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| Folic Acid
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Frequently Asked Questions (FAQs)
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The purpose of these questions and answers is
to educate women of childbearing age on the importance of
consuming 400 micrograms of folic acid every day. Folic acid
can help reduce the risk of spina bifida by up to 70%. |
Q: What are
neural tube defects (NTDs)?
Neural tube defects (NTDs) are major birth defects
of a baby’s brain or spine. They happen when the neural tube (that later
turns into the brain and spine) doesn’t form right, and the baby’s brain
or spine is damaged. This happens within the first few weeks a woman is
pregnant, often before a woman knows that she is pregnant.
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The two most common NTDs are spina bifida (spi-na
bif-a-da) and anencephaly (an-en-sef-a-lee). These birth defects can
cause lifelong disability or death.
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Many NTDs (up to 70%) can be prevented by getting
enough of the B vitamin folic acid every day, starting before a
woman gets pregnant.
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Q: What are
spina bifida and anencephaly?
Spina bifida (spi-na bif-a-da) and anencephaly
(an-en-sef-a-lee) are two common types of NTDs. About 3,000 pregnancies
in the United States are affected by spina bifida or anencephaly each
year. Many of these defects could be prevented if all women got enough
of the B vitamin folic acid every day starting before they get
pregnant.
Spina bifida occurs when the
spine and back bones do not close all the way. When this happens, the
spinal cord and back bones do not form as they should. A sac of fluid
comes through an opening in the baby’s back. Much of the time, part of
the spinal cord is in this sac and it is damaged. Most children born
with spina bifida live full lives, but they often have lifelong
disabilities and need many surgeries.
Some of their problems include:
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Not being able to move lower parts of
their body. (Some might need to use crutches, braces, or wheelchairs
to get around.)
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Loss of bowel and bladder control.
(Some might have to wear protective clothing. Others learn new ways to
empty their bladders and bowels.)
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Fluid building up and putting
pressure on the brain (hydrocephalus), which needs to be fixed with an
operation
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Learning disabilities.
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Allergy to latex (a created material
found in some rubber-type products such as balloons or hospital
gloves).
Children born with spina bifida don’t
all have the same needs. Some children’s problems are much more severe
than others. Even so, with the right care, most of these children will
grow up to lead full and productive lives.
 Anencephaly occurs when the
brain and skull bones do not form right. When this happens, part or all
of the brain and skull bones might be missing. Babies with this defect
die before birth (miscarriage) or shortly after birth.
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Q:
Who can have a baby with a neural tube defect in the United States?
Any woman in the United States can have a baby with
an NTD. If a woman can get pregnant, she is at risk for having an NTD-affected
pregnancy. No one can predict which women will have a pregnancy affected
by an NTD. All women are at risk.
Some things can increase a woman’s chance of having a baby with an NTD:
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Previous NTD-affected pregnancy.
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Diabetes when the blood sugar is out of control.
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Some medicines (like some of those that treat
epilepsy).
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Obesity.
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High temperatures in early pregnancy (such as
fever that lasts a while, or using hot tubs and saunas).
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Hispanic ethnicity (Hispanic women tend to have
more babies affected by NTDs).
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Q: What are
the costs linked with NTDs?
The average cost of caring for a child born with
spina bifida for life is about $636,000.00 per child. This is only an
average cost, and for many families the total cost might be well above
$1,000,000. And it’s not just the money. The physical and emotional
tolls upon the families affected are high as well. That’s why it’s so
important that women take folic acid every day to help prevent these
birth defects.
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Q:
What is folic acid and where can I get it?
Folic acid is a B vitamin that the body
needs to make healthy new cells. If a woman has enough folic acid in her
body before and during pregnancy, her baby is less likely to have an NTD.
Women need to take folic acid every day, starting before they get
pregnant.
Every woman who could possibly get pregnant should take 400 micrograms
(400 mcg or 0.4 mg) of folic acid daily in a vitamin or in foods that
have been enriched with folic acid.
There are two simple ways to be sure to get enough each day:
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Take one vitamin with folic acid each
day. Most multivitamins (MUL-tee-VI-ta-mins) sold in the United States
have the amount of folic acid women need each day. Women can also
choose to take a small pill that has only folic acid in it each day.
Both types of vitamins can be found at most local pharmacy, grocery,
or discount stores.
OR
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Eat a bowl of a
breakfast cereal that has 100% of the daily value (DV) of folic
acid per serving every day. Total, Product 19, Cheerios Plus,
Special K Plus, Life, and Smart Start are some examples. The label
on the side of the box should say “100%” next to folic acid.
Along with taking a vitamin or eating a
cereal that has 100% DV of folic acid, women should always eat a healthy
diet that has lots of fresh fruits and vegetables and other healthy
foods.
Scientists don’t know how folic acid works to prevent birth defects. But
they do know that folic acid is needed to make healthy new cells, like
the ones that make up a baby’s brain and spine. Taking folic acid every
day, starting before and during pregnancy, can reduce the risk for these
serious birth defects by 50% to 70%.
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Q: Are women
getting enough folic acid?
Most women in the United States do not get enough
folic acid to help prevent birth defects. The average woman gets less
than the amount needed from her diet alone. That’s why all women who can
get pregnant are urged to take a vitamin with folic acid or eat a
serving of fully fortified breakfast cereal each day.
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Q: Can women
get too much folic acid?
It’s unlikely that women will be hurt from getting
too much folic acid. We don’t know of an amount that is dangerous. Yet,
for most women, consuming more than 1,000 mcg of folic acid daily is of
no benefit. Unless their doctor advises them to take more, most women
should limit the amount they take to 1,000 mcg a day.
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Q: Why can’t I wait until I’m
pregnant—or planning to get pregnant to start taking folic acid?
Birth defects of the brain and spine happen in the
first few weeks of pregnancy, often before a woman finds out she is
pregnant. By the time she realizes she is pregnant, it might be too late
to prevent those birth defects. Also, half of all pregnancies in the
United States are unplanned. These are two reasons why it is important
for all women who can get pregnant to be sure to get 400 mcg folic acid
every day, even if they aren’t planning a pregnancy any time soon.
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Q: I can’t swallow large pills.
How can I take a vitamin with folic acid?
A woman can get her vitamin with folic acid in one of several ways. She
can take a multivitamin or a small single supplement of folic acid.
These days, multivitamins with folic acid come in chewable chocolate or
fruit flavors, liquids, and large oval or smaller round pills. A single
serving of many breakfast cereals also has the
amount of folic acid that a woman needs each day. Check the label! Look
for cereals that have 100% daily value (DV) of folic acid in a serving.
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Q: Vitamins cost too much.
How can I get the vitamin with folic acid that I need?
Many stores offer a single folic acid supplement for just pennies a day.
Another good choice is a store brand multivitamin, which includes more
of the vitamins a woman needs each day. Unless her doctor suggests a
special type, she does not have to choose among vitamins for women or
active people, or even one to go with a low carbohydrate diet. A basic
multivitamin meets the needs of most women.
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Q: How can I remember to take
a vitamin with folic acid every day?
A woman may combine taking her vitamin with another habit. Taking a
vitamin when she brushes her teeth, has her breakfast, finishes her
shower, or brushes her hair may make it easier to remember. Seeing the
vitamin bottle on the bathroom or kitchen counter could help her
remember it. She might even take a vitamin when her children take
theirs. That sets a good example!
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Q: Are
there other health benefits of taking folic acid?
Folic acid might help to prevent some other birth
defects, such as cleft lip and palate and some heart defects. There
might also be other health benefits of taking folic acid for both women
and men. More research is needed to confirm these other health benefits.
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Date:
January 30, 2008
Content source: National Center on Birth Defects and Developmental
Disabilities
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