How Much Folic Acid to Take During Pregnancy
Folic acid and pregnancy go together like diapers and babies – you can’t have one without the other! “How much folic acid do I take during pregnancy” is often asked, and here’s the answer.
The Nature Made Prenatal Multivitamin + DHA has the right amount of folic acid (0.4 mg of folic acid is how much pregnant women should take during pregnancy). But, if you’ve had babies with a neural tube defect such as spina bifida in the past, then you need to talk to your doctor about increasing your folic acid intake during this pregnancy.
Folic acid is also known as B-vitamin folate. In this article, I briefly share why women need to take folic acid during pregnancy – and why it is very important not to take too much folic acid when you’re pregnant. I also share the results of a research study that examined the timing of folic acid supplements when pregnant.
Why take folic acid during pregnancy?
Supplementing your diet during pregnancy with folic acid has been shown to reduce the risk of neural tube defects, such as spina bifida. During pregnancy, the rate of your baby’s tissue growth is incredibly fast; low folic acid results in decreased cellular growth and repair. It is recommended in Canada, the UK, and the US for women to start taking folic acid BEFORE getting pregnant. However, not many women take folic acid before pregnancy, possibly because they don’t know how much folic acid to take when they’re trying to get pregnant or during pregnancy.
If you don’t want to increase the number of supplements you take during your pregnancy, read about the healthiest foods for pregnant vegan and vegetarian women.
Research shows the importance of timing when you take folic acid during pregnancy
The reason why you should take folic acid supplements before pregnancy is because it significantly reduces the risk of small for gestational age (SGA) at birth. This is from a new study in BJOG: An International Journal of Obstetrics and Gynaecology.
This research study and systematic review of folic acid and pregnancy assessed the effect of timing of taking these supplements on gestational age at birth. The smaller your baby is at birth, the higher the chances of neonatal morbidity and mortality. If you don’t take folic acid during pregnancy, your baby also has an increased risk of chronic diseases in later life, such as diabetes, hypertension, obesity, cardiovascular disease and mental health problems.
See why it’s so important to take folic acid during pregnancy – and to be careful about how much folic acid to take when you’re pregnant? The link to the full study on pregnancy and folic acid is below, in the Resources section.
These researchers found that while folic acid supplementation during pregnancy is a standard recommendation in North America and the UK, it isn’t often done. They also conclude that more research needs to be done on folic acid and pregnancy, to determine how this mineral affects birth rate. They also want to study how much folic acid to take while pregnant for women who are at higher risk of giving birth to babies with low gestational birth weight.
Taking folic acid when you’re trying to get pregnant
Women who are trying to get pregnant – or who are capable of becoming pregnant – should take 0.4 mg of folic acid per day. The effects of higher dosages of folic acid are not well known, but could complicate the diagnosis of a vitamin B12 deficiency. To learn more about the B12 vitamin and pregnancy, read How Vitamin B12 Affects Fertility.
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So, women who are not pregnant yet should be careful NOT to take more than 1 mg per day of folic acid – except under supervision of a doctor or ob-gyn. If you have had a baby in the past who had a neural tube defect, then your next baby is at a higher risk of future health problems.
How Much Folic Acid to Take During Pregnancy
Health Canada and the World Health Organization recommend pregnant women take 30–60 mg of iron and 0.4 mg of folic acid during pregnancy. If women have low iron levels, then a higher dosage of folic acid is recommended – but it’s important to talk to your doctor before increasing your levels of folic acid.
Folic acid and pregnancy
The following is a list of recommendations for folic acid and pregnancy, from Health Canada:
- Eat according to Canada’s Food Guide and taking a daily multivitamin that has 400 mcg (0.4 mg) of folic acid will help you prepare for a healthy pregnancy. Doing this can also reduce the risk to your baby of developing a neural tube defect (NTD).
- Make sure your prenatal vitamin and mineral supplement contains vitamin B12. If you’re not taking a prenatal multivitamin, look into the Prenatal Vitamins Ultra Complete Small One A Day Multi Vitamins and Minerals
- Because many pregnancies are unplanned, all women who could become pregnant should take a daily multivitamin containing 400 mcg (0.4 mg) of folic acid. If you’re trying to get pregnant, start taking folic acid supplements 3 months before pregnancy. Continue taking the folic acid supplement throughout your pregnancy to help meet your need for folic acid and other nutrients like iron.
- If you have had a pregnancy affected by a neural tube defect in the past, or you have a family history of spina bofida or similar problems, you should see your doctor. You may need to take a higher dose of folic acid during pregnancy.
- If you have diabetes, obesity or epilepsy, you may be at higher risk of having a baby with a neural tube defect. See your doctor before planning a pregnancy.
It’s important NOT to take more than the one daily dose of a prenatal multivitamin or folic acid supplement during pregnancy. Do not increase your dose of folic acid beyond 1000 mcg (1 mg) per day without talking to a doctor first.
How much ferrous iron to take during pregnancy
Danish researchers wanted to determine what the lowest dose of folic acid would be, to prevent iron deficiency and anemia in women who are pregnant. They found that a supplement of 40 mg ferrous iron/day from 18 weeks of gestation appears adequate to prevent folic acid or iron deficiency in 90% of the women. Further, this dosage of folic acid during pregnancy prevented iron deficiency anemia in at least 95% of the women after they had their babies (postpartum).
To learn more about being pregnant, read 10 Tips for a Healthy Pregnancy From a Nurse Midwife.
I welcome your thoughts on folic acid and pregnancy below, but I can’t offer medical or health advice. Talk to your ob-gyn or family doctor if you aren’t sure about how much folic acid to take during pregnancy.
Sources: 1) VA Hodgetts, RK Morris, A Francis, J Gardosi, KM Ismail. Effectiveness of folic acid supplementation in pregnancy on reducing the risk of small-for-gestational age neonates: a population study, systematic review and meta-analysis. BJOG: An International Journal of Obstetrics & Gynaecology, 2014; 2) Milman, N., Bergholt, T., Eriksen, L., Byg, K. E., Graudal, N., Pedersen, P., & Hertz, J. (2005). Iron prophylaxis during pregnancy–how much iron is needed? A randomized dose–response study of 20–80 mg ferrous iron daily in pregnant women. Acta obstetricia et gynecologica Scandinavica, 84(3), 238-247.; and 3) Prenatal Nutrition Guidelines for Health Professionals – Folate Contributes to a Healthy Pregnancy via Health Canada.