy vitamins differ?

Each trimester has distinct nutritional priorities. The first trimester focuses on neural tube development, early organ formation and managing fatigue, with folate, iron, iodine and B vitamins as the key nutrients. The second trimester shifts toward skeletal development, with calcium, magnesium and continued iron support. The third trimester prioritises brain development and birth preparation, with choline, vitamin K2 and elevated iron the key additions. The Vital Essence range provides trimester-specific formulations for each stage. Read the full guide to how pregnancy vitamin needs change by trimester.

Is Psyllium Husk or NAC safe in the first trimester?

Psyllium Husk is a soluble fibre supplement that can help manage constipation, common in early pregnancy due to hormonal changes and iron supplementation. It is generally considered safe when taken as directed and with adequate water. NAC is an antioxidant that may be relevant in specific high-risk situations and should only be taken if discussed with your healthcare provider. Discuss both with your midwife or GP before starting.

References

1. NHS (2023). Vitamins, supplements and nutrition in pregnancy. https://www.nhs.uk/pregnancy/keeping-well/vitamins-supplements-and-nutrition/
2. Royal College of Obstetricians and Gynaecologists. Healthy eating and vitamin supplements in pregnancy. https://www.rcog.org.uk/for-the-public/browse-all-patient-information-leaflets/healthy-eating-and-vitamin-supplements-in-pregnancy-patient-information-leaflet/
3. NHS (2023). Have a healthy diet in pregnancy. https://www.nhs.uk/pregnancy/keeping-well/have-a-healthy-diet/

This content is for educational purposes only and is not intended to diagnose, treat or replace medical advice. Always consult your midwife, GP or healthcare provider before starting or changing any supplement during pregnancy.

Related guides

• Why Is Choline Important During Pregnancy And Why Is It Often Overlooked?
• Folic Acid vs Folate: What's Best During Pregnancy?
• Tailoring Pregnancy Nutrition Through Trimesters