Conception

Folic Acid - What All Women Should Know

Folic acid is the best prevention against neural tube defects that affect 2 to 4 babies out of 1000. Here’s everything you should know.

June is Spina Bifida Awareness Month in Canada and various associations take this opportunity to inform women of childbearing age that they can prevent this neural tube defect by as much as 70% by taking the right dose of folic acid starting at least three months before pregnancy.

Research shows that the consumption of multivitamins containing folic acid, during pregnancy, reduces the risk of the baby having spina bifida. The intake of folic acid, vitamin B12 and iron should be greater at the beginning of the pregnancy and even before conception. Vitamin and mineral deficiencies can generally have negative effects on the health of both mother and child.

What are birth defects?

The risk of some problems, due to abnormal separation of genetic material (chromosomes), increases with the mother’s age. Currently, birth defects are the leading cause of death for infants during the first year of life.

There are two main types of birth defects: structural and functional. Structural birth defects are related to a problem with body parts. Functional birth defects are related to a problem with how a body part or body system works.

Some structural problems include cleft lip or cleft palate, heart defects such as missing or misshaped valves, and abnormal limbs, such as a club foot. They also include neural tube defects such as spina bifida – problems that are related to the growth and development of the brain and spinal cord.

Who is at risk of having a baby with a NTD?

Any woman who could become pregnant is at risk of having a baby with a neural tube defect. You may be at greater risk of having a baby with a NTD if:

  • you have had a previous pregnancy affected by NTD's
  • you (or your partner) have a personal or family history of NTD's
  • you have insulin-dependent diabetes
  • you use certain anti-seizure medications
  • you have clinically diagnosed obesity
  • you are not consuming enough vegetables and fortified flour-based foods containing folic acid

What is folic acid?

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.

Why take folic acid before you get pregnant

Neural tube defects occur 25 to 29 days after a woman gets pregnant. At that time, many women are not even aware that they are pregnant. Because these defects form so early, you should begin taking vitamins that contain folic acid before you get pregnant. Begin taking folic acid when you stop using birth control.

Women need more folic acid during pregnancy and breastfeeding than they do normally. So you should continue taking folic acid all the time that you are pregnant. The dosage of folic acid might depend on your health history and the stage of your pregnancy. You should discuss this with your healthcare professional.

How much folic acid should I take and when?

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 including those with 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.

Women taking a multivitamin containing folic acid should not take more than one daily dose, as indicated on the product label.

Can I get enough folic acid in food?

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.

The information in this article is in part from the Spina Bifida & Hydrocephalus Association of Ontario (SB&H) and from the Nutrition in Pregnancy website, which, along with this article, is sponsored by Duchesnay.

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