Answers to the Common Questions on Folic Acid Before and During Pregnancy

The synthetic form of folate, a B vitamin the body needs to make new cells, taken as a supplement or eaten in fortified foods.

Key takeaways

• CDC recommendation: 400 mcg of folic acid every day for anyone who could become pregnant
• USPSTF recommendation: 400 to 800 mcg (0.4 to 0.8 mg) a day for those planning or capable of pregnancy
• Most useful single change: Take a daily vitamin containing 400 mcg of folic acid if there is any chance you could become pregnant.
• Commonest mistake: Waiting for a positive pregnancy test before starting, which can be too late for the most important window.
• See a doctor if any of the signs under "When to speak to a doctor" below apply to you.

What is Folic Acid Before and During Pregnancy?

The synthetic form of folate, a B vitamin the body needs to make new cells, taken as a supplement or eaten in fortified foods.

Why does it matter?

Getting enough before and in early pregnancy lowers the risk of neural tube defects of the brain and spine, which form in the first month, often before a pregnancy is known.

CDC recommendation for Folic Acid Before and During Pregnancy?

400 mcg of folic acid every day for anyone who could become pregnant.

USPSTF recommendation for Folic Acid Before and During Pregnancy?

400 to 800 mcg (0.4 to 0.8 mg) a day for those planning or capable of pregnancy.

When to start for Folic Acid Before and During Pregnancy?

At least 1 month before pregnancy, continuing through early pregnancy.

Why timing matters for Folic Acid Before and During Pregnancy?

Neural tube defects develop in the first few weeks after conception.

What is the single most useful thing to do?

Take a daily vitamin containing 400 mcg of folic acid if there is any chance you could become pregnant.

What is the most common mistake?

Waiting for a positive pregnancy test before starting, which can be too late for the most important window.

When should I see a doctor?

Talk to your doctor before pregnancy if you have epilepsy, diabetes, obesity, a family history of neural tube defects or take medicines that affect folate, since your dose may need adjusting. Call 911 for any severe allergic reaction, such as swelling of the face or trouble breathing, after taking a supplement.

More questions, answered

Can I get too much folic acid?

For most people, the recommended amount from a supplement plus a normal diet is safe. Problems usually come from stacking several products that each contain folic acid, or from taking high doses without a prescription. Large amounts can hide the signs of vitamin B12 deficiency, so add up every product and check with your doctor before going higher.

Do I still need folic acid after the first trimester?

The neural tube closes early, so the most important window is before conception and in the first weeks. Folate remains important throughout pregnancy for making red blood cells and supporting growth, and most people simply continue their prenatal vitamin until birth and often while breastfeeding.

Does folic acid help men planning a pregnancy?

The recommendation to prevent neural tube defects applies to the person who will carry the pregnancy. A balanced diet supports general health for everyone, but men do not need a folic acid supplement to prevent neural tube defects in their children.

Are gummy vitamins as good as pills?

Many gummy vitamins contain folic acid, but some lack iron, and amounts vary. Read the label to confirm the folic acid content. Keep gummies stored safely away from children, who may mistake them for candy.

Is folate from food natural and therefore better?

Food folate is valuable, but it is less stable during cooking and less consistently absorbed than folic acid. The protective effect against neural tube defects has been shown for folic acid, which is why guidelines specifically recommend it in addition to a folate-rich diet.

What if my pregnancy was unplanned and I took no vitamins?

Start folic acid now and book prenatal care. Most babies born to people in this situation are healthy. Your team will offer screening, including an anatomy ultrasound, and can explain what the results mean.

Related topics

• Preconception Health: What the Evidence Actually Says (Women's Health)
• Vitamin B12 Deficiency: Sorting the Evidence From the Noise (Blood Health)
• The Evidence on Whole Grains, Without the Hype (Nutrition)
• What the Guidance Really Says About Vaccination in Pregnancy (Vaccinations)

Where to go next

• Making Sense of Folic Acid Before and During Pregnancy
• Folic Acid Before and During Pregnancy: A Practical Checklist
• Folic Acid Before and During Pregnancy — the reference entry
• Pregnancy and Postpartum: The Complete Guide
• Foods to Avoid in Pregnancy: What the Evidence Actually Says
• The Evidence on Pregnancy Weight Gain, Without the Hype

When to speak to a doctor

Talk to your doctor before pregnancy if you have epilepsy, diabetes, obesity, a family history of neural tube defects or take medicines that affect folate, since your dose may need adjusting. Call 911 for any severe allergic reaction, such as swelling of the face or trouble breathing, after taking a supplement.

Where this comes from

• CDC — About Folic Acid
• US Preventive Services Task Force — Folic Acid Supplementation to Prevent Neural Tube Defects: Preventive Medication

How this page was put together

Every figure, recommendation and warning above is taken from the guidance named in Where this comes from. Nothing on this page is inferred, summarized or generalized beyond what those bodies publish: where they give a number, it is their number, and where they are silent, so are we. Pages are rebuilt whenever the underlying record changes. Sign-off by a named clinician, where it has happened, is shown at the top of the page along with the date.

Medical disclaimer

This article is general information, not medical advice. It cannot account for your own history, medication or circumstances. Always speak to your doctor, pharmacist or another qualified health professional before making changes that affect your treatment, and never delay seeking medical advice because of something you have read here. In an emergency, call 911.