If you are a sexually active woman who could become pregnant, and whether you’re planning a pregnancy or not, you need to take a folic acid supplement every day of 400 micrograms to help to protect the healthy development of your baby’s brain and spine.
Why is it important to take folic acid every day?
Because up to half of all pregnancies are unplanned, you may not even realise you’re pregnant in the first few weeks, which is when your baby’s brain and spine are developing. It’s important you take a folic acid supplement every day for at least 3 months before you get pregnant and continue to do so for the first 3 months of your pregnancy as it helps reduce the risk of serious birth defects of the brain and spine known as neural tube defects (or NTDs). This advice applies whether or not you are planning a baby.
What exactly is a neural tube defect (NTD)?
Neural tube defects (NTDs) happen when part of the unborn baby’s brain or spine doesn’t develop properly. Spina bifida is the most common NTD and literally means "split spine". The spinal cord and surrounding bones (vertebrae) do not develop correctly and a gap or split occurs in the spine. The spinal cord may also be damaged. Taking folic acid daily as a supplement could potentially prevent up to two thirds of neural tube defects every year.
Does taking folic acid prevent all neural tube defects?
70% of cases of neural tube defects, such as spina bifida, could be prevented by taking a daily folic acid supplement in the correct dosage, at the correct time. In some cases there are other reasons why NTDs occur, but taking folic acid can help to prevent most NTDs.
I’m using contraceptives so why would I need to take a folic acid supplement – I’m not planning a pregnancy?
Contraception is not 100% effective so you can still get pregnant. An unborn baby’s brain and spine develops fully in the first few weeks of pregnancy (3 - 4 weeks), often before you even realise you're pregnant which is why it’s so important you take a folic acid supplement, in the correct dosage for you, every day.
What is folic acid?
Folic acid is a vital nutrient for the development of healthy babies in the womb. During the first weeks of pregnancy, the brain and spinal cord are developing rapidly and taking extra folic acid daily is needed to support this - it helps reduce the risk of serious birth defects like spina bifida.
Folic acid is a water soluble vitamin that we can get from our food (called folates) or from supplements or foods that have it added to them (folic acid). Folate also helps our tissues to grow and the cells in our bodies work. It has many functions including helping to form red blood cells and helping to break down, use and create new proteins. It is also essential for the production of DNA, the building block of our bodies and which carries our genetic information.
How much folic acid do women need?
All adults need 200 micrograms per day and we can get this from eating a healthy, balanced diet. Women need an extra 400 micrograms of folic acid in early pregnancy, in order to ensure that this amount is present, it is recommended that an additional supplement is taken every day.
Why do I have to take it every day?
Your body does not store folic acid so you need to take it every day to maintain enough quantities in your body. This is because folic acid is water-soluble (dissolves in water) and leftover amounts leave the body through the urine.
So if you do not take folic acid for even a few weeks, the amount in your blood can become very low. If you do become pregnant, your body will need enough of this important vitamin available, so your baby’s brain and spine can develop properly in early pregnancy.
Where can I get folic acid? Could I get enough folic acid through a multivitamin?
Folic acid tablets are on sale in most chemists, supermarkets and health stores. You can buy a single folic acid supplement quite cheaply for the cost of just a few cent/pennies a day. Some women can get folic acid free on prescription if you have a medical card. Many multivitamin formulas for women, even store brands, also contain 400mcg of folic acid but to be sure always check the labels - some multivitamin supplements also provide Vitamin A, which is not recommended during pregnancy.
Can I avoid taking supplements and get it from my food instead?
The simple answer is no, you can’t – it’s impossible for women to eat a healthy balanced diet alone and get enough folic acid from food. Because women need extra folic acid in early pregnancy, that’s why a daily supplement of 400 mcg is recommended, as well as what you get from food.
What if I need a higher amount of folic acid?
Some women may be at a higher risk of having a baby with an NTD and should consult with their GP first about whether the need a higher dose of folic acid.
The risk categories:
- If you or your child have a neural tube defect (NTD) for example spina bifida or hydrocephalus
- If you or your partner’s family have a history of NTDs
- If you are overweight or obese
- If you have type-1 or type-2 diabetes.
Folic acid can also affect certain medications you may be taking, for example for epilepsy, so if you are unsure for any reason we recommend you consult your family doctor for medical advice and to discuss the options given your own personal circumstances.
I just found out I am pregnant - is it too late to start taking folic acid?
If you’ve just found out you are pregnant and had not been taking folic acid supplements before now, start taking them right away. Continue to take them until the 12th week of your pregnancy.
What if I am not planning on having a baby now?
Folic acid is something we need for normal body maintenance - it helps to make new red blood cells and improve our energy levels. So not only do you need folic acid for your baby, you also need it for yourself and an extra 400 micrograms is safe for you to take.
Taking folic acid daily doesn’t mean you are planning a baby but it does mean that whenever you do have a baby, and whenever that might be, you are already helping to protect their health.
My first baby was not affected by any NTDs. Do I still need to take folic acid in the future?
Yes, you still need to take folic acid if you could potentially get pregnant.
Whether you are a first time mother, or already have children (with an NTD or not), you are still at risk and you need to follow the guidelines. This still applies if you do not have a family history of NTDs or you have no major health issues. Research shows that fewer women take folic acid during their second and subsequent pregnancies which is putting them at risk.