Folic acid: why you need it before and during pregnancy
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Experts recommend that all women who are pregnant or trying to conceive take folic acid every day. Find out how much you need, and why it's so important for your baby.
Here are the answers to everything you need to know about folic acid, including:
- what exactly folic acid is and why it's important
- how much folic acid you need
- whether you can take too much folic acid
- taking it before as well as during pregnancy
- which foods naturally contain folic acid
Keep reading to get the lowdown on folic acid before and during your pregnancy ...
What is folic acid?
Folic acid – also known as vitamin B9 – is a nutrient that helps us to form healthy red blood cells.
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It's particularly important for women who are pregnant or trying for a baby, as it helps to protect your unborn baby from developing potentially serious birth defects known as neutral tube defects (NTDs).
Vitamin B9 is known by two different names, depending on where it comes from:
- folate – naturally occurring in everyday foods such as leafy green vegetables (see below for more examples)
- folic acid – a synthetic form that's used in supplements and to fortify foods, such as breakfast cereals.
Why is folic acid important?
Folic acid helps your baby's neural tube (which turns into your baby's brain and spine) form during your first trimester.
Without folic acid, there is a risk of a specific group of birth defects known as neural tube defects – something that's estimated to affect just over one in every 1,000 pregnancies in the UK.
Two of the most common of these are:
- spina bifida – this is where a baby's spine and spinal cord don't develop properly in the womb, causing a gap or split in the spine. This can lead to physical disability such as paralysis, brain damage and learning difficulties.
- anencephaly – a condition where the brain or spinal cord of an embryo has not developed properly in early pregnancy. Sadly, babies with anencephaly die before they are born or shortly after birth.
Both of these neural tube defects can be detected at your 20-week anomaly scan. Anencephaly may even be picked up as early as 11 weeks, if you have your dating scan around this time.
But try not to worry; both conditions are rare in the UK, and taking your folic acid will reduce the risk even further.
How much folic acid do I need?
Generally speaking, adults need about 200 micrograms a day, which most of us can get from eating a varied and healthy, balanced diet.
However, women who are pregnant or trying to conceive need more than that to help their baby's development. It's difficult to get enough folic acid for having a baby through food alone, so experts strongly recommend you take a supplement:
Trying to conceive (TTC)
If you're TTC, you should take a supplement containing 400mcg of folic acid every day.
Ideally, experts recommend that women start taking it two to three months before they conceive. There's no real way to know exactly when you'll conceive, so it's a good idea to start taking it as soon as you start trying.
Pregnancy
Once you're pregnant, you should keep taking 400mcg daily during your first trimester until you reach the 12th week of pregnancy.
This is because by the second trimester, your baby's neural tube will have developed and closed.
If you've not been taking it already and have found out you're pregnant, start taking the recommended daily amount – 400 micrograms (mcg) – as soon as possible.
Some women have a higher risk of having a baby with an NTD, for example if:
- you or your baby's father have a neural tube defect, or a family history of them
- you've had a previous pregnancy affected by a neural tube defect
- you're taking anti–epileptic medication or anti-retroviral medication for HIV
- you have diabetes
If this is the case, your GP will prescribe a much higher dose of folic acid to give your baby extra protection. You'll need to take 5 milligrams (mg) of folic acid daily while you're TTC and, once pregnant, you'll have to continue taking this until the twelfth week of pregnancy.
What does 'mcg' mean?
The letters 'mcg' stand for 'micrograms', which are 1,000 times smaller than milligrams (mg). You may also see mcg written as µg – they mean the same thing.
Can folic acid help me get pregnant?
No, it can't help you get pregnant – find out what can here.
But what it will do is help towards you having a healthy pregnancy, from the minute you conceive.
Your baby's neural tube forms in the first few weeks of pregnancy, so taking folic acid before you start trying will mean that you have enough vitamin B9 built up in your system to fuel your baby's development in those early weeks.
Can you overdose on folic acid?
No. Studies have found there's no need for an upper limit of folic acid.
Although it used to be thought that 1 mg/day was the maximum suggested intake, a 2018 study by Queen Mary University of London and the School of Advanced Study, University London, has quashed this after finding it to be based on 'flawed' analysis.
So if you're eating foods with lots of folate, don't worry; your supplement won't take you over the edge. It's still a good idea for all pregnant women and those trying to conceive, to take the supplement, even if they're getting a balanced diet.
Can I keep taking folic acid?
According to pregnancy charity Tommy's, 'after 12 weeks it is not harmful to take folic acid but the neural tube will have grown and so it will not benefit from it.'
However, continuing to take folic acid during your pregnancy won't harm your baby. If you're taking a pregnancy supplement that contains it, you can keep on taking it right up until you have the baby, if you wish to.
Which foods contain folic acid?
Folic acid (as folate) can be found in a lot of the foods we eat eat every day.
It occurs naturally in lots of fruit, vegetables, wholegrains, beans and pulses and some foods such as breakfast cereals and some breads, are fortified with it.
The following foods are all good sources:
- broccoli
- brussels sprouts
- leafy green vegetables including spinach, cabbage and kale
- asparagus
- beetroot
- cauliflower
- beans and legumes including chickpeas, kidney beans, lentils and peas
- citrus fruit (oranges)
- papaya
- avocado
- seeds and nuts
- brown rice
- poultry
- pork
- shellfish (make sure shellfish is well cooked if you're pregnant)
- fortified breakfast cereals (check labels)
- fortified foods including wholegrain bread and pasta (check labels)
- liver (but avoid this during pregnancy)
Do I need any other supplements when I'm TTC or pregnant?
Yes, it's also recommended that all pregnant women in the UK take a supplement containing 10mcg of vitamin D every day.
We get most of our vitamin D from the sun, but in the UK, it's not always easy to get enough for healthy baby development.
Some women suffer from anaemia during pregnancy; if you find yourself getting unusually out of breath, pale or dizzy, or have irregular heartbeats or chest pains, talk to your GP about iron supplements.
Individual supplements vs. multivitamins
You can either take separate folic acid and vitamin D supplements, or a multivitamin that contains the right amount of both vitamins.
If you do want to take a multivitamin while you're TTC or pregnant though, choose one that's specially designed for pregnancy or fertility, or double-check with a pharmacist.
Some regular multivitamins contain high levels of vitamin A, which can be dangerous for a developing baby.
Aside from folic acid and vitamin D, most pregnant women don't really need any other supplements unless advised by their GP. But if you prefer to take a pregnancy multivitamin, there's no reason not to.
Healthy start vitamins
If you're on a low income, you may be able to get folic acid and vitamin D for free under the government's Healthy Start scheme once you become pregnant. You can also get vitamin drops for your baby to have after the birth. Visit the Healthy Start website for more info.
Seven Seas Pregnancy Multivitamins contains both folic acid and vitamin D. See more details here at Amazon.
Boots also has a wide range of pregnancy supplements. See more details here.
Worried because you haven't taken any folic acid yet? Join in the chat below. Or check out our articles for more ways to get your pregnancy off to a great start.
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