If you are planning a pregnancy, it is recommended to take a supplement of 400 micrograms a day of folic acid to reduce the risk of neural tube defects in your baby (problem with the spinal cord or brain development such as spina bifida). You can do this by purchasing a pregnancy specific multivitamin supplement. In addition to folic acid, these usually contain 10 micrograms of vitamin D which is also recommended by the department of health in pregnancy. However these can be quite big tablets and if you’re feeling very nauseous, tricky to stomach. If that’s the case then many pharmacies sell smaller folic acid only supplements.

The baby’s nervous system starts forming very early, during week 3 of pregnancy, around the time of your first missed period. So it is best to start the folic acid before you conceive. You should continue it until 12 weeks of pregnancy, although may women choose to continue their pregnancy multivitamins throughout pregnancy. Vitamin D is recommended during breastfeeding as well. Multivitamins that are not specifically designed for pregnancy should be avoided. They contain other vitamins that may be harmful at high doses in pregnancy.

If you or your partner have a neural tube defect, have had a baby with one, or if you have diabetes, coeliac disease or epilepsy, it is recommended to take a higher dose of 5 milligrams, (which needs to be prescribed by a Doctor.). If you have a BMI above 30 you should also consult your Doctor as to whether a higher dose is needed.

A consultation is being launched in 2019 to decide whether the UK government should mandate the addition of folic acid to flour. In the USA fortification was introduced in 1998 and following this a 28% reduction in the number of babies born with neural tube defects was observed. This is an exciting piece of public health work starting in the New Year.

Ladies often ask about natural folate supplements, and whether these are better than synthetic folic acid. There has been alot of recent interest in this topic on pregnancy related websites and blogs. There is robust evidence that folic acid supplementation reduces the risk of neural tube defects. Unfortunately evidence is lacking regarding the effectiveness of folates for this purpose. Folic acid is better absorbed by the body. Therefore it is advisable to take licensed, pharmacy or supermarket sold folic acid preparations.

You can read more about folic acid and vitamin D in pregnancy on the RCOG website. And to read more about the proposed fortification of flour with folic acid click here.

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