Essential Element

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The research is clear: Folic acid is crucial for healthy pregnancies and babies.

“There is no more important thing that a woman can do prior to conceiving than to make sure she is getting large quantities of folic acid in her diet, whether it is folate, derived from green leafy vegetables, citrus fruits, meats, beans, or she takes it as a folic acid, which is the artificial product — it doesn’t matter,” says Mark Grant, a medical doctor who specializes in maternal-fetal medicine at Women’s Wellness Center.

Why It’s Important
Folic acid is a B vitamin that every cell in the body needs for normal growth and development. It is especially important where there is rapid cell division and growth — such as in fetal development.

Birth defects most commonly associated with inadequate folic acid intake affect the baby’s brain and spine (anencephaly and spina bifida). Others, Grant notes, include cleft lip and palate, structural cardiac defects and, perhaps, chromosome problems.

Grant adds that a woman’s placenta also experiences rapid growth and division during pregnancy, so low folic acid levels during pregnancy may be associated with such adverse pregnancy events as prematurity, placental abruption — where the placenta tears loose from the uterine wall — and other complications.

“So there are lots of reasons to get your folic acid prior to conception,” Grant says.

When To Start
Grant says the critical time for folic acid intake to prevent birth defects is at least two months before conception through at least the first month after conception.

“The problem with folic acid supplementation is that around 50 percent of all pregnancies in the United States are unanticipated,” he adds, which means most women don’t know they need supplementation until it’s too late.

That’s why the March of Dimes recommends all women of childbearing age take at least 400 micrograms of folic acid every day. During pregnancy, the recommendation goes up to 600 micrograms; a prenatal vitamin should contain this amount.

Grant, however, views the recommended daily allowance of 400 micrograms per day as “woefully inadequate”; he recommends his patients take 1,600 micrograms per day.

How To Get Enough
The Centers for Disease Control advise two easy ways to be sure to get the recommended daily allowance of folic acid each day:

1. Take a daily vitamin that has folic acid in it. The label will report whether the multivitamin contains 100 percent of the daily value. Women can also choose to take a daily supplement that has only folic acid in it.

2. Eat a bowl of breakfast cereal that has 100 percent of the daily value of folic acid every day. Not every cereal has this amount, so women should check the label on the side of the box and look for one that has “100%” next to folic acid.

Some women might need more than the usual recommendation. A health care provider can offer personalized guidance.

Survey Says …
Among all women of childbearing age:

  • 40% reported taking folic acid daily.
  • 81% reported awareness of folic acid.
  • 12% reported knowing that folic acid should be taken before pregnancy.

Women of childbearing age who were aware of folic acid reported hearing about it from:

  • Health care provider (33%)
  • Magazine or newspaper (31%)
  • Radio or television (23%)

Among women who reported not taking a vitamin or mineral supplement on a daily basis, the most common reasons were:

  • “Forgetting” (33%)
  • “No need” (18%)
  • “No reason” (14%)
  • “Already get balanced nutrition” (12%)

Source: 2007 CDC survey

For more information on folic acid, visit www.womenshealth.gov.

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