Spring 2001

The Folic Acid Message: You are the Link Between Science and Healthy Babies

Folic Acid is a B vitamin that can help prevent birth defects of the brain and spinal cord called neural tube defects (NTDs) when taken before pregnancy and in the early weeks of pregnancy.

About 2,500 babies nationwide are born with NTDs each year, and many other affected pregnancies end in miscarriage or stillbirth. The most common NTDs are spina bifida and anencephaly. Spina bifida is a leading cause of childhood paralysis. Affected children have varying degrees of lower body paralysis and bladder and bowel control problems. Anencephaly is a fatal condition in which a baby is born with a severely underdeveloped brain and skull. Studies also suggest that folic acid may help prevent some other birth defects as well, including cleft lip and palate.

Since NTDs originate in the first month of pregnancy, before many women know they are pregnant, it is important for a woman to have enough folic acid in her system before pregnancy. Folic acid is recommended for all women of childbearing age because 50 percent of pregnancies in this country are unplanned.

The March of Dimes recommends that all women who can become pregnant consume a multivitamin containing 400 mcg of folic acid daily, in addition to eating a healthy diet including foods rich in folic acid. This is the only sure way a woman can get all the folic acid and other vitamins she needs. Most women get only about 200 mcg of folic acid a day from their diets.

Foods that are naturally rich in folates include orange juice, other citrus fruits and juices, leafy green vegetables, beans, peanuts, broccoli, asparagus, peas, lentils, and whole-grain products. Multivitamins, fortified breakfast cereals, and enriched grain products contain a synthetic form of folic acid that is more easily absorbed by the body than the natural form (which must be broken down by the body into a usable form). It is not yet know whether consuming 400 mcg of folate from foods every day provides the same level of protection against birth defects as 400 mcg of the synthetic form. This is because cooking and storage can destroy some of the folate in foods, and the amount of usable folic acid the body can obtain from different foods varies widely.

The boy can absorb almost 100 percent of the synthetic form of folic acid. This is why the March of Dimes, the Centers for Disease Control and Prevention (CDC), and the Institute of Medicine recommended that women who could become pregnant consume 400 mcg a day of the synthetic form. Yet, results of a 2000 Gallup/March of Dimes survey found that only about 30 percent of women take a daily multivitamin containing folic acid before pregnancy. The Institute of Medicine also recommends that women should increase their intake of synthetic folic acid to 600 mcg a day once their pregnancy is confirmed. Most doctors recommend a prenatal vitamin that contains at least this amount of folic acid. However, women should not take more than 1,000 mcg (or 1 milligram) without their doctor’s advice.

The Center for Disease Control and Prevention estimates that if all women of childbearing age in the United States took 400 mcg of folic acid daily beginning at least one month before pregnancy and in the first trimester of pregnancy, up to 70 percent of all NTDs could be prevented. But folic acid will not work if women don’t know about it and don’t take it every day.

Your patients listen to you. Urge all of your patients who could become pregnant to take a multivitamin with 400 mcg of folic acid every day. Tell them to include foods rich in folic acid such as orange juice, fortified breakfast cereals, enriched grain products and green leafy vegetables as part of a healthy diet.

This article is provided by the South Dakota Folic Acid Council as part of its public education campaign to decrease birth defects in South Dakota by increasing the use of folic acid among women of childbearing age. For more information about folic acid or the South Dakota Folic Acid Council, contact the March of Dimes at 605-334-8203 or visit the March of Dimes website at www.modimes.org.