Facts About Folic Acid

CDC urges women to take 400 mcg of folic acid every day, starting at least three months before getting pregnant, to help prevent major birth defects of the baby's brain and spine.

About folic acid

Folic acid is a B vitamin. Our bodies use it to make new cells. Everyone needs folic acid.

Why folic acid is so important

Folic acid is very important because it can help prevent major birth defects of the baby's brain and spine (spina bifida and anencephaly) by 50% to 70%.

How much folic acid a woman needs

400 micrograms (mcg) every day.

When to start taking folic acid

For folic acid to help prevent major birth defects, a woman needs to start taking it at least three months before she becomes pregnant and while she is pregnant.

However, every woman needs folic acid every day, whether she’s planning to get pregnant or not, for the healthy new cells the body makes daily. Think about the skin, hair, and nails. These – and other parts of the body – make new cells each day.

How a woman can get enough folic acid

                                                           

There are two easy ways to be sure to get enough folic acid each day:

1. Take a vitamin that has folic acid in it every day.
   
   Most multivitamins sold in the United States have the amount of folic acid women need each day. Women can also choose to take a small pill (supplement) that has only folic acid in it each day.
   
   Multivitamins and folic acid pills can be found at most local pharmacy, grocery, or discount stores. Check the label to be sure it contains 100% of the daily value (DV) of folic acid, which is 400 micrograms (mcg).
2. Eat a bowl of breakfast cereal that has 100% of the daily value of folic acid every day.
   
   Not every cereal has this amount. Check the label on the side of the box, and look for one that has “100%” next to folic acid.
   

Birth Defects

Birth defects affect about one in every 33 babies born in the United States each year. They are the leading cause of infant deaths, accounting for more than 20% of all infant deaths. Babies born with birth defects have a greater chance of illness and long term disability than babies without birth defects.

In early 1998, Congress passed the Birth Defects Prevention Act of 1998, which became Public Law 105-168. This bill authorized CDC to (1) collect, analyze, and make available data on birth defects; (2) operate regional centers for applied epidemiologic research on the prevention of birth defects; and (3) inform and educate the public about the prevention of birth defects.

Spina Bifida

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Spina bifida is the most common birth defect in the United States. It is a type of neural tube defect (NTD). The neural tube is a narrow channel that folds and closes during the third and fourth weeks of pregnancy to form the brain and spinal cord. Spina bifida happens if the portion of the neural tube that forms the spinal cord does not close completely during the first month of pregnancy.

What We Know About Spina Bifida

• How often does spina bifida occur?
• What problems do children with spina bifida have?

How often does spina bifida occur?

CDC estimates that each year about 1,500 babies in the United States are born with spina bifida (1).  In other words, about 1 of every 2,500 babies born in the United States each year will have spina bifida.

What problems do people with spina bifida have?

Spina bifida can cause physical, as well as learning disabilities. The severity of the problem depends on the size and location of the defect, whether skin covers the affected area(s), and whether spinal nerves come out of the affected area. 

Physical problems might include the following:

• Difficulty controlling bowel and bladder functions.
• Partial or complete loss of strength of the legs (paralysis).
• People with spina bifida might need crutches, braces, or wheelchairs to help them get around, depending on the size of the opening and the care received after birth.
• Babies born with spina bifida might experience buildup of fluid in the brain, a condition known as hydrocephalus.
• Some babies might develop meningitis, an infection in the tissues surrounding the brain. Meningitis can cause brain injury and can be life-threatening.

Long-term outcomes for children with spina bifida are poorest for those with complete paralysis, hydrocephalus, and additional birth defects. With proper care, most children with spina bifida live well into adulthood.

Still, children with spina bifida might have learning disabilities later in life, including:

• Difficulty paying attention.
• Problems with language and reading.
• Trouble learning math.

What We Still Do Not Know About Spina Bifida

• What causes spina bifida?
• Can spina bifida be prevented?

What causes spina bifida?

While the cause of spina bifida is unknown, scientists believe that many factors are involved. 

We at CDC work with many other researchers to study risk factors that can increase the chance of having a baby with spina bifida. Following are examples of what our research has found:

• Hispanic babies are at an increased risk for spina bifida (2). 
• Mothers who are obese before they become pregnant are at a higher risk than mothers who are of average weight for having a baby with spina bifida (3). 
• ·There has been a 24% decline in babies born with spina bifida since the United States began fortifying grains with folic acid (4). 

Can spina bifida be prevented?

Currently, there is no known way to prevent spina bifida, although steps can be taken to lower the risk.  Recent studies have shown that the addition of a B vitamin called folic acid to the diet of women who might become pregnant can greatly reduce the number of babies born with neural tube defects.  CDC recommends that all women of childbearing age consume 400 micrograms of folic acid daily.  A single daily serving of most multivitamins and fortified cereals contain 400 micrograms of folic acid. 

In addition, mothers can take steps before and during pregnancy to be healthy, including not smoking and not drinking alcohol during pregnancy. 

Anencephaly

Anencephaly is a birth defect that affects the closing of the neural tube during pregnancy. The neural tube is a narrow channel that folds and closes during the third and fourth weeks of pregnancy to form the brain and spinal cord. Anencephaly occurs when the portion of the neural tube that forms the brain does not close. This results in the baby lacking parts of the brain, skull, and scalp. Babies with this condition often are born without a forebrain (the front part of the brain) and a cerebrum (the thinking and coordinating part of the brain). The remaining brain tissue is often exposed; that is, it is not covered by bone or skin.

What We Know About Anencephaly

• How often does anencephaly occur?
• What problems do children with anencephaly have?

How often does anencephaly occur?

CDC estimates that each year about 1,000 babies in the United States will be born with anencephaly (1). In other words, about 1 in every 4,000 babies born in the United States will have anencephaly.

What problems do children with anencephaly have?

Unfortunately, almost all babies born with anencephaly will die. Babies born with anencephaly are usually blind, deaf, unconscious, and unable to feel pain. Various studies have shown the survival of infants with anencephaly to be almost impossible. A 2001 study found that, among a group of infants in Texas, all of those with anencephaly died before 1 year of age (2).

What We Still Do Not Know About Anencephaly

• What causes anencephaly?
• Can anencephaly be prevented?

What causes anencephaly?
The cause of anencephaly is unknown. Scientists believe that many factors are involved.
We at CDC work with many researchers to study risk factors that can increase the chance of having a baby with anencephaly. Following are examples of what our research has found:

• Hispanic babies are at an increased risk for anencephaly (3).
• We have found a 21% decline in the birth rate of babies born with anencephaly since the United States began fortifying grains with folic acid (4).

Can anencephaly be prevented?
Currently, there is no known way to prevent anencephaly, although steps can be taken to lower the risk. Recent studies have shown that the addition of a B vitamin called folic acid to the diet of women who might become pregnant can greatly reduce the number of babies born with neural tube defects. CDC recommends that all women of childbearing age consume 400 micrograms of folic acid daily. A single serving size of most multivitamins and fortified cereals contains 400 micrograms of folic acid.

In addition, women can take steps before and during pregnancy to be healthy, including not smoking and not drinking alcohol during pregnancy.

Cereals that Contain 100% of the Daily Value of Folic Acid

A single serving of many breakfast cereals has the amount of folic acid that a woman needs each day. The following cereals contain 100% of the DV of folic acid per serving size.  Please look at nutrition label on the side of the cereal box for the serving size.

General Mills

General Mills Total®

Kashi® Heart to Heart

Kellogg’s®

Quaker® Oats