Summary

  • Folate reduces the risk of neural tube defects in babies.
  • Even women who aren’t planning to have a baby should increase their folate intake (if they are of childbearing age) because about half of all pregnancies are unplanned.
  • Using folate supplements is a good way to ensure adequate daily intake.
Folate (or ‘folic acid’ when added to food or taken as a supplement) is a B-group vitamin essential for the healthy development of the fetus in early pregnancy, in particular their neural tube.

Women of child-bearing age should take extra folate daily to prevent neural tube defects such as spina bifida. Even women who aren’t planning to have a baby should increase their folate intake because about half of all pregnancies in Australia are unplanned.

Folate taken before conception and during the first few weeks of pregnancy can prevent seven out of ten cases of neural tube defects. Over 600 pregnancies in Australia every year are affected by neural tube defects.

The neural tube

In the developing fetus, the neural tube will later become the baby’s brain, spinal cord and the bones that enclose them. If something goes wrong in their development, the result is called a neural tube defect. This can cause a wide range of disabilities such as loss of bladder and bowel control and paralysis of the legs. In some cases the effects can be more severe.

A baby’s neural tube is formed and closed in the first four to six weeks of pregnancy. By the time most women know or suspect they are pregnant, the time for the developing fetus to benefit from extra folate has passed.

Dietary folate

Most women don’t get enough folate from their diet. The recommended daily intake of folate for women is 400 micrograms (mcg) per day. It’s difficult to measure just how much folate you get from your diet because the vitamin is affected by how foods are cooked and stored.

Folate requirements increase substantially in pregnancy, so women should aim to consume at least 600 mcg of folate from their normal daily diet. In addition to eating foods that are rich in folate, if you are planning a pregnancy or are in the early stages of pregnancy (the first three months or ‘first trimester’) you should take a daily supplement containing 0.5 mg of folic acid.

If you are planning a pregnancy, it is recommended that you increase your daily intake of folate for at least one month prior to pregnancy.

Even women who aren’t planning to have a baby should increase their folate intake if they are sexually active, because around half of all pregnancies are unplanned.

Foods in Australia that are fortified with folic acid

Folic acid is the man-made form of folate that is added to lots of other foods that don’t have any folate. Since October 2009, all wheat flour used for bread making in Australia must contain folic acid. This means that most bread sold in Australia (except organic bread) is fortified with folic acid. This is in line with the Food Standards Australia New Zealand mandatory folic acid fortification standard. This standard was introduced to help reduce the number of neural tube defects.

Breakfast cereals and fruit juices for sale in Australia may also have added folic acid.

How to increase your folate intake

You can get enough folate if you:
  • Take folic acid supplements
  • Eat folate-rich foods – folate is present in a variety of vegetables (such as asparagus, spinach and broccoli) and fruits (such as oranges, bananas and strawberries) as well as legumes (such as chickpeas, dried beans and lentils), cereals, nuts and yeast extracts such as Vegemite
  • Choose foods that have been fortified with folic acid – this includes some breakfast cereals and fruit juices, and most bread.

Women at higher risk need more folate

Some women have a higher risk of having a baby with a neural tube defect. For these women dietary folate alone is not sufficient.

You are at greater risk if you (or your partner):
  • already have a baby with a neural tube defect
  • have a neural tube defect yourself
  • have a close relative affected by a neural tube defect
  • take medicine for epilepsy or seizures – some medications affect the absorption of folate
  • have type 1 diabetes – discuss folic acid supplements with your doctor.
If you are at higher risk you should take a higher dose (5 mg) of folate each day. This is 10 times higher than that recommended for women with a low risk. These high doses should be taken under medical supervision.

Where to get help

  • Your doctor
  • Family planning clinic
  • Family Planning Victoria Tel. 1800 013 952 or (03) 9257 0100 – for information about folate and neural tube defects
  • Dietitians Association of Australia Tel. 1800 812 942
  • Pharmacist
  • Community health centre

Things to remember

  • Folate reduces the risk of neural tube defects in babies.
  • Even women who aren’t planning to have a baby should increase their folate intake (if they are of childbearing age) because about half of all pregnancies are unplanned.
Using folic acid supplements is a good way to ensure adequate daily intake.
  • Healthy eating for pregnancy, 2012, The Royal Women’s Hospital. More information here.
  • Mandatory folic acid fortification in Australia, 2012, Food Standards Australia New Zealand. More information here.
  • Pregnancy, Dietitians Association of Australia. More information here.
  • Nutrient reference values for Australia and New Zealand, National Health and Medical Research Council, Australian Government. More information here.
  • Australian dietary guidelines, 2013, National Health and Medical Research Council, Australia. More information here.
  • Mandatory folic acid and iodine fortification in Australia and New Zealand: baseline report for monitoring, 2011, Australian Institute of Health and Welfare, Australian Government. More information here.

More information

Healthy pregnancy

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Keeping healthy during pregnancy

Health concerns during pregnancy

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This page has been produced in consultation with and approved by: Royal Women's Hospital

Last updated: September 2015

Content on this website is provided for education and information purposes only. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your doctor or other registered health professional. Content has been prepared for Victorian residents and wider Australian audiences, and was accurate at the time of publication. Readers should note that, over time, currency and completeness of the information may change. All users are urged to always seek advice from a registered health care professional for diagnosis and answers to their medical questions.