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About three months before my husband and I started trying to get pregnant with our first child, I took prenatal vitamins with folic acid.
Like any new mom, I wanted to do everything perfectly so I researched the vitamins and minerals—and the recommended amounts of each—that I should take. Since I have a cousin who has spina bifida, I knew about the importance of taking folic acid, so I specifically chose a prenatal vitamin with 1,000 micrograms (mcg) of folic acid, the highest amount that’s safe to take.
If you’re trying to get pregnant, your gynecologist, midwife or provider should also make sure you know to take your prenatal vitamins with folic acid before you get pregnant, during your pregnancy and even if you’re not trying to get pregnant.
Read on to learn why folic acid is so important for all women, how much you should take and how to get folic acid in your diet.
Why do you need folic acid?
Folic acid is the synthetic form of folate, or vitamin B9. Folate helps make red blood cells and is vital for the growth and function of healthy cells throughout your body.
Taking folic acid before you get pregnant is important to prevent neural tube defects—
birth defects of the brain and spinal cord. Neural tube defects, which include spina bifida, anencephaly and Chiari malformation, occur in approximately 3,000 pregnancies each year in the U.S., according to a report by the Centers for Disease Control and Prevention (CDC).
What many women don’t know is during the first 4 to 6 weeks after the first day of your last menstrual period is when the neural tube forms and when defects occur. The neural tube ultimately becomes the spinal cord, spine, brain and skull.
Whether you’re trying to get pregnant, trying to avoid getting pregnant or don’t think you can get pregnant, you should take folic acid, since 45 percent of pregnancies are unplanned, according to a March 2016 study published in The New England Journal of Medicine.
Studies suggest taking folic acid may also have more benefits for your baby. In fact, a recent study published in the journal JAMA Psychiatry found moms who were prescribed a multivitamin and folic acid supplement had a 73 percent lower risk for having a child with Autism.
Eating folic acid-fortified foods was associated with an 11 percent reduction in certain heart defects, an August 2016 study published in the journal Circulation found.
Adequate levels of folate during pregnancy may also reduce the risk that a child will become obese, especially those born to moms who are obese, an August 2016 study published in the journal JAMA Pediatrics found.
How much folic acid should you take?
Although experts say all women of childbearing age should take folic acid, 22 percent aren’t getting enough. Folic acid is a water-soluble vitamin, so it needs to be taken every day.
The Institute of Medicine (IOM)’s guidelines state before pregnancy, most women should take a multivitamin or prenatal vitamin that has 400 micrograms (mcg) of folic acid or a separate supplement with the same amount. During pregnancy, you can increase folic acid to 600 mcg and 500 mcg if you decide to breastfeed.
If you have a family history of neural tube defects or another medical condition, you should talk to your doctor about whether or not you should take a higher dose of folic acid.
What are the types of folic acid?
Some women who have an MTHFR genetic mutation can’t utilize folate as well so they may need to take the bioactive form of folate.
Foods with folic acid
Folic acid supplements are actually better absorbed and utilized than food. In fact, folate-rich foods are absorbed and utilized at a rate of 80 percent than that of folic acid supplements, a 2007 study published in The American Journal of Clinical Nutrition.
Nevertheless, foods rich in folate are still an excellent addition to your supplement. Foods highest in folate include:
- Beef liver: 215 mcg
- Spinach: 131 mcg
- Black-eyed peas: 105 mcg
- Asparagus: 89 mcg
- Brussels sprouts: 78 mcg
Additionally, there are certain folic acid-fortified foods such as cereal, bread, pasta, rice and grains. Be sure to read labels carefully. Some of the highest sources of folic acid-fortified foods include:
- Cereals: 100 mcg
- White rice: 90 mcg
- Spaghetti: 83 mcg
- Bread: 43 mcg
If you’re unsure about how much folic acid and folate you should be getting or if you think you could be deficient, be sure to speak to your doctor.