A simple vitamin can help prevent
birth defects

What is folic acid, and why is it so important?

Two very serious birth defects can be easily avoided when women get the right amount of a common vitamin called folic acid.

Folic acid, a B vitamin, has been found to significantly reduce the rate of neural tube defects, a disorder in which the tissues fail to close the tube containing the spinal cord, which is continuous with the brain. Common neural tube defects include spina bifida, in which part of the spinal cord remains outside the body at birth, and anencephaly, in which the baby is born without a brain. Approximately one in every thousand live births is affected.

These neural tube defects are sometimes fatal and often severely disabling. Babies with anencephaly die shortly after birth. Persons with spina bifida have varying degrees of paralysis of their legs, and bowel and bladder incontinence. Lifelong medical care, including repeated hospitalizations, is usually needed. By simply consuming enough folic acid in the first weeks of pregnancy, a woman can cut in half the chance that her baby will have a neural tube defect.

Do I need to take folic acid if I'm not pregnant?

Yes. The U.S. Public Health Service recommends that all women capable of becoming pregnant should consume 0.4 milligrams of folic acid every day. Neural tube defects occur in the first few weeks after conception, as the fetus is forming, generally before a woman even knows she's pregnant. After that, folic acid does no good in preventing neural tube defects. So, if you're capable of getting pregnant even if you don't plan to you should make sure you get enough folic acid daily.

How much folic acid is needed?

The U.S. Public Health Service recommends that women get 0.4 milligrams of folic acid daily. This is the amount usually contained in most daily multivitamin supplements.

How can I make sure I get enough folic acid?

Most daily multivitamin tablets contain the recommended amount of 0.4 milligrams of folic acid, so taking a multivitamin supplement every day should provide a woman with the correct amount of folic acid. However, women should check to make sure their brand of vitamin supplement contains the recommended 0.4 milligrams of folic acid.

This B vitamin is also found naturally in foods in a form called "folate." Fortified breakfast cereals are an excellent source of folic acid. Other good sources of folate are fresh green vegetables, some fresh fruits and liver.

Women who are knowledgeable about nutrition can select diets that provide 0.4 milligrams of folates each day, but many women who eat a well-balanced diet may not be getting enough of the vitamin. The Food and Drug Administration is considering requiring that enriched flour and other grains be fortified with folic acid.

Should I worry about taking too much folic acid?

Folic acid, even in large quantities, isn't harmful, although it can interfere with the diagnosis of vitamin B12 deficiency, a rare problem in women of childbearing age. But experts say that risk can be dealt with, and that the benefits of folic acid far outweigh any risk.

The Public Health Service recommends that women get no more than 1 milligram of folic acid per day, except under the supervision of a physician. Women taking one vitamin supplement per day, and eating foods that contain folic acid, generally do not need to worry about getting too much folic acid.

Women should be careful, however, not to take extra large amounts of multivitamin supplements, because excesses of other vitamins can cause serious health problems. Women should take no more than one multivitamin pill per day, except under a physician's supervision.

What if I've already had a baby with a neural tube defect?

Women who have previously had a pregnancy affected by a neural tube defect face a greater risk with subsequent pregnancies. But folic acid has been found to be effective for these women, too. In studies of women who have previously had a pregnancy affected by a neural tube defect, folic acid supplements in larger doses reduced neural tube defects in later pregnancies by as much as 70 percent.

The Public Health Service recommends that all women who have had previous pregnancies affected by neural tube defects should consult their doctor before getting pregnant. Your doctor will follow Public Health Service guidelines for placing you on a higher dosage of folic acid prior to conception. When not pregnant, and not planning a pregnancy, you should take the recommended 0.4 milligrams daily.

How reliable is this research on folic acid?

The role of folic acid in protecting the unborn child from neural tube defects has been documented by numerous research studies conducted by a variety of medical and research agencies over a period of years.

The results of these studies have been widely reported in medical journals such as the Journal of the American Medical Association, the New England Journal of Medicine and Lancet.

The U.S. Public Health Service's recommendation that all women of childbearing age should consume 0.4 milligrams of folic acid daily was developed through the efforts of the Centers for Disease Control and Prevention, the Food and Drug Administration, the Health Resources and Services Administration and the National Institutes of Health, coordinated through the Office of the Assistant Secretary for Health.