What is folate and folic acid?

Folate is a B group vitamin needed for healthy growth and development. It is known as ‘folate’ when it is found naturally in food, such as leafy green vegetables, fruits and legumes. ‘Folic acid’ is the synthetic form of folate and is added to food, such as bread and breakfast cereals, or used in dietary supplements.

Why is folate important for pregnancy?

Folate and folic acid are important for pregnancy because they can help prevent birth defects known as neural tube defect, such as spina bifida.

Spina bifida is one of the most common birth defects. It occurs in the first weeks of pregnancy, when the brain and spinal cord are forming.

Most cases of neural tube defects can be prevented if you have enough folate before and during early pregnancy.

You can get enough folate by eating folate-rich foods and taking a supplement.

Which foods contain folate?

Many foods are naturally rich in folate, but folate dissolves in water and is easily destroyed by cooking. It is best to lightly cook vegetables or eat them raw. Microwave or steam cooking is best.

The following are good sources of natural folate:

• vegetables (broccoli, brussels sprouts, cabbage, cauliflower, English spinach, green beans, lettuce, mushrooms, parsnip, sweet corn, zucchini)
• fruit (avocado, grapefruit, oranges, berries, bananas)
• legumes (chickpeas, soya beans, lima beans, red kidney beans, lentils, haricot beans)
• eggs
• nuts
• juices (many apple and orange juices)
• Vegemite

In Australia, all flour used for making bread (except organic bread), rolls, bagels, English muffins and flat breads made with yeast must contain folic acid. It can also be found in some breakfast cereals.

Three slices of bread (100g) contains an average of 120 micrograms of folic acid.

You can check the food label of any bread product made in Australia to check if it contains folic acid (sometimes listed as folate) in the ingredients.

When should I start taking folic acid supplements?

Folic acid supplements are available in Australia over the counter from pharmacies and supermarkets, and through your doctor at varying doses. Some women need more folate than others. Talk to your doctor about what dose of folic acid is right for you.

Generally, when trying to get pregnant or in the early months of pregnancy, you will need to look for supplements that contain at least 400 micrograms of folic acid. These will generally be supplements that contain only folic acid or special pregnancy supplements. Although many multivitamins targeted at pregnant women may contain folic acid, it’s important to check you are getting the recommended dose.

The best way to guarantee you get enough folic acid is to take a daily folic acid supplement at least 1 month before and until 3 months after conception. You don’t need to take folic acid supplements after that.

How will I know if I need a high dose of folic acid?

Some women have an increased risk of having a pregnancy affected by a neural tube defect and are advised to take a higher dose (5mg) of folic acid each day until they are 12 weeks pregnant. Women have an increased risk if:

• they or their partner have a neural tube defect
• they or their partner have a family history of neural tube defects
• they have had a previous pregnancy affected by a neural tube defect
• they have diabetes
• they have a body mass index (BMI) greater than 30
• they have a risk of not absorbing nutrients well

In addition, women who are taking anti-epileptic medication should consult their doctor for advice because they may also need to take a higher dose of folic acid.

If any of the above apply to you, talk to your doctor since they can prescribe a higher dose of folic acid. Your doctor or midwife may also recommend additional screening tests during your pregnancy.

Who can I talk to for more information and advice?

Speak to your doctor if you are planning a pregnancy or if you think you might be pregnant.