Folic Acid BEFORE Pregnancy

by Danelle Frisbie


I was recently surprised to find that only 7% of women polled in OB/GYN clinics were aware that folic acid should be taken for 30-90 days before becoming pregnant. This same time frame holds true for healthy sperm production if you are trying to become pregnant. When a father-to-be stops smoking, limits or stops alcohol use, starts taking vitamins and eating right, exercising, and making other health-conscious choices, his sperm development and integrity are impacted as well. It is wise to implement these choices for both men and women at least 90 days before trying to conceive. This appears to be the best way to ensure healthy sperm, mature vial eggs, and an optimal conception and healthy pregnancy.

Having a healthy baby means making sure you are healthy, too. And one important thing you can do to help prevent serious birth defects in your baby is to get enough folic acid every day - especially before conception and during early pregnancy.

What Is Folic Acid?

Folic acid, sometimes called folate, is a B vitamin (B9) found mostly in green leafy vegetables like kale and spinach, oranges, and enriched grains (some whole grain cereals). Repeated studies have shown that women who get 400 micrograms (0.4 milligrams) daily prior to conception and during early pregnancy reduce the risk that their baby will be born with a serious neural tube defect (a birth defect involving incomplete development of the brain and spinal cord) by up to 70%.

The most common neural tube defects are spina bifida (an incomplete closure of the spinal cord and spinal column), anencephaly (severe underdevelopment of the brain), and encephalocele (when brain tissue protrudes out to the skin from an abnormal opening in the skull). All of these defects occur during the first 28 days of pregnancy - usually before a woman even knows she's pregnant.

For this reason it is so important for all women of childbearing age to get enough folic acid - not just those who are planning to become pregnant - but anyone who may potentially become pregnant. Because only 50% of all pregnancies are planned, any woman who could become pregnant may want to fill her plate with green leafy veggies and snack on oranges on a regular basis.

Researchers still are not sure why folic acid has such a profound effect on the prevention of neural tube defects, but they do know that this vitamin is crucial in the development of DNA. As a result, folic acid plays a large role in cell growth and development, as well as tissue formation.

Getting Enough Folic Acid

The U.S. Centers for Disease Control and Prevention (CDC) recommends that all women of childbearing age - and especially those who are planning a pregnancy - consume about 400 micrograms (0.4 milligrams) of folic acid every day. Adequate folic acid intake is especially important 30 days before conception and at least 90 days after to reduce the potential risk of having a baby with a neural tube defect.

So, how can you make sure you're getting enough folic acid?

In 1998, the Food and Drug Administration mandated that folic acid be added to enriched grain products - so you can boost your intake by looking for breakfast cereals, breads, pastas, and rice containing 100% of the recommended daily folic acid allowance. For many women, however, the fortified foods in their diet isn't enough. To reach the recommended daily level, you may want a vitamin supplement.

During pregnancy, you require more of all of the essential nutrients than you did before you became pregnant - after all, you're growing another human! This does not mean you need double the calories, but you do need more nutrients and minerals. The best advice I've heard is to "eat to taste" - i.e. listen to what your body (and your baby) is telling you it needs. And then make smart choices to meet these needs.

Use the natural sugars in fruits or honey or pure maple syrup or milled flax, to satisfy cravings for sweets. Use seasoned vegetables and salt to taste when you are craving something salty. Try a locally-made, Stonyfeild, or other organic brand of natural yogurt or ice cream when you need something smooth and creamy. Munch on nuts and seeds and raw vegetables and fruits when you need the 'crunch'.

Prenatal vitamins should not replace a well-balanced diet - we get far more benefits from consuming whole foods in their natural forms, with their nutrient-rich vitamins and minerals, than we do from manufactured vitamins. However, taking prenatal vitamins can give your body - and, therefore, your baby - a cushion of protection of these essentials in case any are lacking from the foods you consume. Many health care providers now recommend taking a folic acid supplement in addition to your regular prenatal vitamin. Even if there are days (post-conception) where 'morning sickness' gets the best of you and the prenatal vitamins are too much to handle, a folic acid supplement is easier to pop. There is typically no problem in taking a prenatal vitamin every other day, or even every 3 days, with a folic acid supplement on the days in between.

One of the best folic acid supplements I've found for women who suffer with morning sickness (or anyone interested in an 'easy' folic acid tablet) is Trader Joe's dissolving B6/B12/Folic Acid, pictured above. These are tiny little tablets that dissolve quickly and effortlessly in your mouth. No swallowing necessary. Ubber quick, easy, and 'painless' - even on those days when your stomach tells you otherwise. If you have a Trader Joe's near you, check them out. Or, have a friend mail you a bottle - they are worth the $1.30 in postage and one small bottle contains enough for your first 100 days. Other whole foods and health stores likely offer a similar product - ask at Whole Foods, Heritage (VA Beach), Roots (Cedar Falls), or your local health supply vendor.

In addition to folic acid, research suggests that consuming adequate amounts of omega-3 (an essential fatty acid) is important to optimal pregnancy health and the development of baby (especially his brain!). While you are shopping around, grab a bottle of organic krill or fish oil capsules, or similar product, and some organic milled flax seed (to throw in and on everything you cook). Implement these items into your daily routine as well -- both before and after conception -- to ensure you are getting the omega-3 you and baby needs.


Note: Two recent meta-analysis studies related to the levels of Vitamin A in cod liver oil suggest that this particular form of omega-3 is not ideal (as I previously was in the habit of recommending and taking daily myself). Dr. Mercola, who also long-supported the use of cod liver oil for omega-3, discusses his revised recommendation here.


For additional information on measures you can take before pregnancy to ensure an optimally healthy conception, gestation, and baby, see Ogle's excellent book, Before Your Pregnancy: A 90 Day Guide for Couples on How to Prepare for a Healthy Conception.