What you need to know about folic acid

A healthy diet is always a good idea, but it’s particularly pertinent when you’re growing a baby. The various vitamins and minerals you consume work together to ensure the bundle inside you develops and thrives. While the list of essentials is long, there’s one vitamin building block that rises to the top: folic acid. What is it, and why do you need it? Let’s find out.

What is folic acid?
“Folic acid is the well-absorbed synthetic form of folate, a water-soluble B vitamin (vitamin B9),” explains Jan Rydfors, MD, co-creator of the Pregnancy Companion app. It’s a huge player in early fetal development. In fact, it is recommended that all women of childbearing age consume 400 micrograms or more of folic acid each day, regardless of where they stand on the parenting spectrum. Because half of all pregnancies in the U.S. are unplanned and folic acid is most important in the very early days of pregnancy, medical professionals agree that it’s better to adopt a “better safe than sorry” approach and simply advise it for all women of childbearing age.

Why is it important?
Folic acid is most well-known for its role in DNA synthesis and cell formation. Every cell in your body needs this essential vitamin to properly grow and develop, and its presence is vital for maintaining the rapid cell growth of the placenta and fetus in the early stages of embryonic development. A lack of folic acid can lead to neural tube defects (NTDs) in the fetus, which are serious birth defects of the spinal cord and brain that happen when growth is not properly achieved. These defects occur very early in pregnancy, typically within the first 28 days, and oftentimes before a woman even knows she is expecting.

Folic acid is also needed to make red blood cells, which carry oxygen to your body and your baby. During pregnancy, your body produces more blood than it normally does, and mild anemia due to a lack of healthy red blood cells isn’t uncommon. Folic acid, along with iron and certain other nutrients, helps to prevent this. In addition, studies show that folic acid could reduce your baby’s risk of certain other non-NTD birth defects, including some heart defects, cleft lip and cleft palate, and it might lower your risk of preeclampsia. It’s also been researched as a possible candidate for cancer prevention.

How do I get folic acid?
Folate, the naturally occuring version of this essential vitamin, can be found in many foods, particularly leafy green vegetables such as kale and spinach. You can find folic acid, the synthetic version of this vitamin, in enriched grain products, such as bread, cereal, pasta and rice. In 1998, the U.S. Food and Drug Administration (FDA) mandated that folic acid be added to enriched grain products, so if a food says “fortified” or “enriched” on the label, it has folic acid in it.

However, Rydfors notes, “Folate intake from food is variable, and it is therefore recommended you get additional folic acid from a daily supplement to ensure adequate levels reach your baby.” Most prenatal vitamins contain the recommended daily amount of 400 micrograms, but check the label of your particular brand to be sure. Although many organizations (including the Centers for Disease Control and Prevention, the March of Dimes, and the American College of Obstetricians and Gynecologists) agree with the recommended 400 micrograms, it doesn’t hurt to get a bit more. In fact, the U.S. National Institutes of Health suggests shooting for at least 600 micrograms instead. If you have a healthy, normal pregnancy, your doctor will likely recommend you aim for 400 to 800 micrograms.

Do some women need more folic acid than others?
Although most women require the standard amount, there are cases in which an increased dosage might be recommended. “In some situations—such as in women with a prior pregnancy with an NTD, women who have diabetes or women who are taking antiseizure medications—a higher does of daily folic acid is usually recommended,” says Rydfors. If you fall into one of these categories, your doctor can help determine the amount that’s right for you.

Once baby has arrived, continue to take a prenatal every day while breastfeeding. When baby is weaned, you can go back to a regular multivitamin. However, keep in mind that even if you’re planning on waiting awhile before adding to the family again, you never know what might happen. Play it safe by making folic acid intake a part of your regular routine.

It’s easy to stress over every detail of baby-growing, and it’s true that a folic acid deficiency can have some drastic consequences. However, you can rest easy knowing that simply popping your daily prenatal and eating a folate-rich diet will typically give you the volume recommended for a healthy mom and baby.