Essential Vitamins & Minerals /

Folate

01 In Brief

Folate is essential for the healthy development of your baby, particularly in the early weeks of pregnancy when your baby is growing rapidly. Folate is a B group vitamin which occurs naturally in food, such as green leafy vegetables, although a supplement is also recommended during pregnancy. A daily supplement of 400 micrograms (mcg) of folic acid taken one month before and three months after conception helps prevent Neural Tube Defects (NTDs). These are serious developmental abnormalities such as Spina Bifida.

 

02 What Do I Need To Know?

FOOD SOURCES OF FOLATE 

  • Rich sources of folate include: green leafy vegetables, asparagus, broccoli, brussel sprouts, spinach, chickpeas, some nuts and dried beans and peas.
  • Very good sources of folate include: cabbage, cauliflower, oranges, orange juice, parsley, leeks, peas, wheat germ and wholegrain bread.
  • Good sources of folate include parsnips, potatoes, salmon, strawberries, tomatoes, unsalted peanuts, hazelnuts and walnuts. 
  • Liver is high in folate but should be limited because of its high Vitamin A content. Vitamin A is associated with an increase in birth defects such as malformations of the face, head, heart and nervous system. Find out more at Flourish Vitamin A in pregnancy.
  • When folate is artificially added to food it is known as folic acid. 
  •  In Australia, in September 2009 it became a legal requirement that all bread-making flour (with the exception of organic flour) contain added folic acid. Three slices of bread contain 120mcg of folic acid. Current scientific evidence supports that folic acid added to bread is safe for everyone.
  • Remember that folate in fruit and vegetables is easily destroyed by cooking and prolonged storage. Eat fruit and vegetables that are fresh, raw or only lightly cooked.

 

 

NEURAL TUBE DEFECTS

  • Folate is required for optimal neurological development of your baby. Deficiency increases the chances of developing Neural Tube Defects (NTDs) such as Spina Bifida, Encepaholocele and Anencephaly. 
  • NTDs develop early in pregnancy and are serious abnormalities. Less than 40 per cent of babies affected in utero survive to birth. Those which do survive are permanently disabled. The degree of disability depends on whereabouts the lesion is located in the spinal cord, the extent of the defect and the type of nerve cells affected. For example, a Spina Bifida that is in the lower back is less disabling than one in the thoracic or back of chest region - the higher up the spinal cord, the worse the disability. For further information see reference articles in the I want to know more section, below.

 


PREVENTION OF NEURAL TUBE DEFECTS

  • Adequate intake of folate in the month before conception and in the peri- conceptual period (around or about the time of conception) reduces the chance of NTDs by up to 70 per cent.
  • Many women of child-bearing age are folate deficient, and 40 per cent of pregnancies are unplanned.
  • It is recommended that women who are planning, or are in the early stages of pregnancy, take an additional 400mcg per day until week 12 of pregnancy. 
  • Folic acid supplements are available over the counter and should be at least 400mcg per tablet. They should be taken either as a folic acid only supplement or as part of your pregnancy supplement. There is usually insufficient folic acid in standard non-pregnancy multivitamins. Pregnancy-specific supplements contain the right balance of vitamins and minerals. Don't be tempted to cheat by increasing the dose of your standard multivitamins in order to get sufficient folic acid, as an excessive amount of other vitamins, such as Vitamin A, may harm the baby.
  • You are at higher risk of having an NTD-affected pregnancy if you have a past or family history of NTDs or if you are taking anticonvulsants for epilepsy, such as Dilantin, Phenytoin or Primidone. Women at high risk of an NTD affected pregnancy will need to take a much higher dose of folic acid. An additional 5 milligrams (mg) per day is recommended but you should discuss this with your doctor.
  • Vitamin B12 deficiency causes anaemia and also serious neurological problems in infants. Folic acid intake of more than 1mg a day can mask a B12 deficiency, so your doctor may want to check your B12 levels first, particularly if you are following a vegetarian diet. Vegetarians and vegans in particular are often deficient in Vitamin B12. Find out more at Flourish Vitamin B12 in pregnancy

 

03 What Others Say

  • Centre for Genetics Education NSW Health

Folate Pamphlet

  • Food Standards Australia and New Zealand: Information on Folate in pregnancy and mandatory fortification

 Food Standards Australia New Zealand : Folic Acid and pregnancy and mandatory folic acid fortification   


Food Standards Australia and New Zealand mandatory Folic Acid fortification

04 I Want To Know More

  • Download the EVM report from the Expert Group on Vitamins and Minerals for evidence-based information

UK food standards evidence-based reports Folic Acid

  • NSW Centre for Genetics Education: excellent fact 

Neural Tube defects -Spina Bifida and Anencephaly

 

05 Clinicians Tools and Resources

  • National Institute of Health USA government website provides a detailed table of the folate content of food as well as an in-depth discussion

NIH Fact sheet Folate content of food 

The information published here has been reviewed by Flourish Paediatrics and represents the available published literature at the time of review.
The information is not intended to take the place of medical advice.
Please seek advice from a qualified healthcare professional.
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Last updated: 12/07/2011 by Dr Elizabeth Hallam/Claire Galea*