Iron and folate get all the attention. The one your body burns through fastest while feeding is the one your supplement most likely left out.

By Hilary Metcalfe

I read the back of the bottle. It is a habit, and an occupational one, and there is a particular nutrient I keep going looking for and keep not finding, on prenatal labels, on postnatal labels, in the conversation altogether. Choline.

We talk endlessly about iron and folate, and rightly. But choline is the one your body draws down faster while breastfeeding than at any other point in your life, and almost nothing on the shelf puts it back. So here is the case for the nutrient that gets left off the list, and how to cover it yourself.

What choline does

Three jobs, roughly, and all three matter more in the year after birth, not less.

The first is your brain. Choline is the raw material your body uses to make acetylcholine, the neurotransmitter most tied to memory and recall. In a twelve-week controlled trial in adults, supplementing choline from egg yolk raised blood choline and improved verbal memory against placebo. I will not tell you choline cures the postnatal fog, because that specific trial has not been done in new mothers. But the building block of your memory chemistry is the one you are running low on, and the biology is more than suggestive.

The second is your liver. Choline keeps fat moving out of the liver rather than building up in it, which is why a low-choline diet drives fat accumulation in the liver, reversibly, when choline goes back in. It is also a methyl donor, part of the same one-carbon machinery as folate and B12, the system that switches genes on and off and keeps your metabolism ticking.

The third is your baby. The strongest evidence sits in pregnancy: in randomised feeding trials, higher maternal choline improved infants' information-processing speed and, years on, their sustained attention. Breast milk is rich in choline too, drawn straight from your stores, which is exactly why the demand does not ease off once the baby arrives. It climbs.

Why feeding is the hungriest moment

Here are the two numbers worth knowing. The adequate intake for choline is 450 mg a day in pregnancy. While breastfeeding it rises to 550 mg, the highest it ever is across a woman's life. More than pregnancy, not less.

And your body prioritises the milk. During lactation, choline is pulled from your bloodstream into your breast milk to enrich it for the baby, and your own liver becomes the account it draws down to do so. Researchers describe a mother-to-child gradient: the baby is topped up, and the mother is left short. Put that next to the fact that most women take in around 300 mg a day, well under the mark, and you can see how a feeding mother ends up running on empty without anything obvious to point at.

Food first, and it starts with the yolk

The good news is that food does this better than any pill, and one food does most of the heavy lifting. A large egg carries around 150 mg of choline, nearly all of it in the yolk. Two eggs get you roughly halfway to the day's 550, and three to four yolks covers very nearly the whole of it before you have touched anything else. This is the hill I will die on: do not throw the yolk away. The yolk is the entire point.

After that, the richest sources are liver, lean red meat, fish, poultry, and then, further down, legumes, cruciferous vegetables like broccoli, and nuts. A plant-led eater can get there, but it takes intention, because the densest sources are animal ones. If you eat eggs most mornings, you are most of the way home.

The label problem

So why have you never been told this? Partly because choline was only formally recognised as an essential nutrient in 1998, which is recent as these things go. And partly for a dull, practical reason: choline is a bulky molecule. Fitting a full daily dose into a tablet alongside everything else would make the pill too big to swallow, so manufacturers leave most of it out. Most prenatal and postnatal supplements contain little choline, typically between zero and around 55 mg, a fraction of the 550 you are aiming for.

That is the gap. Your supplement is not lying to you, it just cannot carry this one for you. Which means choline is a job for your plate, and worth being deliberate about, especially in the months when your body is handing most of its supply to someone else.

I am putting together a companion guide on how to read a prenatal or postnatal label properly, which nutrients to demand and which brands clear the bar, and when it is ready it will live here on the journal. In the meantime, the first chapter of our book, The First 100 Days Postpartum, is free, and our newsletter is where I share the rest of the reading-the-label habit.

Two eggs tomorrow. Start there.

Hilary x

The science, sourced

• Choline requirements, maternal depletion and the intake gap: A Narrative Review on Maternal Choline Intake and Liver Function of the Fetus and the Infant

• How little choline is in most supplements: Choline During Pregnancy and Lactation, InfantRisk Center

• Choline, acetylcholine and adult memory: Effects of egg yolk choline intake on cognitive functions, a randomised controlled trial

• Maternal choline and the infant brain: Association between Maternal Choline, Fetal Brain Development, and Child Neurocognition, systematic review and meta-analysis

DISCLAIMER

The SABI blog and articles are not meant to instruct or advise on medical or health conditions, but to inform. The information and opinions presented here do not substitute professional medical advice or consultations with healthcare professionals for your unique situation.

ABOUT HILARY

Hilary Metcalfe is Co-Founder of The SABI, a Certified Holistic Nutritionist, whole foods chef, and women's health product developer. Her path through fertility challenges, miscarriage, and Adenomyosis drives her mission to help women reconnect with their cycles, understand their hormones, and feel truly supported in their bodies.

At The SABI, Hilary leads product development, formulating OB-GYN safety-approved rituals and hormone-conscious skincare rooted in nutrition, herbal wisdom, and clinical insight. Originally from Los Angeles, she lives in Todos Santos, Mexico, with her husband Kees, rescue dog Flint, and their rainbow babies, Paloma and Bea.

HORMONAL & PROUD

The SABI was created to help women through the hardest moments of pregnancy, childbirth, postpartum and every stage that follows. We want to change the story around our hormones, from one of taboo, embarrassment and loneliness to one of awareness, and even pride.

More than a wellness brand, The SABI is a line of rituals, supportive tools and functional herbal remedies, tested by hundreds of years of traditional medicine and now backed by modern science. It was conceived by women who have lived the joys and the deeper costs of bringing a child into the world, of a heavy or difficult period, of miscarriage and trouble conceiving.

Consider this an invitation to know your body and its cycles, to learn to work with them at any stage of life, and to know that support exists. Look for the right sources, know there is help, and know that you are not on your own.