Pregnancy and Nutrition:
Folate and Neural Tube Defects
What are folate and folic acid?
Folate is a B vitamin found naturally in foods.
Folic acid is the form of folate found in vitamin supplements and fortified foods. Fortified foods, also called enriched foods, are foods that have specific nutrients added to them.
Folate is needed for a healthy pregnancy, in the form of folate or folic acid.
For more information on food sources of folate see the HealthLinkBC File #68g: Folate and Your Health.
Why is folate important?
Your body uses folate during your pregnancy to make blood cells and to help your baby grow.
Folic acid also lowers the risk of your unborn baby having a neural tube defect (NTD). NTDs are a group of serious birth defects that affect a baby’s spinal cord, brain and skull. Some babies with severe NTDs are stillborn or do not survive long after birth.
NTDs happen when the tissues and bone around the brain and spine do not grow well. NTDs can happen in the third and fourth week after conception (the first or second week after your first missed period). This could be before you know that you are pregnant.
Spina Bifida is the most common NTD. People with Spina Bifida have different amounts of paralysis. Paralysis means that one or more of the muscles in the legs, bladder, and/or bowel don’t work. People with Spina Bifida need medical care for their entire life.
How common are neural tube defects?
The Spina Bifida and Hydrocephalus Association of BC reports that 1 in every 750 children born each year in Canada are born with a neural tube defect.
To reduce your baby’s risk of being born with a NTD, take a multivitamin supplement with folic acid and eat foods high in folate before you are pregnant and while you are pregnant, especially for the first 3 months.
What increases my risk of having a baby with a neural tube defect?
You are at higher risk of having a baby with a NTD when:
- you already had a baby with an NTD or a pregnancy affected by an NTD
- you have a family member with a NTD
- you have epilepsy, obesity or diabetes
If you are at higher risk of having a baby with a NTD, talk to your doctor, midwife or other health care provider. You may need to take a supplement with more folic acid each day.
How much folate do I need each day?
All women 14 to 50 years of age who could become pregnant need to eat foods that are high in folate and take a supplement with 400 mcg of folic acid every day.
Pregnant women need at least 600 mcg of folate each day from foods and supplements.
Breastfeeding women need at least 500 mcg of folate each day from food and supplements.
400 micrograms (mcg) = 0.4 milligrams (mg)
|Recommended Dietary Allowance (RDA) for Folate (Daily)|
|19 - 30||600||500|
|31 - 50||600||500|
*mcg = micrograms. Micrograms can also be written with the symbol μg
Keep taking the multivitamin supplement every day during pregnancy and while you are breastfeeding. Don’t take a multivitamin or folic acid supplement with more than 1000 mcg or 1 milligram of folic acid unless your doctor or midwife has told you to. Too much folic acid can cause other health problems.
When you choose a multivitamin supplement, pick one that also has vitamin B12. Vitamin B12 works with folate to make DNA.
Talk to your health care provider about a supplement that is best for you. Do not take more than 1 supplement each day.
How can I get more folate from my diet?
Good sources of folate are:
- cooked dried beans, peas, lentils and edamame (green soybeans);
- dark green vegetables such as asparagus, avocado, spinach, broccoli, romaine lettuce, beets, Brussels sprouts, green peas, gai-lan, and bok choy;
- oranges and orange juice;
- wheat germ, sunflower seeds, yeast extract like marmite, and peanuts.
Although liver and liver products (e.g. liverwurst spread and liver sausages) are high in folate, they are also very high in vitamin A. Too much vitamin A may cause birth defects, especially during the first trimester. The safest choice is to limit these foods during pregnancy. If you choose to eat liver or liver products, have no more than 75g (2 ½ ounces) per week.
In Canada, folic acid must be added to white flour, enriched pasta and enriched cornmeal. Other foods that may contain added folic acid include breads, buns, cookies, crackers, pasta, and ready-to-eat cereals.
For More Information
For more information on folate and health see HealthLinkBC File #68g Folate and Your Health.
For more information on neural tube defects, contact the Spina Bifida and Hydrocephalus Association of BC at 604-878-7000, or visit www.sbhabc.org.
For more information on Eating Well with Canada’s Food Guide visit hc-sc.gc.ca/fn-an/food-guide-aliment/index-eng.php.