This is the only vitamin that you require double the amount of during pregnancy than at other times and it can take more than six months after childbirth for your folic acid needs to return to normal levels. Folic acid is needed for copying genetic material and the healthy division of cells, for healthy nerves and for the metabolism of sugars and proteins. If folate is lacking, dividing cells become abnormally large and are more likely to contain abnormal chromosomes.
Lack of folic acid during the first few weeks of pregnancy, when the brain and spinal cord are being laid down, is associated with a form of congenital abnormality known as a neural tube defect (e.g. spina bifida), and with an increased risk of cleft palate, hare lip and abnormalities of the limbs, heart, lungs and skeleton. Sadly, at least two babies are conceived with a neural tube defect in the UK every day. It is now suggested that every woman of childbearing age should take supplements containing 400 mcg folic acid. This is especially important when planning to conceive and for at least the first 12 weeks of pregnancy.
If a woman who has previously had a child with a neural tube defect takes 4 mg folic acid daily from before conception until the 12th week of gestation, her risk of a recurrence is reduced by 70 per cent compared with similar women who took no folic acid supplements or other vitamins. Similarly, women taking multivitamins including folic acid throughout the first six weeks of gestation had around 70 per cent fewer affected pregnancies compared with those who took multivitamins without folic acid.
If you have epilepsy, and are taking drugs to stop your seizures, you should seek medical advice before trying for a baby. Some anticonvulsant drugs work by interfering with the way your body handles folic acid, so supplements can affect your treatment. It is best to seek specialist advice about which antiepilepsy drugs are safe to take during pregnancy (you may need your medication changed), and what level of folic acid supplementation you need.
How much you need ?
Increase your intake of folic acid in three ways as follows :
- Take a supplement providing 400 mcg folic acid daily. If you have previously conceived a child with a neural tube defect, you should take a supplement containing at least ten times more folic acid. Supplements containing 5 mg folic acid are available on prescription for this purpose.
- Choose foods that have been fortified with folic acid; these include many breakfast cereals and some breads. They are now easier to spot thanks to the Health Education Authority’s (HEA’s) ‘flash’ scheme, which leading manufacturers are adding to their packaging. Look out for flashes saying: ‘contains folic acid’—on foods that can provide at least one-sixth of your daily requirement—and ‘with extra folic acid’—on foods enriched to provide at least half your daily requirements.
- Eat more foods that are naturally rich in folic acid.
You should start increasing your folic acid intake from the time you first start trying to conceive, and for at least the first 12 weeks of pregnancy and preferably throughout the whole nine months.
Good dietary sources for pregnant women include :
- fortified foods ;
- yeast extract ;
- green leafy vegetables e.g. spinach, broccoli, Brussels sprouts, kale and spring greens ;
- soya beans, green beans, chickpeas, cooked black-eye beans and baked beans; wholemeal or granary-style bread ;
- asparagus, avocados and cauliflowers ;
- milk, butter, cheese, cottage cheese and yoghurt ;
- eggs.
