Folic Acid and Pregnancy: How Much Do You Need?

Maternal folic acid supplements may decrease risk of congenital heart defects and prevent cleft lip and palate. The recommended daily dose is 600 mcg. Many foods also contain natural folic acid.
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Folic acid is a B vitamin found in many supplements and fortified foods. It’s the synthetic form of folate. Folic acid is used by your body to make new cells and produce DNA. It’s required for normal growth and development throughout your life.
Taking folic acid is particularly vital before and during pregnancy. It’s important for the proper organ development of a developing baby.
Research shows that taking folic acid before you get pregnant may help prevent birth defects including serious neural tube defects such as spina bifida, encephalocele (rarely), and anencephaly.
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What are the health benefits of taking folic acid during pregnancy?

What are the health benefits of taking folic acid during pregnancy?
Approximately 3,000 babies are born with neural tube defects in the United States each year. Normally, the neural tube develops into the spinal cord and brain by 28 days after conception.
If the neural tube doesn’t close properly, neural tube defects occur. Anencephaly is a condition in which the brain doesn’t develop properly. Babies born with anencephaly cannot survive.
Babies born with spina bifida or encephalocele may face multiple surgeries, paralysis, and long-term disability.
According to a 2015 review of studies, maternal folic acid supplementation significantly decreases the risk of congenital heart defects. These defects occur in 8 out of every 1,000 births in the United States.
According to the American Heart Association, congenital heart defects happen when the heart or blood vessels don’t grow normally before birth. They may impact the interior walls of the heart, the heart valves, or the arteries and veins of the heart.
Research also shows folic acid supplementation in early pregnancy may help prevent cleft lip and cleft palate.
These birth defects occur if parts of the mouth and lip do not merge together properly during the first 6 to 10 weeks of pregnancy. One or more surgeries are usually needed to correct the condition.

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How much folic acid do you need?

How much folic acid do you need?
All pregnant women should take get at least 600 micrograms (mcg) of folic acid daily, according to The American College of Obstetricians and Gynecologists. Most prenatal vitamins contain this amount of folic acid.
Taking folic acid after you discover you’re pregnant may not be soon enough. Many women don’t realize they’re pregnant until 6 weeks or more after conception. Neural tube defects occur during the first month of pregnancy, often before you realize you’re pregnant.
To make sure you have enough folic acid in your body to prevent neural tube defects, the CDC recommends women who plan to become pregnant or who are of childbearing age take 400 mcg of folic acid daily.
If you’ve already given birth to a child with a neural tube defect, you may need higher doses of folic acid in the months leading up to your next pregnancy and during the first few months of pregnancy. Your doctor can advise you on the right dose.
You may also need higher doses of folic acid if you:
have kidney disease and are on dialysis
have sickle cell disease
have liver disease
drink more than one alcoholic beverage daily
take medications to treat epilepsy, type 2 diabetes, lupus, psoriasis, rheumatoid arthritis, asthma, or inflammatory bowel disease

Can you get enough folic acid from foods?

Can you get enough folic acid from foods?
Natural folate is found in many foods including leafy greens, beets, and broccoli. Some foods in the United States are fortified with folic acid. These include:
cereals
rice
orange juice
pasta
Many servings of fortified breakfast cereals contain 100 percent of the folic acid you need. Even so, it may be hard to know exactly how much you’re getting unless you track the amounts of folate and folic acid in everything you eat.
There’s no guarantee that you will get enough folic acid from food alone, so a supplement is important.
If you have morning sickness in early pregnancy, it may be difficult to eat enough fortified foods to get the folic acid you need.
To make sure you get enough folic acid, doctors will usually recommend taking a folic acid supplement or a prenatal vitamin that contains folic acid before and during pregnancy.
You can’t get too much natural folate from foods. However, you should not consume more than 1,000 mcg (1 mg) of folic acid (from vitamins, fortified foods, or a combination of both) daily.

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Current Version
Jun 20, 2023
Written By
Annette McDermott
Edited By
John Bassham
Copy Edited By
Kara Williams
Oct 12, 2020
Medically Reviewed By
Carolyn Kay, MD
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