Choline: The Unsung Hero for Baby’s Brain

Why Most Prenatal Vitamins Miss the Mark 

When you first become pregnant, or begin the journey to trying, there’s a rush of information about which prenatal vitamin is best. Folate, DHA, and iron usually take center-stage and tend to dominate packaging claims and the conversations with friends and perhaps your doctor. But one critical nutrient tends to fly under the radar: choline.

Just as important for fetal development as folate, choline plays a vital role in your baby’s brain and spinal cord development, liver function, and methylation—a key process that supports everything from how your baby’s genes are expressed to its body’s detoxification efforts. It's also essential for memory, cognition, and nervous system signaling. Despite these key roles, chances are high you’ve never heard much about it—and that your prenatal supplement either doesn’t contain enough or enough of the right form. 

Choline’s Role

Choline is essential for producing acetylcholine, a neurotransmitter involved in memory, attention, and learning. During pregnancy, your need for choline increases significantly as your baby’s brain and central nervous system develop rapidly—especially in the first trimester.

Emerging research shows that adequate choline intake during pregnancy supports proper neural tube closure, long-term cognitive benefits for the baby, healthy placental function, and reduced risk of pregnancy complications such as preeclampsia or preterm labor. In fact, some studies suggest that high maternal choline intake may help mitigate the effects maternal stress may have on fetal development, which can then support healthier birth outcomes and infant behavior.

So Why Are Most Prenatals Lacking Choline?

Despite its critical importance, choline is often either missing, or severely under-dosed, in most prenatal vitamins on the market today. The Adequate Intake (AI) for choline is 450 mg/day for pregnant women and even higher at 550 mg/day for breastfeeding women. So why are most popular prenatal vitamins offering less than 50 mg in their daily doses? This gap comes down to a few “behind-the-scenes” issues. 

First, is the cost since high-quality, bioavailable forms of choline are expensive for manufacturers to source. The nutrient itself can also take up a lot of space in a capsule or tablet, which means it’s difficult to include a meaningful dose without increasing the number of pills—something many brands try to avoid because they know most people prefer to only take a few. On top of that, unfortunately a lot of companies still haven’t caught up with the latest research highlighting how critical choline is during pregnancy. Instead, the focus tends to be on nutrients that are easier to market or more familiar to the average consumer (cue folate). Unfortunately, that means many women are left without enough support at a time when their choline needs are actually at their highest.

What About Food Sources? 

While food sources of choline can certainly help, it’s not always realistic to meet the recommended 450 mg per day through diet alone. It takes ongoing awareness and careful planning to consistently hit that target, and many of the best sources of choline (like eggs, liver, and certain meats) may not be well-tolerated due to food aversions, nausea, or shifting appetite in the first trimester. On top of that, busy schedules or dietary preferences (vegans or vegetarians) can make it even more challenging.. That’s where a well-formulated prenatal with a meaningful dose of choline can really help fill the gap and offer peace of mind.

Bioavailable Forms of Choline: What to Look For

Citocholine and Phospatidylcholine are two highly bioavailable and research-backed forms to look for in your prenatal vitamin. Citocholine supports brain development and repair, crosses the blood-brain barrier efficiently, and also may enhance memory and focus in mom. Phosphatidylcholine is a key component of cell membranes and fetal brain structure. It supports the production of acetylcholine, which is a neurotransmitter for learning and attention, and is naturally found in eggs and soy lecithin, though is more effective in supplement form for therapeutic doses. Choline bitartrate is another form you may find, which is used less efficiently by the body and has poorer absorption, sometimes with digestive side effects.  

When reading labels, look for products that provide at least 200-250 mg of choline per day in one of the bioavailable forms mentioned above. This won’t always get you to the full AI on its own, but it can meaningfully close the gap—especially when paired with food sources.

What Does the Research Say?

Clinical research continues to reinforce choline’s value in pregnancy. Several trials have shown that higher choline intake during pregnancy is associated with improved cognitive performance in children, lower levels of cortisol and stress reactivity in infants, and enhanced placental function and nutrient delivery. Given these promising results, some researchers are even calling for the daily recommendations for choline to be increased, particularly during pregnancy and lactation.

The Bottom Line: Choline Matters! 

Choline is a nutrient you should absolutely be screening for when picking a prenatal vitamin, yet is so commonly missed. It is a key player in your baby’s brain development, placental function, and long-term cognitive health and should no longer be viewed as an “optional” nutrient it once was. When choosing a prenatal supplement, don’t just look for the basics. Check the label for citicoline or phosphatidylcholine, and aim to round out your intake with choline-rich whole foods.

You and your baby deserve more than just the minimum. And in this case, choline could make all the difference!

-Jennifer Dela Cruz, MS, RD, CDCES