Though doctors now routinely recommend folic acid supplements and folic acid-rich foods to pregnant women, its role in supporting a healthy pregnancy wasn’t recognized until the mid-1960s. By the early 1990s, the connection between folic acid and fetal development was so well-established, the CDC started recommending that all women of child-bearing age consume at least 400 micrograms of folic acid every day. In 1998, the Food and Drug Administration went a step further and started requiring that folic acid be added to enriched grain products, like pasta, rice, and cereal.
That’s how crucial folic acid is for pregnancy and fetal development. Health professionals recommend that foods high in folic acid are eaten regularly beginning up to a year prior to conception. Many would-be parents treat this as a minor dietary diversion, plucking a bit more asparagus out of the produce section. But can you just eat folic acid foods and forget about the supplements? Maybe not.
Why Is Folic Acid Important?
Folic acid is a B vitamin that can help prevent certain birth defects. It’s especially important to neural tube formation in the first few weeks of fetal development. Very serious neural tube defects (NTDs) like spina bifida and anencephaly can occur if there are deficiencies during that critical period.
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“Folic acid does seem to be quite important in the development of the nervous system,” says Dr. Mary Jane Minkin, Clinical Professor of Obstetrics and Gynecology at Yale University. “It has been shown for many years that supplementation with folic acid before conception and continuing for the first few weeks of pregnancy significantly lowers the chances of babies being born with neural tube defects.”
Research shows that the risk of NTDs can be decreased by up to 50 percent when women take the daily recommended 400 mcg of folic acid for pregnancy. For women who’ve already had a child with an NTD, that risk can be reduced by up to 70 percent. Those women, Minkin says, should load up on folic acid to the tune of 4 mg a day.
How Should Women Get Folic Acid for Pregnancy?
While many healthy foods — such as leafy green vegetables, citrus fruit, and eggs — are rich sources of folic acid, it can be difficult to know you’re consuming enough of any one food to hit the 400 mcg target that offers the real benefits. So one of the best ways to score folic acid is through a daily supplement, such as a prenatal vitamin.
“Unfortunately, it is hard to take in that much folic acid without a supplemental vitamin form,” Minkin says. “Many cereal products are fortified with folic acid, but again, most women do need a pill for folic acid supplementation to get the right amount.”
To find if your grocery items include the levels of folic acid a pregnant partner needs, check out the nutrition label. Note that folic acid can also be listed as “folate.” The percentage to the right is the percentage of DV contained in a serving. Although they are metabolized slightly differently, folate and folic acid essentially offer the same prenatal benefits.
How to Make Sure Your Partner Gets 400 mcg of Folic Acid Daily
- Supplement her diet with over-the-counter B9. Whether she’s taking tablets or capsules, using drops, or chewing gummies, make sure she’s getting at least the 400 mcg DV.
- Shop for foods that are fortified with folic acid. Leafy greens, such as spinach salads, lentils, asparagus, and broccoli are all good sources. Citrus fruit and avocado are quite high too. Remember to track quantities, though, and make sure that the foods you choose contain enough to reduce those risks.
- Consider your family history of NTDs. If she has had a baby with an NTD before, research shows that a big increase in her folic acid intake is probably beneficial.
- Always follow her doctor’s orders. As with everything during pregnancy, make sure that you follow the nutritional, dietary, and supplemental advice of her primary care physician and her OB–GYN.
Are There Risks of Taking Too Much Folic Acid?
A study published early in 2016 suggests that “very high” levels of folate in women (far more than what is recommended) at delivery could double the risk of the child developing an autism spectrum disorder. That risk was doubled further when high levels of B12 were also present. “Most experts agree that if a mother has a history of having had a baby with a previous neural tube defect that she actually take 4 mg a day of folic acid before she conceives again,” Minkin says. “So I don’t think that a higher dose should be problematic.”
Minkin says that there may be additional benefits to consuming plenty of folic acid during pregnancy.
“There is emerging data on many other fronts that other problems may be reduced by folic acid supplementation,” Minkin says. “A few studies have shown a decreased autism risk; some studies have suggested a decrease in heart defects as well.”