Folic acid in pregnancy
Folic acid is perhaps the most important supplement to take during the early stages of pregnancy. It has been proven to reduce the prevalence of neural tube defects, such as spina bifida and anecephaly, which affect the spine and brain.
It is also thought to reduce the risk of other birth defects such as cleft palate and heart defects. Some studies have suggested that it might protect against prematurity and a low birth weight.
How much folic acid do I need to take in pregnancy?
Although you can get folic acid through food and many foods are fortified with folic acid, it is advisable to take a supplement as you will need a much higher amount during pregnancy and pre-conception (almost double the recommended daily intake for when you aren't pregnant).
The National Institute for Health and Clinical Excellence (NICE) recommends that women take a supplement of 400 micrograms of folic acid every day for at least the first 12 weeks of pregnancy and also when trying to become pregnant.
• Pregnancy home page
• Week by week pregnancy calendar
• All pregnancy health
• Antenatal appointments
• Pregnancy blood tests
• Nuchal scan
You will need a higher dose of folic acid (4-5mg daily) if you are in a higher-risk group for neural tube defects. This includes women with:
- A history of neural tube defects in their family (this applies to both the mother's and father's sides of the family)
- Insulin-dependent diabetes
- A previous pregnancy where neural tube defects were identified in their baby
- Coeliac disease
- A body mass index higher than 30
And also women taking anti-epilepsy medication.
Taking a higher dose of folic acid should be discussed with your doctor, who can prescribe the higher dose but may need to check for vitamin B12 deficiency first.
When should I start taking folic acid supplements?
Folic acid helps the body create new cells, which is why it is so important in the very early stages of pregnancy. If you're thinking of getting pregnant, then you should take supplements straight away or as soon as you know you are pregnant.
The Association for Spina Bifida and Hydrocephalus recommends you take folic acid supplements three months before conception. There are no serious side-effects, although some women may feel nauseous or bloated, particularly when they first start to take it. There is no problem in taking supplements for prolonged periods while trying to conceive.
And there's no need to worry if you miss a dose, but try to take one a day as the body does not store folic acid and needs a constant supply.
What foods are rich in folic acid?
Foods that are rich in folic acid include yeast extract, spinach, beans, broccoli, potatoes and peas, as well as many fortified breakfast cereals and some bread.
Are vitamins and supplements necessary in pregnancy?
Folic acid will be included in pregnancy multivitamins along with a multitude of other added extras, but the essential supplements to take during pregnancy are vitamin D and folic acid.
Vitamin D helps to maintain calcium levels and will help your baby develop strong teeth and bones. It can be difficult to get enough through diet alone. You can get Vitamin D from exposure to sunlight, but that's not always readily available in the UK climate. A deficiency in vitamin D can result in rickets, which despite sounding like it should only belong in a Victorian novel, has recently been on the increase. A 10mcg supplement daily is an appropriate amount.
Vitamin C, while essential for your health and your baby's development, should not be taken in excessive 'mega' supplement amounts as it has been linked to premature labour. It's easy to get enough vitamin C in your diet by eating lots of fresh fruit and vegetables and through pre-natal multivitamins.
Unless you have anaemia, iron supplements should be avoided in pregnancy as too much iron can affect foetal growth.
What Mumsnetters say about taking folic acid in pregnancy
- My mum is a midwife and she said there is no point in taking it after the first trimester, as by that point the neural tube is closed, and the whole point of taking folic acid is to prevent neural tube diseases. Lou19
- I'm taking 5mg of folic acid every day, and I asked my GP whether I'd be overdosing if I took a multivitamin too (which contains 0.4mg of folic acid). She said it'd be fine. She said that to overdose on folic acid, I'd have to take a helluva lot more than 5.4mg per day. MollyDefoe
- Folic acid is nothing but a B vitamin and your body is unable to store it. If you take in more than you need it just comes out. Your body can only store fat-soluble vitamins for future use. KatAndKit