Folic acid – also known as folate or folacin when it naturally occurs in foods – is a B vitamin that is essential for the healthy development of a baby’s spine, brain and skull during the early weeks of pregnancy. Folic acid has been proven to help reduce the risk of NTDs by as much as 70% if taken before pregnancy, and has also been shown to reduce the risk of other birth defects, including cleft palate and heart abnormalities.
While scientists don’t know exactly how folic acid affects the risk of neural tube defects, they do know that women need more folic acid during pregnancy to support their expanding blood volume and the growth of maternal and fetal tissues, including the neural tube.
Studies show that the risk of a neural tube defect can be reduced by as much as 70% by taking a daily multivitamin containing a minimum of 0.4 mg of folic acid and by eating a healthy diet containing foods high in folate and foods fortified with folic acid at least three months prior to conception and throughout the first trimester.
Neural tube defects occur in the first 30 days after conception, before most women even know that they are pregnant. And, since many Canadian pregnancies are unplanned, it is important for all women of childbearing age who are sexually active to be taking a multivitamin containing a minimum of 0.4 mg of folic acid daily.
To help reduce the risk of NTDs, women with no personal health risks and a planned pregnancy require a good diet of folate-rich foods and a daily multivitamin containing between 0.4 and 1.0 mg of folic acid for at least two to three months before conception and throughout pregnancy and the postpartum period (i.e., four to six weeks and as long as breastfeeding continues).
High-risk women with compromised health or particular health conditions such as insulin-dependent diabetes, obesity, or a previous child in the family with a neural tube defect require a daily multivitamin containing between 4.0 and 5.0 mg of folic acid, beginning at least three months before conception and continuing until 10 to 12 weeks post-conception and an increased dietary intake of folate-rich foods . From 12 weeks post-conception and continuing throughout pregnancy and for four to six weeks after the baby is born (or as long as breastfeeding continues), supplementation should consist of a daily multivitamin containing between 0.4 and 1.0 mg of folic acid.
All women who plan to have children are advised to start their folic acid supplementation as early as three months before they conceive. Women taking a multivitamin containing folic acid should not take more than one daily dose, as indicated on the product label.
Even in very high amounts, folic acid is non-toxic. However, it is recommended that women consume no more than 1.0 mg of synthetic (multivitamin supplement) folic acid a day unless you are in the high-risk category. Large amounts of folic acid may hide the ability to quickly diagnose a rare vitamin B-12 deficiency, pernicious anemia. This condition primarily affects the elderly population and, in some cases, can lead to neurological damage. Today, doctors can use a simple test to check for a B-12 deficiency. Take supplements as directed on the package label, and if you take more that 1.0 mg, please consult your physician.
The easiest way to get the required daily amount of folic acid is to take a daily multivitamin containing a minimum of 0.4 mg of folic acid. Taking a vitamin does not reduce or replace the need for eating a healthy, well-balanced diet based on Eating Well With Canada’s Food Guide. You should consume foods high in folic acid such as broccoli, spinach and orange juice, as well as foods fortified with folic acid (such as white flour, bread, enriched pasta and enriched cornmeal).
All women who could become pregnant should take a daily multivitamin containing folic acid. Since many pregnancies in Canada are unplanned, and neural tube defects occur before most women even know they are pregnant, all women who could become pregnant should take folic acid supplements.