The Nutrient Every Woman Needs Before Pregnancy
Folic acid, or vitamin B9, is an essential nutrient that every woman should take, whether planning to get pregnant or not.
If youre planning to become pregnant, you already know how important a healthy diet, exercise and getting plenty of sleep are, but one of the most important ways to ensure a healthy pregnancy is to get enough folic acid prior to conception.
Folic acid, the synthetic form of folate or Vitamin B9, is one of many super-star nutrients that our bodies need to run on all cylinders. Everyday new cells are rapidly reproducing in every organ of our bodies but without folic acid, none of it would happen.
Folic acid has a very important role in making those cell reproductions possible and happen in an efficient manner, Tama Bloch, RDN, a pediatric research scientist with Abbott says.
During pregnancy, folic acid becomes even more important because of its role in the prevention of neural tube defects .
Why Folic Acid is Important
Neural tube defects are birth defects of the spinal cord such as spina bifida, the brain such as anencephaly, and Chiari malformation, another type that causes brain tissue to descend into the spinal canal.
Neural tube defects affect approximately 300,000 babies worldwide each year but between 50 and 70 percent of neural tube defects can be prevented when women take folic acid in a prenatal vitamin or supplement.
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Folic Acid: How Much Do You Need?
Do You Need Prenatal Vitamins
Prenatal vitamins are important before and during pregnancy to help your body meet the demands of pregnancy and aid in your babys development, says Dr. Nwankwo. Your balanced diet should be the foundation of your nutritional vitamins. Your body is able to absorb more from your diet than from supplements. However, your prenatal will help fill in the gaps.
A run-of-the-mill multivitamin wont cut it when youre pregnant. Prenatal vitamins are specially designed multivitamins that deliver the extra amounts of nutrients needed during various stages of your babys development. For example, they contain folic acid, which is important for babys brain development in the earliest stages. And many have vitamin D and calcium to build strong bones and teeth during the third trimester of pregnancy.
Plus, prenatal vitamins help make sure you have enough nutrients such as iron, to not only provide to your baby but so your own body doesnt become depleted.
What Is A Prenatal Vitamin
A prenatal vitamin is a supplement designed to provide nutrients and minerals needed for a healthy pregnancy. The American College of Obstetrics and Gynecologists notes taking a prenatal vitamin and eating nutritious foods should provide a person with all the vitamins and minerals they need during pregnancy.
A prenatal vitamin is important for pregnant people, as the growing fetus requires certain nutrients that can be hard to get through diet alone.
Fetal development is rapid and requires a lot of metabolismits dependent on the proper amount of amino acids and nutrients, says James Grifo, M.D., the program director at NYU Langone Fertility Center in New York City and chief executive physician at Inception Fertility.
ACOG recommends pregnant people consume certain amounts of calcium to help build strong bones and teeth, iron to help red blood cells deliver oxygen to the fetus, iodine and choline to aid in brain development, and folic acid to help prevent birth defects. Additionally, it recommends vitamins A, B6, B12, C and D, which provide benefits that range from promoting healthy skin and eyesight to the formation of red blood cells. While much of these nutrients can be obtained through a healthy diet, a prenatal vitamin provides the extra assurance your daily nutrition needs are met, no matter whats on the menu.
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Folate And Folic Acid In Pregnancy
Folate and its cousin folic acid are vital for developing a healthy baby because it prevents neural tube defects. Since the neural tube develops within the first 28 days of pregnancy, it is recommended all women of childbearing years consume folate. Folate prevents certain heart abnormalities, cleft palate and cleft lip. It also lowers the risk of developing anemia, miscarriage, preterm delivery and low birth weight. It can be found in fortified breakfast cereals, lentils, spaghetti, rice, beans, broccoli, orange juice, spinach and strawberries.
Why Is Folic Acid Important During Pregnancy
Folic acid is a B vitamin found in many supplements and fortified foods. Its the synthetic form of folate. Folic acid is used by your body to make new cells and produce DNA. Its required for normal growth and development throughout your life.
Taking folic acid is particularly vital before and during pregnancy. Its 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 , and anencephaly.
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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 babys brain or spine occur very early in pregnancy , 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 the recommended intake level of folic acid here.
How Much Folic Acid Is Too Much
While there is no concern about consuming too much folateyou really cant overdo eating lentils and spinachthere are growing concerns over the possible effects of too much folic acid. A supplement containing 0.4 mg of folic acid plus a number of servings of folate-rich food each day is enough to meet the daily folic acid/folate recommendation of 0.6 mg during pregnancy. But many women are consuming far more than that. For one thing, most prenatal supplements contain 1 mg of folic acid, which on its own is much higher than the recommended amount, and is actually the safe upper limit of folic acid.
But Health Canada also requires foods like white flour, enriched pasta, and cornmeal to be fortified with folic acid. Manufacturers of many other foods, like plant-based beverages, such as soy, rice and almond milk, various breakfast cereals, goats milk and pre-cooked rice, voluntarily fortify with folic acid. Even the newly popular nutritional yeast is often fortified with significant amounts of folic acid.
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Optimizing Dietary Folate Intake
Following a healthy eating pattern and choosing foods that are rich in nutrients helps women meet their requirement for folate and other nutrients. To promote adequate dietary folate intake:
- Encourage women to use Canada’s Food Guide. It describes a healthy eating pattern that is rich in dietary folate. Following Canada’s Food Guide will also help women meet their needs for other nutrients and can help them achieve overall health.
- Promote use of tools such as My Food Guide Servings Tracker. This can help women keep track of the amount and type of food they eat each day and compare their intake to Canada’s Food Guide.
- Encourage women to include grain products fortified with folic acid each day, such as enriched bread or enriched pastaFootnote 11. They can make informed choices, by looking for the term ‘folic acid’ in the ingredient list.
- Encourage women to have legumes, such as beans or lentils, often and eat at least one dark green vegetable, such as peas or romaine lettuce, each day.
- Refer women to a Registered Dietitian if they have a significantly restricted food intake. This can happen when women exclude an entire food group or have severe nausea or vomiting. These women can benefit from comprehensive nutritional assessment and counselling.
- Refer nutritionally at-risk women to services or programs that can help. The Canada Prenatal Nutrition ProgramFootnote 12 .Website provides contact information for programs and services for vulnerable pregnant women.
How Much Folic Acid Do I Need To Take
You should take a supplement with 400 micrograms of folic acid per day from 12 weeks before you become pregnant through to the first 12 weeks of pregnancy. Folic acid supplements are available over the counter from pharmacies at varying doses. Look for supplements that contain at least 400 micrograms of folic acid. Multi-vitamin supplements generally contain less.
It is also important to eat healthy foods that contain folate including green leafy vegetables, broccoli, oranges, avocado, or fortified breads and cereals. You can read more about what foods to eat when pregnant here.
You should talk to your doctor, pharmacist or a dietitian before starting to take any new supplements.
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What Is A Neural Tube
The neural tube is one of the first things your baby will grow. It will become your babys brain and spinal cord and the bones that enclose them. The neural tube is formed in the first four to six weeks of pregnancy.
A neural tube defect can happen when something goes wrong in the development of a babys neural tube. This can cause a range of disabilities including loss of bladder and bowel control, and paralysis of the legs. In some cases, the effects can be more severe.
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Although boric acid can be an effective pest control, boric acid and pets don’t mix. When they find boric acid, dogs can be curious enough to eat it. The Cooperative Extension says that boric acid poisoning in dogs results in digestive issues, disorders, seizures, skin redness, and other mild to serious problems.
On average this occurs about twice a year or every six months, although it varies from dog to dog. When cycling first begins, there may be a great deal of variability in the time between cycles. This is normal. Some females take eighteen months to two years to develop a regular cycle.
Prenatal vitamins for dogs do have some benefits, though.
When they become pregnant there are other vitamins and minerals that need to be “upped” to fill momma’s need for healthy pups for example, folic acid and iron.
Babies need vitamins for their growth and development, these all must come from mom.
We do not recommend Science Diet® Puppy Large Breed for pregnant or nursing dogs.
It does not provide enough calcium and energy to meet a dog’s needs during this special time.
Feed your pregnant dog the amount suggested on the food package, and keep feeding her puppy food until her puppies are finished weaning.
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What Should I Look For When Buying Vitamins With Folic Acid
Look for “USP” or “NSF” on the label when choosing vitamins. These “seals of approval” mean the pills are made properly and have the amounts of vitamins it says on the label. Also, make sure the pills have not expired. If the bottle has no expiration date, do not buy it.
Ask your pharmacist for help with selecting a vitamin or folic acid-only pill. If you are pregnant and already take a daily prenatal vitamin, you probably get all the folic acid you need. Check the label to be sure.
If You Have An Mthfr Variant Can Taking Folic Acid Help Prevent Ntds In Your Baby
Yes. If you have an MTHFR variant, taking 400 mcg of folic acid every day before and during early pregnancy can help prevent NTDS in your baby.
MTHFR stands for methylenetetrahydrofolate reductase. Its an enzyme that helps your body break down and use folate. One MTHFR variant is a change in your bodys MTHFR gene that makes you use folate more slowly than usual. Genes are parts of your bodys cells that store instructions for how your body grows and works. They are inherited . MTHFR variants are inherited. If you know you have an MTHFR variant or you think it runs in your family, talk to your provider.
Your provider may want to test you for an MTHFR variant if you have high levels of a substance in your blood called homocysteine. Too much homocysteine in your blood can cause heart conditions, blood clots and stroke. You can find out your homocysteine levels with a blood test. If your level is high, you can have a genetic test to see if you have an MTHFR variant. A genetic test looks for changes in genes that can cause birth defects or other medical conditions.
You may have heard not to take folic acid if you have an MTHFR variant because it can increase your risk of pregnancy complications and your baby having health problems. The Centers for Disease Control and Prevention recommends that all women take 400 mcg of folic acid every day before and during early pregnancy. If you have an MTHFR variant, talk to your provider.
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What Is Folic Acid
Folic acid is a vitamin that every cell in your body needs for healthy growth and development. If you take it before pregnancy and during early pregnancy, it can help protect your baby from birth defects of the brain and spine called neural tube defects. The neural tube is the part of a developing baby that becomes the brain and spinal cord. NTDs happen in the first month of pregnancy, before you may know that youre pregnant. This is why its important to have enough folic acid in your body before you get pregnant.
NTDs affect about 3,000 pregnancies each year in the United States. If all women take 400 micrograms of folic acid every day before getting pregnant and during early pregnancy, it may help prevent up to 7 in 10 NTDs. Because nearly half of all pregnancies in the United States are unplanned, all women who can get pregnant should take folic acid every day.
Some studies show that folic acid also may help prevent birth defects in a babys mouth called cleft lip and palate. A cleft lip is a birth defect in which a babys upper lip doesnt form completely and has an opening in it.
What Can Happen If I Do Not Get Enough Folic Acid During Pregnancy
If you do not get enough folic acid before and during pregnancy, your baby is at higher risk for neural tube defects.
Neural tube defects are serious birth defects that affect the spine, spinal cord, or brain and may cause death. These include:
- Spina bifida.6 This condition happens when an unborn baby’s spinal column does not fully close during development in the womb, leaving the spinal cord exposed. As a result, the nerves that control the legs and other organs do not work. Children with spina bifida often have lifelong disabilities. They may also need many surgeries.
- Anencephaly.7 This means that most or all of the brain and skull does not develop in the womb. Almost all babies with this condition die before or soon after birth.
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Good Food Sources Of Folic Acid
Foods that can help you get more folic acid in your diet include:
- 400 mcg: Breakfast cereals fortified with 100% of the DV, 3/4 cup
- 215 mcg: Beef liver, cooked, braised, 3 oz
- 179 mcg: Lentils, mature seeds, cooked, boiled, 1/2 cup
- 115 mcg: Spinach, frozen, cooked, boiled, 1/2 cup
- 110 mcg: Egg noodles, enriched, cooked, 1/2 cup
- 100 mcg: Breakfast cereals, fortified with 25% of the DV, 3/4 cup
- 90 mcg: Great Northern beans, boiled, 1/2 cup
Look For Supplements That List At Least 400 Mcg Of Folic Acid
The safest way to ensure that you’re getting enough folic acid, West says, is to take a supplement containing at least 400 mcg of folic acid. That, combined with folate from food, will ensure you get the 600 mcg of folate each day recommended for people who may become pregnant.
Over the counter prenatal vitamins typically fit your needs. Remember that the prenatal may also be labelled as 667 mcg DFE.
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Prenatal vitamins for dogs do have some benefits, though.
When they become pregnant there are other vitamins and minerals that need to be “upped” to fill momma’s need for healthy pups for example, folic acid and iron.
Selecting A Multivitamin Containing Folic Acid
For women who can become pregnant, health care professionals play an important role in motivating them to use supplements . To ensure proper use of multivitamin supplements:
- Use the ‘Key messages on folate for women of childbearing age‘ to write or talk about folic acid supplementation during the childbearing years.
- Encourage women to look for a multivitaminFootnote 13 that provides 400 mcg of folic acid per daily dose. The product should also include vitamin B12.
- Advise women that prenatal supplements contain higher amounts of nutrients than are usually needed by women who are not pregnant. A non-prenatal multivitamin supplement is often enough. Following this advice can help women avoid taking excessive amounts of nutrients over time.
- Ensure that women look for a Drug Identification Number or Natural Product Number on the product label showing that the product is government-approved for safety, efficacy, and quality.
- Emphasize the importance of reading product labels. Some supplements may include cautionary notes about their use during pregnancy and breastfeeding.
- Caution women not to take more than one daily dose. This will help women not go over the Tolerable Upper Intake Level for vitamin AFootnote 14, which is 3,000 mcg retinol activity equivalent or 10,000 IU.
- Remind women to keep all supplements stored out of reach of young children.
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