Choline: the essential nutrient during pregnancy and breastfeeding

Throughout pregnancy and breastfeeding, you are the sole source of nutrition for this rapidly growing new life.  You alone are fuelling their healthy growth and development.  The fuel you provide can set them up with the best start for a happy, healthy life. 

There are certain nutrients which are especially important to fuel healthy growth during pregnancy and breastfeeding. 

We hear a lot about folate and iron, but one of the most important nutrients for both pregnancy and breastfeeding is choline.  Yet around 90% of us aren’t getting enough. [1] [2]

“Choline is often referred to as the unknown essential nutrient as few people, even health professionals, know about it” says choline researcher Professor Marie Caudill.

“Dietary recommendations for choline were not established until 1998 as compared to the early 1940s for the other nutrients.  In addition, only recently has choline been featured in nutrition textbooks and included in the curriculum for nutrition majors.” 

Choline is one of the few nutrients, which actually becomes more important during breastfeeding.  The recommended adequate intake increases from 440mg during pregnancy to 550mg during breastfeeding. [3]  Yet 90 – 95% of pregnant women aren’t meeting recommended levels [4]

“Our preliminary dietary studies clearly show an insufficient choline intake compared to the recommended levels,” said Curtis, an analytical chemist and project leader for ongoing choline research at the University of Alberta [1]

During pregnancy, choline works alongside folate in the development of the neural tube, as well as supporting healthy brain development which has been shown to have lasting effects on learning and memory function. 

Benefits of choline during pregnancy and breastfeeding

  • Supports healthy neural tube closure [5] [6]
  • Reduces the risk of neural tube defects [7] [8]
  • Supports healthy brain development [9]
  • Helps support lifelong learning and memory [10]
  • Reduces stress and anxiety levels in the infant [11]
  • Supports healthy growth of the placenta [12] 

The importance of choline is summed up well by Gerald Weissmann MD Editor in chief FASEB Journal

 “The importance of choline cannot be overstated as we continue to unravel the role it plays in human health and development” [13]

Sources of Choline

Animal products are the richest food sources of choline including egg yolks, red med, chicken and fish.  

Other good sources of choline include lecithin granules, baked beans, kidney beans, lentils, brussel sprouts, broccoli, spinach, cauliflower, wheatgerm and oats.  However, vegetarians and vegans are at most risk of choline deficiency.

Due to the importance of choline in pregnancy and breastfeeding, the American Medical Association recently made recommendations to include choline in all prenatal supplements. [14] 

Currently in Australia, most prenatal supplements don’t provide this important prenatal nutrient.  I recommend choosing a prenatal supplement which provides 300mg of choline alongside a healthy variety of choline rich foods.

Download your free checklist [here] for practical tips to get you started creating your fertile pantry and nourishing your future baby, today.

About the author: 

Tasha Jennings is a Natural Fertility Naturopath and Nutritionist. Through her consultations, professional presentations, webinars, published books (The Vitamins Guide and The Fertility Diet), Conceive Baby Podcast and online courses, she helps proactive women and couples optimise fertility wellbeing to create healthy pregnancies and healthy babies.

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[1] Claudill MA. Pre and postnatal health: evidence of increased choline needs J Am Diet Assoc. 2010 Aug;110(8):1198-206 [pub med abstract]

[2] National Institutes of Health. US Department of Health Human Services – Health Professionals Facts Sheet [fact sheet]

[3] Nutrient reference values Australia and New Zealand https://www.nrv.gov.au/nutrients/choline

[4] Brunst KJ, Wright RO, DiGioia K, Enlow MB, Fernandez H, Wright RJ, et al. Racial/ethnic and sociodemographic factors associated with micronutrient intakes and inadequacies among pregnant women in an urban US population. Public Health Nutr 2014;17:1960-70 [pubmed abstract]

[5] Shaw GM1Carmichael SLYang WSelvin SSchaffer DM Periconceptional dietary intake of choline and betaine and neural tube defects in offspring Am J Epidemiol. 2004 Jul 15;160(2):102-9 [pubmed abstract]

[6] Kelei LiMark L. Wahlqvist and Duo Li Nutrition, One-Carbon Metabolism and Neural Tube Defects: A Review Nutrients. 2016 Nov; 8(11): 741 [pubmed article]

[7] Shaw GM1Carmichael SLYang WSelvin SSchaffer DM Periconceptional dietary intake of choline and betaine and neural tube defects in offspring Am J Epidemiol. 2004 Jul 15;160(2):102-9 [pubmed abstract]

[8] Kelei LiMark L. Wahlqvist and Duo Li Nutrition, One-Carbon Metabolism and Neural Tube Defects: A Review Nutrients. 2016 Nov; 8(11): 741 [pubmed article]

[9] Lisa M. Sanders, PhD, RD and Steven H. Zeisel, MD, PhD Choline Dietary Requirements and Role in Brain Development Nutr Today. 2007; 42(4): 181–186 [pubmed article]

[10] Lisa M. Sanders, PhD, RD and Steven H. Zeisel, MD, PhD Choline Dietary Requirements and Role in Brain Development Nutr Today. 2007; 42(4): 181–186 [pubmed article]

[11] Jiang X et al. A higher maternal choline intake among third-trimester pregnant women lowers placental and circulating concentrations of the antiangiogenic factor fms-like tyrosine kinase-1 (sFLT1) FASEB J. 2013

Mar;27(3):1245-53. doi: 10.1096/fj.12-221648. Epub 2012 Nov 29 [pubmed abstract]

[12] Jiang X et al. A higher maternal choline intake among third-trimester pregnant women lowers placental and circulating concentrations of the antiangiogenic factor fms-like tyrosine kinase-1 (sFLT1) FASEB J. 2013 Mar;27(3):1245-53. doi: 10.1096/fj.12-221648. Epub 2012 Nov 29 [pubmed abstract]

[13] Federation of American Societies for Experimental Biology. "Sick from stress? Blame your mom… and epigenetics." ScienceDaily. ScienceDaily, 31 July 2012 [article]

[14] AMA backs global health experts in calling infertility a disease AMA June 2017[article]