This sheet is about exposure to folic acid in pregnancy and while breastfeeding. This information should not take the place of medical care and advice from your healthcare provider.
What is folic acid?
Folic acid is available as a nutritional supplement. It is the lab-made form of the vitamin folate (vitamin B9). Folate is necessary for making and maintaining healthy cells in the body.
Many foods contain folate. These foods include dark leafy greens, asparagus, broccoli, avocado, beans, carrots, squash, nuts and citrus fruits. Folic acid is added to some foods to increase their nutritional value. In the United States, folic acid is added to cereal, wheat flour, corn meal, rice, and many types of bread and pasta. Many other countries also supplement wheat and maize flour with folic acid.
Taking a folic acid supplement before and during pregnancy can lower the chance of certain types of birth defects. The body has an easier time absorbing folic acid than folate.
How much folic acid should I be taking?*
In general, it has been recommended to take 400 micrograms (mcg), or 0.4 milligrams (mg) of folic acid per day starting at least one month before a pregnancy. During pregnancy, the recommended daily amount is 600-800 mcg. Most people can get enough folic acid by eating foods with folate and by taking a folic acid supplement.
In addition to daily recommended levels for vitamins, there are also tolerable upper intake levels, abbreviated as “UL”. The UL is the highest level of daily nutrient intake recommended. Getting more than the UL of a vitamin might lead to negative health effects. The UL for folic acid / folate is 1,000 micrograms (mcg), or 1 milligram (mg) per day.
The amount that is right for you might be different if you have a family history of neural tube defects or if you have certain medical conditions. For example, taking some medications or drinking large amounts of alcohol can lower the amount of folic acid in the body. Diseases of the intestines can interfere with folic acid use by the body. Ask your healthcare provider if any medications that you take or other conditions that you have can affect the amount of folic acid in your body. They can talk with you about how much folic acid is right for you.
I take folic acid. Can it make it harder for me to get pregnant?
Based on the studies reviewed, folic acid is not expected to make it harder to get pregnant. It has been recommended to take a daily supplement of folic acid at least one month before getting pregnant.
Does taking folic acid increase the chance for miscarriage?
Miscarriage can occur in any pregnancy. Based on the studies reviewed, folic acid is not expected to increase the chance for miscarriage. Some studies suggest that folic acid might help to lower the chance of miscarriage.
Does taking folic acid increase the chance of birth defects?
Every pregnancy starts out with a 3-5% chance of having a birth defect. This is called the background risk. Taking folic acid before and during pregnancy lowers the chance of a baby having a birth defect of the brain and spinal cord known as a neural tube defect. Taking folic acid might also lower the chance of other birth defects.
Does taking folic acid in pregnancy increase the chance of other pregnancy-related problems?
Based on the studies reviewed, taking folic acid is not expected to cause other pregnancy-related problems, such as preterm delivery (birth before week 37) or low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth). Some studies suggest that taking folic acid might lower the chance of some pregnancy complications such as preterm delivery or getting high blood pressure during pregnancy.
Does taking folic acid in pregnancy affect future behavior or learning for the child?
Based on the studies reviewed, it is not known if folic acid increases the chance for behavior or learning issues for the child.
Breastfeeding while taking folic acid:
Folic acid is naturally found in the breast milk of people who are well-nourished. While breastfeeding, it is recommended to get 500 mcg (0.5 mg) of folic acid every day. Babies gets folic acid from breastmilk, so it is important that you have enough folic acid while breastfeeding. Talk to your healthcare provider about all of your breastfeeding questions.
If a male takes folic acid, could it affect fertility (ability to get partner pregnant) or increase the chance of birth defects?
Some studies have suggested that folic acid is needed to make healthy sperm. The recommended amount of folic acid for males is 400 mcg/day (0.4 mg/day). Most people get enough folate from their diet alone. If there is a concern about how much folic acid a person is getting, talk with a healthcare provider. In general, exposures that fathers or sperm donors have are unlikely to increase the risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.
Please click here for references.
OTIS/MotherToBaby encourages inclusive and person-centered language. While our name still contains a reference to mothers, we are updating our resources with more inclusive terms. Use of the term mother or maternal refers to a person who is pregnant. Use of the term father or paternal refers to a person who contributes sperm.
