Top Pregnancy Nutrient: Folate

Getting enough of this B vitamin is more crucial than ever in preventing birth defects and prematurity. Here's what you need to know to give your baby the best start.


You want to do it all perfectly to make sure that your baby will be healthy. But you might be lacking in one of the most crucial pregnancy nutrients: folate. Even though we now have proof that this B vitamin is key in preventing serious birth defects and preterm birth, recent research shows that consumption is on the decline.

Back in 1998, prompted by the pioneering work of British researcher Nicholas Wald, who linked folate consumption to a reduction in neural-tube defects (NTDs), including spina bifida and anencephaly, the U.S. Food and Drug Administration ordered cereal manufacturers to fortify their products with folic acid (the synthetic form of folate, found in supplements and fortified foods). The result was a boon for pregnant women: a 43 percent reduction in the number of babies born with crippling NTDs.

Unfortunately, recent research shows a drop in folic acid intake. "The study authors speculate that the decrease may be due to the decline in the consumption of [fortified] flour, which could be driven by low-carb diets," explains Jean Lawrence, Sc.D., M.P.H., an epidemiologist at Kaiser Permanente's Department of Research and Evaluation in Pasadena, Calif. Because of this trend, the risk of NTDs may have rebounded by 4 percent to 7 percent since the initial post-fortification decrease.

Preventing Serious Birth Defects

Spina bifida ("open spine") can cause lifelong disabilities, including loss of bowel control and lower-body paralysis. Babies with anencephaly, in which part or all of the brain is missing, die before or shortly after birth. By getting adequate folate or folic acid daily, before and during pregnancy, you can reduce your baby's risk for NTDs by 70 percent!

Recent research also has found that getting the recommended amount of folate cuts a baby's risk of being born with a cleft lip or cleft palate by one-third. But perhaps the most intriguing new science, involves folate and preterm-birth prevention. In a new unpublished study of 38,000 women sponsored by the National Institutes of Health, folate supplementation for at least one year before conception was linked to a 70 percent decrease in very early preterm deliveries—20 to 28 weeks—and a 50 percent decline in deliveries at 28 to 32 weeks. Additionally, new research has shown that folic acid taken early in pregnancy can reduce the risk of preeclampsia, a potentially life-threatening blood pressure disorder.

It's vital for other reasons as well. "Folic acid helps maintain and produce new cells," says Dawn Jackson Blatner, R.D., national media spokeswoman for the American Dietetic Association. Every cell of your growing baby's body requires it. You need it, too, Mom: producing enough red blood cells to prevent anemia—a common problem during pregnancy—is dependent on your getting enough folate.

Start Taking It NOW

For folate to confer the greatest benefits, you need to supplement before conceiving. Birth defects of the spine and brain occur in the first weeks of pregnancy; often, this is before a woman even realizes she's pregnant.

Because 50 percent of pregnancies are unplanned, the current Institute of Medicine recommendation is that all women capable of becoming pregnant get 400 micrograms of folic acid from supplements or fortified foods in addition to their intake of folate from a varied diet. If you are already expecting, getting the folate you need is still important. In fact, once pregnancy is confirmed, the IOM- recommended intake for supplementation jumps to 600 micrograms. Most prenatal vitamins contain 800-1,000 micrograms, which will cover your folic acid needs. But you also need to eat foods like fortified cereals, beans and leafy greens (see box at below). "Folate is better absorbed by your body from food," explains Blatner.

Best Foods For Folate

It's better to get folate from food. Here's how much of your daily value is in each serving.

-Fortified cereals (¾ cup) 400 micrograms 100% -Black-eyed peas (½ cup) 105 micrograms 25% -Frozen spinach (½ cup) 100 micrograms 25% -Asparagus 4 spears 85 micrograms 21% -Enriched egg noodles (½ cup) 50 micrograms 13% -Fortified wheat bread (2 slices) 50 micrograms 13% -Peanuts (1 ounce) 40 micrograms 10% -Orange juice (¾ cup) 35 micrograms 9% -Banana (1 banana) 20 micrograms 5%