Vitamin A
Vitamin & mineralAlso called · 5 names▾▴
retinol, beta-carotene, provitamin A, retinyl acetate, retinyl palmitate
Vitamin supplement
Herbs and supplements are not FDA-approved before sale. About these sources
- Capsule/tablet
- Softgel
- Gummy
Research strength: 3 / 5
MotherToBaby reports mixed findings on vitamin A supplements and birth defects, with high-dose preformed retinol more concerning than beta-carotene. The 1995 Rothman cohort linked higher preformed intakes, especially before week 7, with some cranial-neural-crest defects, while Mills 1997 and Mastroiacovo 1999 did not find increased malformations in their studied groups. NIH ODS says excessive preformed vitamin A can cause birth defects and lists a tolerable upper limit, not a target, of 3,000 mcg daily for ages 19 to 50 and 2,800 mcg for ages 14 to 18. NHS advises against all supplements or multivitamins containing retinol, while ACOG says to take one prenatal serving and warns against doubling or tripling it. Ask your provider about your situation.
Last reviewed: 2026-10-14
Sources
- MotherToBaby: Vitamin AUS government
- NIH Office of Dietary Supplements: Vitamin A and Carotenoids, Health Professional Fact SheetUS government
- NHS: Vitamins and supplements in pregnancyUK government
- ACOG: Healthy Eating During PregnancyProfessional society
- Rothman et al., New England Journal of Medicine 1995US government
- Mills et al., American Journal of Obstetrics and Gynecology 1997US government
- Mastroiacovo et al., Teratology 1999US government
Research strength: 3 / 5
MotherToBaby reports that recommended amounts are not expected to increase preterm delivery or low birth weight, while the effects of higher amounts on these outcomes are not known. Dirnena-Fusini et al. reported a 2026 Norwegian post-hoc study that measured blood retinol at weeks 18 to 22 and 32 to 36 in 723 low-risk pregnancies; lower levels were associated with higher birth weight, but the study did not test supplements. NIH ODS says excessive preformed vitamin A can cause birth defects and its upper limit applies only to preformed vitamin A. NHS advises against supplements and multivitamins containing retinol, while ACOG discusses one prenatal serving and warns against taking double or triple doses. Ask your provider about your situation.
Last reviewed: 2026-10-14
Sources
- MotherToBaby: Vitamin AUS government
- NIH Office of Dietary Supplements: Vitamin A and Carotenoids, Health Professional Fact SheetUS government
- NHS: Vitamins and supplements in pregnancyUK government
- ACOG: Healthy Eating During PregnancyProfessional society
- Dirnena-Fusini et al., Frontiers in Nutrition 2026US government
Research strength: 3 / 5
MotherToBaby reports that recommended amounts are not expected to increase preterm delivery or low birth weight, while the effects of higher amounts on these outcomes are not known. Cao et al. reported a 2026 nested case-control study of 8,897 pregnancies in which low dietary vitamin A intake in the third trimester was associated with preterm birth; it did not test high-dose supplements. NIH ODS says excessive preformed vitamin A can cause birth defects and its upper limit applies only to preformed vitamin A. NHS advises against supplements and multivitamins containing retinol, while ACOG discusses one prenatal serving and warns against taking double or triple doses. Ask your provider about your situation.
Last reviewed: 2026-10-14
Vitamin A — Breastfeeding
Research strength: 3 / 5
MotherToBaby describes vitamin A as a normal part of breast milk and says breastfeeding parents should get the recommended daily amount. LactMed reports that higher maternal doses have not been studied and says daily doses above 3,000 mcg, or 10,000 IU, should be avoided. NIH ODS says milk from people with adequate vitamin A intake contains enough for infant needs during the first 6 months, while deficiency may leave infant stores low. Ali et al. reported that a 2026 study of 48 breastfeeding women found adequate milk retinol at weeks 4 and 8, but it did not test high-dose supplements. Ask your provider about your situation.
Last reviewed: 2026-10-14
Pregnancy
MotherToBaby says studies of extra vitamin A from supplements have mixed results for birth defects. It reports that preformed retinol at high doses is more concerning than beta-carotene and summarizes guidance to meet the RDA and avoid more than 10,000 IU per day unless directed by a provider. ODS lists pregnancy upper limits for preformed vitamin A only: 2,800 mcg daily for ages 14 to 18 and 3,000 mcg for ages 19 to 50. These limits include food and supplement sources and are upper limits, not intake goals. ACOG says one serving of prenatal supplement daily and warns that doubling or tripling the dose can cause birth defects. The NHS pregnancy page instead advises avoiding supplements and multivitamins containing retinol, and liver and liver products. ACOG's separate birth-defect FAQ says not to take high levels and gives a ceiling of 10,000 IU daily. The 2026 CDC measles clinical page says pregnant women should avoid high levels because they have been linked to severe birth defects; this appears in its measles-treatment section and sets no dose threshold. The primary human studies are mixed. Rothman et al. (1995) studied 22,748 pregnancies and reported a higher prevalence of cranial-neural-crest defects with more than 15,000 IU daily from food and supplements, or more than 10,000 IU daily from supplements alone; the increase was concentrated among high intake before week 7. Mills et al. (1997), a case-control study with 548 neural-tube-defect pregnancies, 387 other-malformation pregnancies, and 573 controls, found no association at the studied doses above 8,000 or 10,000 IU daily. Mastroiacovo et al. (1999) prospectively followed pregnancies exposed to at least 10,000 IU daily during the first 9 weeks; their studied sample did not show an increased risk of major malformations. The studies differ in design, outcomes, and exposure measurement, so the null studies do not establish that high-dose supplementation lacks risk, and the association in Rothman does not establish causation. Ma et al. (2023) meta-analyzed 55 studies including 426,098 pregnancies and reported differing results across maternal health and study-design subgroups; its growth outcomes do not establish the safety of high-dose retinol in pregnancy. Three 2026 observational papers add context but do not test high-dose supplement safety. Yuan et al. measured first-trimester serum retinol in 1,077 pregnancies and found associations with both lower and higher odds of selected outcomes. Dirnena-Fusini et al. analyzed serum retinol in 723 low-risk Norwegian pregnancies at weeks 18 to 22 and 32 to 36; lower levels were associated with higher birth weight, and the authors cautioned about the post-hoc design. Cao et al. studied dietary intake in 8,897 pregnancies and found low intake associated with preterm birth, including in the third trimester. These observational associations cannot show that changing supplement intake causes the outcome. No study in this review establishes separate dose guidance for each trimester.
Breastfeeding
LactMed says retinol and provitamin A carotenoids are normal components of human milk. It reports that maternal supplementation may be needed when intake is inadequate, that daily maternal doses above 3,000 mcg (10,000 IU) should be avoided, and that higher maternal doses have not been studied. ODS says milk from lactating people with adequate vitamin A intake contains enough to meet infant needs in the first 6 months, while milk vitamin A may be insufficient to maintain infant stores when the parent has deficiency. Ali et al. (2026) was a secondary analysis of 48 breastfeeding women, with serum and milk collected at weeks 4 and 8 postpartum; mean breastmilk retinol was 3.7 and 3.2 micromol/L, described by the authors as adequate. This small study measured status and milk composition, not effects of high-dose supplementation. Shinde et al. (2025) reviewed 87 papers, including 76 trials; vitamin A supplementation improved maternal status and postpartum supplementation improved milk vitamin A, while effects on infant status were negligible or inconsistent. The review covered low- and middle-income countries and nutritional-status outcomes, not a universal recommendation for high-dose use.
Vitamin A includes preformed vitamin A, such as retinol and retinyl esters, and provitamin A carotenoids such as beta-carotene. Retinyl acetate and retinyl palmitate are preformed forms used in supplements; beta-carotene is a plant-derived provitamin A. Preformed vitamin A occurs in animal foods, including liver, while beta-carotene occurs in plant foods. MotherToBaby distinguishes vitamin supplements from prescription retinoid medicines, which are outside this entry's scope.
What was tested
The pregnancy evidence reviewed includes an observational cohort, case-control studies, a prospective exposure study, a meta-analysis, and 2026 cohorts measuring serum vitamin A or dietary intake. The older birth-defect studies examined early pregnancy and did not agree. The 2026 pregnancy studies did not test high-dose vitamin A supplements. Breastfeeding evidence includes milk-composition research and supplementation studies, including a 2026 secondary analysis of 48 women at weeks 4 and 8 postpartum. The most recent small milk study measured vitamin status and milk retinol, not high-dose exposure or infant clinical outcomes.
Whether pregnant readers should avoid every supplement or multivitamin containing retinol, or focus on avoiding excessive preformed vitamin A
- Source A says
- The NHS pregnancy page advises avoiding supplements and multivitamins containing vitamin A (retinol), and also liver and liver products. (NHS: Vitamins and supplements in pregnancy)
- Source B says
- ODS says excessive preformed vitamin A can cause birth defects and gives an upper limit that applies to preformed vitamin A, while ACOG says to take one daily prenatal serving and warns against doubling or tripling it. MotherToBaby summarizes guidance to meet the RDA and avoid doses above 10,000 IU daily unless directed by a provider. (NIH Office of Dietary Supplements: Vitamin A and Carotenoids, Health Professional Fact Sheet, ACOG: Healthy Eating During Pregnancy, MotherToBaby: Vitamin A)
- Why they differ
- The NHS public page uses a broad precaution for retinol-containing supplement products and liver foods. ODS and ACOG distinguish recommended prenatal use from excessive preformed vitamin A, and specify intake limits or duplicate-dose concerns. These pages do not state the same scope or use the same dose framing.
- What the evidence shows overall
- The sources agree that high intake of preformed vitamin A can be a concern, but their wording differs on whether a supplement containing retinol should be avoided altogether. Keep the difference visible, distinguish food and supplement forms, and do not present an upper limit as an individual target. The reviewed evidence does not establish harm from a recommended prenatal serving or a separate trimester-specific dose rule.
- MotherToBaby asks readers to bring supplement bottles or label photos to a healthcare provider so total vitamin A from foods, drinks, and supplements can be reviewed against recommended amounts. (MotherToBaby)
- ACOG says to take one serving of prenatal supplement each day and says an obstetrician-gynecologist may recommend an extra nutrient separately when needed. (ACOG)
- The NHS pregnancy page advises avoiding supplements and multivitamins containing retinol and liver products during pregnancy. (NHS)
- LactMed says breastfeeding parents should avoid daily maternal doses above 3,000 mcg (10,000 IU) and notes that higher doses have not been studied. (LactMed)
General research, not specific to pregnancy.
NIH ODS reports that excess preformed vitamin A can build up in the body and that very high single or repeated doses can cause toxicity. These general effects are separate from the pregnancy-specific evidence.
- ODS says excess vitamin A is stored mainly in the liver and acute toxicity after a very high dose can include headache, blurred vision, nausea, dizziness, muscle aches, and coordination problems. (NIH Office of Dietary Supplements: Vitamin A and Carotenoids, Health Professional Fact Sheet)
- ODS says repeated high-dose intake can cause dry skin, painful muscles and joints, fatigue, depression, and abnormal liver test results. (NIH Office of Dietary Supplements: Vitamin A and Carotenoids, Health Professional Fact Sheet)
- MotherToBaby: Vitamin AUS governmentSecondaryPage dated 2026-03-01
- NIH Office of Dietary Supplements: Vitamin A and Carotenoids, Health Professional Fact SheetUS governmentSecondaryPage dated 2025-03-10Independent check
- NHS: Vitamins and supplements in pregnancyUK governmentSecondaryIndependent check
- ACOG: Healthy Eating During PregnancyProfessional societySecondaryIndependent check
- ACOG: Reducing Risks of Birth DefectsProfessional societySecondaryIndependent check
- CDC: Clinical Overview of MeaslesUS governmentSecondaryPage dated 2026-08-05
- LactMed: Vitamin AUS governmentSecondaryPage dated 2024-09-15
- Rothman et al., New England Journal of Medicine 1995: Teratogenicity of high vitamin A intakeUS governmentPrimaryIndependent check
- Mills et al., American Journal of Obstetrics and Gynecology 1997: Vitamin A and birth defectsUS governmentPrimaryIndependent check
- Mastroiacovo et al., Teratology 1999: High vitamin A intake in early pregnancy and major malformationsUS governmentPrimaryIndependent check
- Dirnena-Fusini et al., Frontiers in Nutrition 2026: Maternal vitamin A levels during second and third trimester and associations with offspring's birth weightUS governmentPrimaryIndependent check
- Cao et al., PeerJ 2026: Maternal dietary vitamin A and polyunsaturated fatty acids intake and risk of preterm birthUS governmentPrimaryIndependent check
- Yuan et al., Frontiers in Nutrition 2026: First-trimester serum vitamin A and pregnancy outcomesUS governmentPrimaryIndependent check
- Ma et al., Critical Reviews in Food Science and Nutrition 2023: Vitamin A supplementation during pregnancy in shaping child growth outcomesUS governmentPrimaryIndependent check
- Ali et al., Journal of Nutrition 2026: Vitamins A, D, E, and K intakes, status, and breastmilk concentrations in breastfeeding women in IrelandUS governmentPrimaryIndependent check
- Shinde et al., Advances in Nutrition 2025: Vitamin supplementation for pregnant and/or lactating women, systematic review and meta-analysisUS governmentPrimaryIndependent check
Last reviewed 2026-10-14
Independent check 2026-10-14
Not yet clinician-reviewed
Ask your provider about your situation.