How much folic acid to take during pregnancy

Folic Acid | CDC

CDC urges all women of reproductive age to take 400 micrograms (mcg) of folic acid each day, in addition to consuming food with folate from a varied diet, to help prevent some major birth defects of the baby’s brain (anencephaly) and spine (spina bifida).

About folic acid

Folic acid is a B vitamin. Our bodies use it to make new cells. Think about the skin, hair, and nails. These–and other parts of the body – make new cells each day. Folic acid is the synthetic (that is, not generally occurring naturally) form of folate used in supplements and in fortified foods such as rice, pasta, bread, and some breakfast cereals

Why folic acid is important before and during pregnancy

When the baby is developing early during pregnancy, folic acid helps form the neural tube. Folic acid is very important because it can help prevent some major birth defects of the baby’s brain (anencephaly) and spine (spina bifida). The neural tube forms the early brain and spine.

Women of reproductive age need 400 mcg of folic acid every day

• All women of reproductive age should get 400 mcg of folic acid every day to get enough folic acid to help prevent some birth defects because
  • About half of U.S. pregnancies are unplanned, and
  • Major birth defects of the baby’s brain or spine occur very early in pregnancy (3-4 weeks after conception), before most women know they are pregnant.

• When taking folic acid, a higher dose than 400 mcg of folic acid each day is not necessarily better to prevent neural tube defects, unless a doctor recommends taking more due to other health conditions.
  • When planning to become pregnant, women who have already had a pregnancy affected by a neural tube defect should consult with their healthcare provider. CDC recommends that these women consume 4,000 mcg of folic acid each day one month before becoming pregnant and through the first 3 months of pregnancy.

Learn more about CDC’s folic acid recommendations here.
Learn more about the recommended intake level of folic acid here.

When to start taking folic acid

Every woman of reproductive age needs to get folic acid every day, whether she is planning to get pregnant or not, to help make new cells.

Are folate and folic acid the same thing?

The terms “folate” and “folic acid” are often used interchangeably, even though they are different. Folate is a general term to describe many different types of vitamin B9.

Types of folate can include

• Dihydrofolate (DHF)
• Tetrahydrofolate (THF)
• 5, 10-methylenetetrahydrofolate (5, 10-Methylene-THF)
• 5-methyltetrahydrofolate (5-Methyl-THF or 5-MTHF)

Food fortification is a way to add vitamins or minerals, or both, to foods. Some rice, pasta, bread, and breakfast cereals are fortified with folic acid. These foods are labeled “enriched.” Folic acid is a specific type of folate that does not generally occur naturally.

Folic acid is the ideal form of folate to use for food fortification. It is more stable than types of natural food folate, which can easily be broken down by heat and light. Folic acid is better suited for food fortification because many fortified products, such as bread and pasta, are cooked.⁶

CDC recommends that women of reproductive age who could become pregnant consume at least 400 micrograms (mcg) of folic acid every day. However, it’s difficult to get 400 mcg of folic acid through diet alone. You can get 400 mcg of folic acid each day by taking a vitamin with folic acid in it, eating fortified foods, or a combination of the two, in addition to consuming a balanced diet rich in natural food folate.

How to get enough folic acid to prevent neural tube defects

In addition to eating foods with folate from a varied diet, women can get folic acid from

• Taking a vitamin that has folic acid in it:
  • Most vitamins sold in the United States have the recommended daily amount of folic acid (400 mcg) that women need for the prevention of neural tube defects. Vitamins can be found at most local pharmacy, grocery, or discount stores.
• Eating fortified foods:
  • You can find folic acid in some breads, breakfast cereals, and corn masa flour.
• Getting a combination of the two: taking a vitamin that has folic acid in it and eating fortified foods.

If taking folic acid for reasons other than neural tube defect prevention, talk to your healthcare provider.

Learn more about where to find folic acid in the United States here.

More Information

For more information, visit the Frequently Asked Questions page.

You can also contact CDC-INFO in English or Spanish:

• 1-800-CDC-INFO (800-232-4636)
• TTY: 1-888-232-6348
• In English
• en español

Folic Acid and Pregnancy: How Much You’ll Need

Folic acid is a B vitamin found in many supplements and fortified foods. It’s the synthetic form of folate. Folic acid is used by your body to make new cells and produce DNA. It’s required for normal growth and development throughout your life.

Taking folic acid is particularly vital before and during pregnancy. It’s important for the proper organ development of a developing baby.

Research shows that taking folic acid before you get pregnant may help prevent birth defects including serious neural tube defects such as spina bifida, encephalocele (rarely), and anencephaly.

Approximately 3,000 babies are born with neural tube defects in the United States each year. Normally, the neural tube develops into the spinal cord and brain by 28 days after conception.

If the neural tube doesn’t close properly, neural tube defects occur. Anencephaly is a condition in which the brain doesn’t develop properly. Babies born with anencephaly cannot survive.

Babies born with spina bifida or encephalocele may face multiple surgeries, paralysis, and long-term disability.

According to a 2015 review of studies, maternal folic acid supplementation significantly decreases the risk of congenital heart defects. These defects occur in 8 out of every 1,000 births in the United States.

According to the American Heart Association, congenital heart defects happen when the heart or blood vessels don’t grow normally before birth. They may impact the interior walls of the heart, the heart valves, or the arteries and veins of the heart.

Research also shows folic acid supplementation in early pregnancy may help prevent cleft lip and cleft palate.

These birth defects occur if parts of the mouth and lip do not merge together properly during the first 6 to 10 weeks of pregnancy. One or more surgeries are usually needed to correct the condition.

All pregnant women should take get at least 600 micrograms (mcg) of folic acid daily, according to The American College of Obstetricians and Gynecologists. Most prenatal vitamins contain this amount of folic acid.

Taking folic acid after you discover you’re pregnant may not be soon enough. Many women don’t realize they’re pregnant until 6 weeks or more after conception. Neural tube defects occur during the first month of pregnancy, often before you realize you’re pregnant.

To make sure you have enough folic acid in your body to prevent neural tube defects, the CDC recommends women who plan to become pregnant or who are of childbearing age take 400 mcg of folic acid daily.

If you’ve already given birth to a child with a neural tube defect, you may need higher doses of folic acid in the months leading up to your next pregnancy and during the first few months of pregnancy. Your doctor can advise you on the right dose.

You may also need higher doses of folic acid if you:

• have kidney disease and are on dialysis
• have sickle cell disease
• have liver disease
• drink more than one alcoholic beverage daily
• take medications to treat epilepsy, type 2 diabetes, lupus, psoriasis, rheumatoid arthritis, asthma, or inflammatory bowel disease

Natural folate is found in many foods including leafy greens, beets, and broccoli. Some foods in the United States are fortified with folic acid. These include:

• cereals
• rice
• orange juice
• pasta

Many servings of fortified breakfast cereals contain 100 percent of the folic acid you need. Even so, it may be hard to know exactly how much you’re getting unless you track the amounts of folate and folic acid in everything you eat.

There’s no guarantee that you will get enough folic acid from food alone, so a supplement is important.

If you have morning sickness in early pregnancy, it may be difficult to eat enough fortified foods to get the folic acid you need.

To make sure you get enough folic acid, doctors will usually recommend taking a folic acid supplement or a prenatal vitamin that contains folic acid before and during pregnancy.

You can’t get too much natural folate from foods. However, you should not consume more than 1,000 mcg (1 mg) of folic acid (from vitamins, fortified foods, or a combination of both) daily.

There’s no way to prevent all birth defects with 100 percent certainty. Taking adequate amounts of folic acid before and during pregnancy may help decrease your risk of:

• neural tube defects
• congenital heart defects
• cleft palate
• cleft lip

If pregnancy is in your future, consider adding a prenatal vitamin to your daily routine. Prenatal vitamins are available in capsule, tablet, and chewable forms. To avoid stomach upset, take prenatal vitamins with food.

Always talk to your doctor about taking the correct dose of prenatal vitamin because taking too many supplements can be toxic for your baby-to-be.

You should also add foods fortified with folic acid to your diet. Don’t wait until you find out you’re pregnant to get serious about folic acid. By then, it may be too late. Talk to your doctor to determine the right amount of folic acid you’ll need.

what you need to know, why you need it during pregnancy

In 1931, the English physician and scientist Lucy Wills decided to prescribe brewer's yeast extract to pregnant women with anemia. After a short time, the condition of the patients improved markedly. Scientists have long tried to understand what kind of healing component helped them.

Thanks to the improvement of technologies for extraction and isolation of substances in the form of crystals, it was possible to identify the secret component. In 1941, a team of scientists led by Professor Mitchell managed to get what they were looking for from spinach leaves. It turned out that this is an organic acid, which was called folic acid (from the Latin folium - "leaf"). nine0003

What you need to know about folic acid

Folic acid (or vitamin B9) is a water-soluble vitamin that is essential for many vital processes. Bacteria synthesize it in small amounts in the body, but most of it comes from food. These are leafy vegetables, seaweed, nuts, sunflower seeds, etc.

Among the main functions of folic acid are:

• participation in the processes of cell division during the period of active growth and development in childhood and adolescence; nine0014
• participation in DNA synthesis;
• stimulation of hematopoiesis;
• participation in metabolic processes.

Help: what are water-soluble and fat-soluble vitamins

Water-soluble vitamins are eliminated from the body naturally within a few hours. Therefore, you need to use them regularly. As for fat-soluble ones, they can be deposited, for example, in the liver. Among these are vitamins A, E, K, D.

Benefits of folic acid for women

For a woman, folic acid is one of the essential components to maintain youth. Sufficient consumption of this vitamin promotes tissue regeneration, maintaining skin firmness and elasticity.

B9 is also essential for successful conception. He takes part in the maturation of female germ cells (oocytes), implantation and the formation of the placenta.

Important! Folic acid isn't just for women. Vitamin B9takes an active part in spermatogenesis - the formation of male germ cells (spermatozoa). Therefore, for successful conception, both partners need a sufficient level of its consumption. It's over 200 micrograms. per day.

Why folic acid is so important during pregnancy

Pregnant women need more vitamin B9. The World Health Organization (WHO) recommends taking at least 400 micrograms of folic acid per day during pregnancy. This is most important in the first trimester, when the organs of the future baby are laid. For their development, it is necessary to ensure intensive cell division, which requires a large amount of folate. This is especially true of the neural tube of the fetus, from which the brain and spinal cord are then formed. nine0003

Lack of vitamin B9 in the diet can lead to serious adverse effects on the fetus, including:

• malformations of the nervous system;
• heart defects;
• increased risk of developing Down syndrome;
• vascular disorders.

Taking folic acid (and other vitamins and minerals) in the first half of pregnancy is also justified by the woman's relatively poor appetite. This happens against the background of toxicosis. Due to malnutrition, there is a shortage of biologically active substances necessary for mother and fetus. nine0003

Note that a pregnant woman needs not only folic acid, but also other B vitamins (B1, B2, B6, B12), vitamins A, D, E, C, biotin and minerals. Therefore, expectant mothers are often prescribed special complexes, for example, Elevit *, Complivit, Multi-tabs and others. Such preparations contain several vitamins and minerals at once, which are necessary for maintaining a healthy pregnancy. Folic acid is also available separately, mainly in the form of tablets - Foliber, Folacin and others. nine0003

Folic acid intake during pregnancy and lactation is important to coordinate with your doctor, who will determine the need for prescribing the drug and dosage. The drug is contraindicated in the absence of an established deficiency of vitamin B9, individual intolerance, malignant tumors, as well as pernicious anemia without additional intake of vitamin B12.

*dietary supplement. Not a drug

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What is Folic Acid and what it is used for

Folic acid is a B vitamin. Folic acid can be used:

to treat:

• folic acid deficiency anemia due to malnutrition, malabsorption of nutrients (for example, celiac disease or indigestion), with an increased body need for this vitamin (for example, during pregnancy).

prophylaxis:

• folic acid deficiency caused by certain drugs (such as those used to treat epilepsy, such as phenytoin, phenobarbital, and primidone).
• folic acid deficiency caused by prolonged destruction of red blood cells (hemolytic anemia) or kidney dialysis.
• development of neural tube defects of the fetus (for example, spina bifida) in women with an increased risk of its development in the fetus.

What you need to know before taking Folic Acid

Do not take Folic Acid and tell your doctor if you:

untreated vitamin B deficiency ₁₂ eg in certain types of anemia and in vegetarians.