Folic Acid Benefits in Pregnancy: How Much to Take

Folic acid is generally taken as a supplement, but certain foods also contain a great amount. Since folic acid has been added to foods in the U.S., about 1,300 neural tube defects have been prevented each year.

But experts say there are still about 3,000 neural tube defects annually, and that some of those could be prevented if all women would take folic acid while pregnant ⁽¹⁾.

We’ll give you the 411 on folic acid benefits in pregnancy and how this vitamin affects your growing baby.

What Is Folic Acid?

Folic acid is a type of synthetic water-soluble vitamin B, more specifically, vitamin B9 ⁽²⁾. It stems from its natural form called folate, which occurs naturally in foods like beans, lentils, peas, oranges, and asparagus.

Folic acid helps our bodies develop new cells for things like our hair, nails, and skin. It’s vital for a developing embryo as it helps in establishing healthy neural tubes, the sacs that surround the developing brain and spinal cord. Not getting enough folic acid can lead to various congenital disabilities, which can affect the lifespan and overall health of a newborn ⁽³⁾.

Benefits of Folic Acid During Pregnancy

The first weeks of gestation are delicate, which is why it’s important to take folic acid as early as possible. This is the time where the neural tubes develop — those responsible for growing the brain and spine.

Not getting enough folic acid at the beginning of pregnancy can increase the chance of neural tube defects. That includes conditions like spina bifida and anencephaly, both of which can have devastating outcomes ⁽⁴⁾.

Spina bifida affects the spinal cord. Babies born with this condition have an increased risk of being permanently disabled. The nerves for leg movement and bladder control do not develop properly, often resulting in the inability to walk or void without assistance. Anencephaly affects the growth of the brain, and babies with this usually don’t live long ⁽⁵⁾.

Neural tube defects always occur during the first weeks of pregnancy — sometimes, even before the mom knows she’s expecting. It’s been estimated that birth defects affect around one in every 33 babies across the U.S ⁽⁶⁾. When expecting mothers take folic acid, it has shown to reduce the chances by as much as 70 percent ⁽⁷⁾.

Another benefit of folic acid is that it promotes rapid cell growth in the placenta and the embryo. If you previously had a baby born with a neural tube defect, folic acid can reduce the risk of having another one.

When you take folic acid before and during early pregnancy, this super vitamin can also protect your little one against ⁽⁸⁾:

• Premature birth.
• Low birth weight.
• Poor growth in the womb.
• Miscarriage
• Cleft lip and palate.
• Reduced risk of pregnancy complications such as preeclampsia.

Folic acid can also benefit the mother when she isn’t pregnant ⁽⁹⁾. It can help prevent:

• Heart disease.
• Some types of cancer.
• Stroke.
• Dementia.

How Much Folic Acid During Pregnancy

How much folic acid you need to consume depends on your specific needs. Expert recommendations state that every woman of childbearing age should take around 400 micrograms of folic acid daily ⁽¹⁰⁾.

Begin taking it at least a month before you start trying to conceive and throughout your pregnancy. During the first four months, it’s typically recommended to consume 400 micrograms. Then from four to nine months, it’s generally 600 micrograms ⁽¹¹⁾. Alternatively, the National Institute of Health (NIH) recommends 600 micrograms at any stage of pregnancy ⁽¹²⁾.

However, always consult your doctor to get the right amount — every woman is different. You can get too much folic acid, especially if you’re already eating a diet rich in vitamin B9.

Avoid taking more than 1,000 micrograms per day, unless otherwise instructed by your doctor ⁽¹³⁾. Doing so can mask other deficiencies, ultimately making you sicker.

You should particularly be careful if you’re living on a vegan diet. Not consuming animal products places you at risk of vitamin B12 deficiency ⁽¹⁴⁾. If you then counter this by taking too much folic acid, it becomes challenging to diagnose the scarcity.

Consuming prenatal vitamins is also fine — many of these contain a fair amount of folic acid. Prescription prenatal vitamins can have as much as 800 to 1,000 micrograms. Check the label and ask your health care provider if you have any worries.

If the prenatal vitamins you’re taking don’t contain enough folic acid, it’s best to switch brands. You should never consume more than one prenatal vitamin per day unless your doctor advises it.

Along with the supplements, try to include as many folic acid-rich foods as possible into your diet.

When Is It Necessary to Consume More?

For some women, it’s crucial to take more folic acid than the recommended daily amount. Consult your doctor about your folic acid needs — be sure to do this when you’re planning on conceiving. Here are some circumstances where more folic acid might be necessary:

• You previously conceived a baby with a neural defect: Sometimes, in such cases, your doctor will advise you to take a lot more folic acid. It might be necessary to increase the amount to 4,000 micrograms a day for three months before conceiving ⁽¹⁵⁾.
• You’re having twins: When you’re pregnant with more than one baby, it’s essential to increase the amount of folic acid. Your doctor may recommend that you take up to 1,000 micrograms ⁽¹⁶⁾.
• You suffer from diabetes or take anti-seizure medications: These two factors can increase your baby’s risk of developing a neural tube defect.

What Happens If You Have Too Much?

Getting too much folic acid from food alone isn’t likely to happen as it already appears as its natural form, namely folate. However, when taking multivitamins and other supplements, you can quickly overdose.

Although there’s a limited research regarding folic acid overdose, we do know that it can conceal vitamin B12 deficiencies ⁽¹⁷⁾. If this remains undiagnosed, it could lead to nerve damage.

If not corrected, it will allow vitamin B12 deficiency to worsen, ultimately leading to confusion, dementia, and eventually nerve damage. However, this deficiency is highly unlikely to occur in healthy individuals who consume an unrestricted diet— those at risk include the elderly and strict vegetarians. Vitamin B12 is present in eggs and dairy, so following a vegan diet is a higher risk for this deficiency ⁽¹⁸⁾.

Folic acid can also directly lead to side effects if taken over a long period ⁽¹⁹⁾. These symptoms include:

• Nausea.
• Abdominal cramps.
• Gas.
• Diarrhea.
• Sleep problems.
• Irritability.
• Confusion.

Signs of Folic Acid Deficiency

Signs of folic acid deficiency are subtle in most cases. Some of the symptoms are general, and can also occur due to other conditions. The signs include ⁽²¹⁾:

• Sore throat.
• Irritability.
• Diarrhea.
• Weakness.
• Weight loss.
• Headaches.
• Anemia.
• Fatigue.
• Heart palpitations.
• Shortness of breath.
• Numbness and tingling in hands or feet.
• Muscle weakness.
• Reduced sense of taste.

If you’re experiencing only a minor deficiency, the symptoms might not be noticeable at all, if you even have any. However, you still aren’t getting an adequate amount for your baby’s earliest development. So if you fear you aren’t consuming enough, contact your healthcare provider.

Folic Acids from Food

It’s been estimated that around half of pregnancies in the U.S. are unplanned ⁽²²⁾. Due to this, it isn’t always easy to know when to start taking folic acid.

To combat this, the FDA has made it a requirement for some foods to be fortified with additional folic acid ⁽²³⁾. Such foods include cereal, pasta, bread, and rice. This is meant to help women who are not trying to conceive.

If you are trying to conceive, fortified foods are rarely enough to provide the daily recommended amount. Even eating complete servings of fortified foods every day doesn’t guarantee you’re getting everything you need. Many of the synthetic nutrients added to cereals usually end up floating in the milk, which some people don’t drink after eating their cereal.

Foods that contain natural folate aren’t that reliable either. Some research even showed that the body is much more effective at absorbing synthetic folic acid than natural folate ⁽²⁴⁾. In addition to this, folate tends to dissipate during storage or cooking.

Folic acid-rich foods are best consumed as a complement to the supplements. Some good folate sources include:

• Dried peas, nuts, and beans.
• Lentils.
• Avocado.
• Dark green vegetables like spinach, broccoli, turnip greens, okra, collard, asparagus, and brussels sprouts.
• Bananas.
• Citrus fruit and juice.
• Tomato juice.
• Wheat germ.
• Corn masa, which you can find in taco shells, tamales, or tortillas.
• Peanuts.
• Cornmeal.
• Squash.

Folic Acid Supplementation

Besides eating fortified foods and those containing natural folate, you can get folate from specific vitamins containing folic acid. Look for a brand containing at least 400 micrograms.

Most of the vitamins sold within the U.S. already have the recommended daily amount. Supplements and vitamins are easy to find — they’re sold in most pharmacies, grocery stores, and discount stores.

In addition to folic acid, it’s a good idea to find a prenatal vitamin containing other required elements. This includes calcium and iron ⁽²⁵⁾.

In the End

Folic acid is a synthetic, water-soluble vitamin B9. It’s crucial during the early stages of pregnancy, even before conceiving. When getting an adequate amount, you reduce the chances of your baby developing a neural defect.

Knowing about folic acid benefits in pregnancy is essential. Not getting enough can have serious effects on your growing baby. Luckily, folic acid is found in several foods and almost all multivitamins and prenatal vitamins.

Always consult your doctor about how much to consume both before and during your pregnancy.