Folate (or folic acid) is a B-group vitamin that is essential for healthy fetal development. Folate can prevent neural tube defects, including spina bifida, if it is taken before conception and early in pregnancy. All women of child-bearing age should take extra folate as around half of all pregnancies are unplanned.
Folate (also known as folic acid) is a B-group vitamin essential for the healthy development of the fetus in early pregnancy, in particular their neural tube. Women of child-bearing age should take extra folate daily to prevent neural tube defects such as spina bifida. Even women who aren’t planning to have a baby should increase their folate intake because about half of all pregnancies in Australia are unplanned.
Folate taken before conception and during the first few weeks of pregnancy can prevent seven out of ten cases of neural tube defects. Over 600 pregnancies in Australia every year are affected by neural tube defects.
The neural tube
In the developing fetus, the neural tube will later become the baby’s brain, spinal cord and the bones that enclose them. If something goes wrong in their development, the result is called a neural tube defect. This can cause a wide range of disabilities such as loss of bladder and bowel control and paralysis of the legs. In some cases the effects can be more severe.
A baby’s neural tube is formed and closed in the first four to six weeks of pregnancy. By the time most women know or suspect they are pregnant, the time for the developing fetus to benefit from extra folate has passed.
Most women don’t get enough folate. The recommended daily intake of folate for women is 400 micrograms (mcg) per day. It’s difficult to measure just how much folate you get from your diet because the vitamin is affected by how foods are cooked and stored.
Folate requirements increase substantially in pregnancy, so women should aim to consume at least 600 mcg of folate from their normal daily diet. In addition to eating foods that are rich in folate, if you are planning a pregnancy or are in the early stages of pregnancy (the first three months or ‘first trimester’) you should take a daily supplement containing 0.5 mg of folic acid.
If you are planning a pregnancy, it is recommended that you increase your daily intake of folate for at least one month prior to pregnancy.
Even women who aren’t planning to have a baby should increase their folate intake if they are sexually active, because around half of all pregnancies are unplanned.
Foods in Australia that are fortified with folate
Since October 2009, all wheat flour used for bread making in Australia must contain folic acid. This means that most bread sold in Australia (except organic bread) is fortified with folic acid. This is in line with the Food Standards Australia New Zealand mandatory folic acid fortification standard. This standard was introduced to help reduce the number of neural tube defects.
Breakfast cereals and fruit juices for sale in Australia may also have added folic acid.
How to increase your folate intake
You can get enough folate if you:
- Take folate supplements
- Eat folate-rich foods – folate is present in a variety of vegetables (such as asparagus, spinach and broccoli) and fruits (such as oranges, bananas and strawberries) as well as legumes (such as chickpeas, dried beans and lentils), cereals, nuts and yeast extracts such as Vegemite
- Choose foods that have been fortified with folate – this includes some breakfast cereals and fruit juices, and most bread.
Women at higher risk need more folate
Some women have a higher risk of having a baby with a neural tube defect. For these women dietary folate alone is not sufficient.
You are at greater risk if you (or your partner):
- Already have a baby with a neural tube defect
- Have a neural tube defect yourself
- Have a close relative affected by a neural tube defect
- Take medicine for epilepsy or seizures – some medications affect the absorption of folate
- Have type 1 diabetes – discuss folate supplements with your doctor.
If you are at higher risk you should take a higher dose (5 mg) of folate each day. This is 10 times higher than that recommended for women with a low risk. These high doses should be taken under medical supervision.
Where to get help
- Your doctor
- Family planning clinic
- Family Planning Victoria Tel. 1800 013 952 or (03) 9257 0100 – for information about folate and neural tube defects
- Dietitians Association of Australia Tel. 1800 812 942
- Your local pharmacist
- Community health centre
Things to remember
- Folate reduces the risk of neural tube defects in babies.
- Even women who aren’t planning to have a baby should increase their folate intake (if they are of childbearing age) because about half of all pregnancies are unplanned.
- Using folate supplements is a good way to ensure adequate daily intake.
You might also be interested in:
- Baby due date.
- Birth defects - central nervous system.
- Breastfeeding and your diet.
- Childbirth - medical interventions.
- Food and your life stages.
- Maternal serum screening.
- Nutrition - women's extra needs.
- Pregnancy - morning sickness.
- Pregnancy - signs and symptoms.
- Pregnancy - week by week.
- Pregnancy and diet.
- Spina bifida.
- Vitamin B.
- Vitamins - common misconceptions.
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Royal Women's Hospital
Last reviewed: July 2012
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