Folic Acid Before and During Pregnancy: A Practical Checklist
Folic Acid Before and During Pregnancy: what is worth doing, what is worth avoiding, and when to stop and see a doctor.
The synthetic form of folate, a B vitamin the body needs to make new cells, taken as a supplement or eaten in fortified foods. 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.
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.
Do
- Take a daily vitamin containing 400 mcg of folic acid if there is any chance you could become pregnant
- Check the label of your prenatal vitamin for the folic acid amount
- Eat folate-rich foods too: leafy greens, beans, lentils, oranges and fortified cereals
- Tell your doctor if you take medicines for seizures or have had a pregnancy affected by a neural tube defect, as you may need a different dose
Do not
- Waiting for a positive pregnancy test before starting, which can be too late for the most important window
- Taking several supplements that each contain folic acid without adding up the total
- Relying on food alone if you could become pregnant; guidelines recommend a supplement as well
The numbers behind the list
Where the items above come from.
| Measure | Figure |
|---|---|
| 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 |
| When to start | at least 1 month before pregnancy, continuing through early pregnancy |
| Why timing matters | neural tube defects develop in the first few weeks after conception |
| After a previous pregnancy affected by a neural tube defect | a higher dose, as your doctor prescribes |
| Fortified US foods | enriched bread, pasta, rice, flour and many breakfast cereals |
If you change one thing
Take a daily vitamin containing 400 mcg of folic acid if there is any chance you could become pregnant. Start there. The rest of the list keeps.
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
- Myths About Folic Acid Before and During Pregnancy, Checked Against the Guidance
- 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.
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