If you're pregnant, planning to have a baby, or providing support to someone who's pregnant, you need to know about folic acid. This type of vitamin B is crucial in preventing certain birth defects in the brain and spinal cord called neural tube defects (NTDs). The neural tube starts out as a flat sheet of cells that normally folds into a tube and goes on to form the brain and spinal cord. The tube closes by the 29th day after conception – before many women even realize they're pregnant – but if it doesn't close properly, NTDs are the result. That's why it's so important to start getting extra folic acid before you become pregnant if at all possible. If you are already pregnant and are not taking a folic acid supplement, it's important to start taking one as soon as possible, and to continue taking it during your pregnancy.
Healthy women who are planning to become pregnant should take a vitamin supplement containing between 0.4 mg (400 micrograms) to 1 mg (1000 micrograms) of folic acid every day. Most women only get about 0.2 mg of folic acid from foods, like grains, green vegetables (spinach, broccoli), meat (liver), and legumes (lentils and beans), so a supplement is the only way to be sure you're getting enough. Women with diabetes, epilepsy, or a family history of NTDs, or who have already had an infant with an NTD, or with a BMI greater than 35 should take 5 mg of folic acid daily under doctor's supervision for 3 months before trying to conceive, after which the daily dose may change depending on their doctor's recommendation.
Once you're positive that you're pregnant, you should continue taking your daily dose of folic acid. If your doctor initially recommended 5 mg of folic acid daily, speak to your doctor as your daily dose may require changes at this point. You'll continue to need folic acid during pregnancy to help produce added blood cells and allow the fetus and placenta to grow rapidly. If you plan on breast-feeding, you should keep taking extra folic acid after delivery.
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