How to Properly Take Folic Acid During Pregnancy: Recommendations and Tips

Highlights

• Folate (also known as folic acid) is one of the B vitamins that supports healthy growth and development.
• Folate is found naturally in foods, and it is known as ‘folic acid’ when it is added to food, such as bread and breakfast cereals, or used in dietary supplements.
• Your baby needs folate for their brain, spine, and nerve development.
• It is important to take folic acid supplements in pregnancy, as it can help prevent birth defects.
• Folic acid supplements are available in Australia over the counter from pharmacies and supermarkets — ask your doctor about the dose that’s right for you.

In This Article

• Folate and Folic Acid
• Importance of Folate During Pregnancy
• Foods Containing Folate
• Starting Folic Acid Supplements
• Recommended Dosage of Folic Acid
• High Dose of Folic Acid
• Excessive Folic Acid Intake
• Tools And Assistance

Folate and Folic Acid

Folate, also known as vitamin B9, is an essential nutrient required for healthy growth and development. It occurs naturally in many foods, such as leafy green vegetables, fruits, and legumes. When folate is added to foods or taken in supplements, it is referred to as folic acid. This vitamin plays a crucial role in cell division and the formation of DNA, making it particularly important during periods of rapid cell growth, such as pregnancy.

Folic acid is the synthetic form of folate and is often used in dietary supplements and fortified foods. It is easily absorbed by the body, making it a convenient way to increase folate intake, especially for those who may not get enough from their diet.

Importance of Folate During Pregnancy

Folate is especially important during pregnancy because it helps prevent neural tube defects, such as spina bifida. Neural tube defects are serious birth defects that occur when the spinal cord or brain does not develop properly. These defects can develop in the first few weeks of pregnancy, often before a woman even realizes she is pregnant.

Having adequate levels of folate before and during the early stages of pregnancy is critical for reducing the risk of these birth defects. By ensuring that you have enough folate, you can significantly improve the chances of a healthy pregnancy. This is why it is recommended to start taking folic acid supplements before conception and to continue through the first trimester.

Foods Containing Folate

Many foods naturally contain folate, and it is best to include these in your diet to ensure you are getting sufficient amounts of this important nutrient. Some foods that are excellent sources of folate include:

• Vegetables: Broccoli, spinach, Brussels sprouts, cabbage, cauliflower, green beans, zucchini, and lettuce
• Fruits: Oranges, avocados, bananas, strawberries, and grapefruit
• Legumes: Chickpeas, lentils, kidney beans, soya beans, and peas
• Eggs
• Nuts
• Juices: Many fruit juices, particularly orange juice, are good sources of folate
• Fortified Foods: Certain bread, breakfast cereals, and other grain-based foods may be fortified with folic acid

It is important to note that folate can be sensitive to heat and can be destroyed during cooking, particularly when foods are boiled or soaked in water. To maximize folate retention, try steaming, microwaving, or eating vegetables raw when possible.

Starting Folic Acid Supplements

Ideally, you should begin taking folic acid supplements at least one month before you start trying to conceive. This allows your body to build up adequate folate levels before pregnancy. Continuing to take the supplement throughout the first trimester is also recommended, as this is when the neural tube is developing and is most vulnerable to defects.

If you have not started taking folic acid before becoming pregnant, it is important to begin as soon as you find out you are expecting. Even starting in the first few weeks of pregnancy can help reduce the risk of birth defects.

Folic acid supplements are widely available in pharmacies and supermarkets. They can be purchased over the counter or through a healthcare provider, often in varying doses.

Recommended Dosage of Folic Acid

When trying to conceive or during the first few months of pregnancy, it is generally recommended to take a folic acid supplement that contains at least 400 micrograms (mcg) of folic acid per day. This is the standard dose that is sufficient for most women to reduce the risk of neural tube defects.

Many folic acid supplements are available in a daily dose of 500 mcg, which is considered a safe and effective amount for most individuals. In addition to folic acid supplements, there are multivitamins that may contain folate, but it is important to check that you are not exceeding the recommended dose, as too much folic acid can have potential side effects.

Your doctor can guide you in determining the appropriate dose based on your health and individual needs.

High Dose of Folic Acid

In some cases, a higher dose of folic acid may be necessary. This is typically recommended for women who are at an increased risk of having a pregnancy affected by a neural tube defect. Factors that may increase the risk include:

• A personal or family history of neural tube defects
• A previous pregnancy affected by a neural tube defect
• Having diabetes or obesity
• Taking medication for epilepsy
• A medical condition that affects nutrient absorption

For women with these risk factors, a higher dose of folic acid (usually 5 mg per day) is often recommended, starting before pregnancy and continuing until the 12th week. If you think you may be at higher risk, discuss this with your doctor, who will assess your individual situation and prescribe the appropriate dose.

Excessive Folic Acid Intake

Folic acid, like other B vitamins, is water-soluble, which means that any excess folic acid that the body does not need is typically excreted in urine. As a result, most people can tolerate an extra dose of folic acid without harm. However, consistently taking large amounts of folic acid (above the recommended daily dose) could lead to potential side effects.

In rare cases, taking too much folic acid can mask the symptoms of vitamin B12 deficiency, which is important for nerve function. This can delay the diagnosis of a B12 deficiency, leading to neurological complications.

If you believe you may have taken too much folic acid, it is important to contact your healthcare provider for advice. In the case of an overdose, you can also call a poison control center for immediate assistance.

Tools And Assistance

If you are planning a pregnancy, are already pregnant, or have questions about folic acid and its role in pregnancy, it is always best to consult with your healthcare provider. They can offer personalized advice based on your health history and specific needs.

If you need further information or support, many organizations offer resources and guidance, including family planning services and local clinics. They can provide you with more information about folate, folic acid supplements, and general pregnancy health.

Additionally, if you have concerns about taking too much folic acid or if you experience any adverse effects, your doctor or a medical professional can provide expert guidance.

Need more information?

Folate and pregnancyTaking the vitamin folate before and during pregnancy reduces the risk of your baby having a neural tube defectRead more on WA Health websiteFolate and iodine – PregnancyBabies need folate and iodine for the healthy development of their spine, brain, and nervous system. Sometimes our diet does not have enough folate and iodine, and a supplement is needed. It can take time to build up these nutrients.Read more on NSW Health websitePregnancy and healthy eating | Health and wellbeing | Queensland GovernmentAdvice on foods to avoid when you are pregnant, the importance of folate and folic acid and risks associated with foodborne illness.Read more on Queensland Health websiteNeural tube defects: children & teens | Raising Children NetworkNeural tube defects are brain and spinal cord abnormalities, including spina bifida, encephalocele and anencephaly. Folate in pregnancy helps prevent them.Read more on raisingchildren.net.au websiteSpina bifida – Better Health ChannelFolate can prevent up to 70 per cent of spina bifida cases if taken daily for one month before conception and during the first three months of pregnancy.Read more on Better Health Channel websiteVitamins and supplements during pregnancyFolic acid, iodine and vitamin D supplements are recommended during pregnancy. But a healthy diet will provide all the other nutrients that you need.Read more on Pregnancy, Birth & Baby websiteVitamin and mineral (micronutrient) supplementsHere is what you need to know about the benefits for fertility and pregnancy health of folic acid, iodine, vitamin D, zinc, and selenium supplements.Read more on Your Fertility websitePlanning for your pregnancyIf you are thinking about pregnancy, visit your doctor for a preconception consult to provide you with expert advice on planning your pregnancy.Read more on Pregnancy, Birth & Baby websiteRACGP – MTHFR gene testingReproduced with permission from The Royal Australian College of General PractitionersRead more on RACGP – The Royal Australian College of General Practitioners websiteNeural tube defectsNeural tube defect affects less than 1 in 1000 pregnancies. Learn about factors that increase your baby’s risk, and what you can do to reduce risk.Read more on Pregnancy, Birth & Baby website