How Much Folic Acid Is Recommended During Pregnancy?

Folic acid is needed by every woman, especially during pregnancy. Folic acid prevents the babies from birth defects. However, why pregnant women need to take folic acid and how much of folic acid is needed by them during pregnancy is not known to many.

Folic acid is a type of B vitamin (Vitamin B9) that helps the body to make new and healthy cells. Folic acid is synonymous with ‘folate’ that is the natural form of this vitamin. Whereas ‘folate’ is available naturally in foods, folic acid is man made in laboratories. Most of the time, the folate that women get from food is not enough; and they have to depend on folic acid supplements.^[1]

Folic acid is needed by every person. It is especially needed for women both before and during pregnancy. Folic acid helps prevent major birth defects in the unborn infant. Lack of folic acid in the body of the pregnant woman or the potential mother may lead to two difficult conditions and they are:

Folic Acid is Recommended to Prevent Spina Bifida: In spina bifida, the unborn baby’s spinal column is left open, which makes the spinal cord unprotected. This is why; the nerves controlling leg movements are dysfunctional as the spinal cord covering leaves a gap.^[2] This permanent nerve damage of spina bifida due to lack of folic acid in pregnancy is a lifelong disability leading to paralysis and children with this condition and they may have to undergo various surgeries to improve this condition.^[3]

Folic Acid is Recommended to Prevent Anencephaly: Anencephaly is a condition where the entire or a portion of the brain of the unborn infant does not develop. In most of anencephaly cases, the infant dies shortly after birth or even before birth.^[4]

Not just these two main issues, but folic acid is required in pregnancy to help prevent many other major defects in the unborn baby, such as cleft palate, cleft lip, and certain types of heart defects. Along with heart health, folic acid also takes care of production of the normal red blood cells. This ensures that a certain type of anaemia is prevented. Folic acid in pregnancy also plays an essential role in the genetic map and is the building block for producing, repairing and functioning of DNA. Without folic acid, the rapid cell growth of the placenta of the developing baby will be interrupted, leading to incomplete development and lifelong health issues.^[5]

During pregnancy, right from the beginning of the pregnancy or as soon as the conception, the pregnant woman should start taking folic acid supplements. The folate that is supplied through natural sources of food is not enough for the pregnant woman and hence folic acid supplements are a must during pregnancy.

If a woman has a planned pregnancy and if she doesn’t have any personal health risks, she must have a good folate-rich diet for herself. Along with this, it is recommended that the mother consume about 0.4 to 1.0 mg or 400 microgram to 1 milligram of multivitamin with folic acid from at least two to three months before conception, through the pregnancy, right till the postpartum period that is 4 to 6 weeks after giving birth to the baby or as long as she continues breastfeeding.^[6]

In case the expecting mother has obesity, insulin dependent diabetes or if she has had a child or any of the children in the family has previously had a birth defect associated with the neural tube, then it is highly recommended and required to take an increased amount of folic acid during pregnancy. The diet that she consumes must be high in folic acid. The daily recommended intake of the multivitamin with folic acid should be 5 mg from 3 to 4 months before the conception, right till 10 to 12 weeks post conception. After this period, the dosage can be reduced to 400 microgram to 1 milligram of multivitamin with folic acid, but consumption must be continued for as long as breastfeeding is continued.

Birth defects of the unborn infant may occur within the first 3 to 4 weeks of the potential mother’s pregnancy. Hence, it is very important that right from the beginning of the brain and spinal cord development of the baby, folic acid is supplied to the body. The neural defects of the unborn infant occur within 25 to 29 days of the pregnancy. During this time, even the mother is unaware of her pregnancy. Therefore, it is always a good idea, rather mandatory, that you start taking the folic acid pills as soon as you stop using birth control measures.

During this time, the potential mother, who is planning to get pregnant, should start taking 400 micrograms of folic acid for as long as 12 weeks of the pregnancy; after which the dosage of the folic acid be increased. If you haven’t taken folic acid before getting pregnant, you must start at once, if you have found out about your pregnancy. The Centres for Disease Control and Prevention or CDC as well as the American Public Health Service highly recommends that all women within 15 years to 45 years of age take 400 mcg of folic acid daily. This is because in the United States of America, half of the pregnancies are unplanned and therefore, the mother does not get the chance to plan her folic acid intake. Consequently, even before she knows about her pregnancy, the damage is already done. So, taking folic acid before pregnancy is the best way to ensure that these birth defects are prevented in the unborn baby.^[7]

Folic is needed for every woman in the age group of 15 years to 45 years, since during this time; they are in the fertile age and are likely to give birth.^[8] However, more than the scheduled amount of folic acid that is acquired from the natural food that is rich in folate, is recommended for women who are planning to get pregnant and women who are pregnant. In fact, women who have personal health problems like obesity and diabetes are also recommended more folic acid than normal, as they are likely to pass these diseases to the unborn infant, leading to serious birth defect. Even if there is a child in the family who has had birth defects; the pregnant woman must take extra care and have folic acid from even before planning for conception.

Although folic acid is naturally available in the form of folate in different foods, it is not enough for the body. Especially in case of pregnancy, the folate that is available from the natural foods is not enough. The reason being the body cannot effectively absorb the folate supplied from food. Rather than the natural form of folate, the manmade folic acid is easier for the body to absorb and use. So, folic acid should be taken in the forms of multivitamin pills.^[9]

Different foods have different amounts of folate. The ones that are rich in folic acid supply include:

• Wheat germ, breakfast cereals, pasta.
• Leafy green vegetables.
• Oranges and orange juice.
• Chickpeas, beans, lima beans.
• Peas, asparagus.
• Sunflower seeds.
• Peanuts.

So, to make sure that your baby is protected from the birth defects, you need to take folic acid as per the dosage and directions recommended by the doctor.^[10]

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