How many of you are taking a prenatal vitamin (or folic acid supplement) right now? How many of you, even in the slightest off-chance, could be pregnant? Then, this article is for you. The American Congress of Obstetricians and Gynecologists (ACOG) recommends that women begin taking at least 400 micrograms (mcg) of folic acid at least one month before they become pregnant and should increase to 600 mcg in the first trimester. Basically, in the early phases of development, your baby “steals” from your stores of folate to develop. If you aren’t replacing your stores, not only can you develop a deficiency, but your baby can too. In other words, you should start taking a prenatal vitamin at least 30 days before you have sex.
Folate is a huge deal because appropriate intake can reduce neural tube defects – a category of birth defects that affect the brain and spinal cord. Because this phase of development takes place during the first few weeks of pregnancy, a woman may not even realize she is pregnant before the damage is done. Almost 50% of US pregnancies are unplanned, so this crucial prenatal step may be overlooked. Folic acid – the form of folate added to vitamin supplements, as well as fortified and enriched foods – is so important that in the 90’s, it became mandatory for refined grain products to become fortified with it.
Recently, a study has been published stating that in addition to the known effects of supplementation with folic acid, it may also decrease the chance that a baby is born small for gestational age (SGA). An infant is considered SGA if they are in the lowest 10th percentile for weight compared to other babies the same age. This can be a huge risk for the baby and increase the chance of death within the first year (obviously, something we all want to avoid). The fewest small babies were born to the women who had the highest intake of folic acid before becoming pregnant and the largest number of small babies had moms who had no supplementation.
The researchers saw a trend between the two variables: “folic acid supplementation” and “babies small for their age”. This trend had a negative correlation, meaning that the women who had the most folic acid had the least occurrence of a small baby. However, the first rule of research is: CORRELATION IS NOT CAUSATION. It may be that the moms who took the vitamins also had some other behavior, social similarity, or genetic trait in common and the ones who did not supplement did not have these specific behaviors/similarities/traits. Also, there were still moms in the study who took a prenatal vitamin before conception and still had a small baby, so this is not saying that it is 100% effective for preventing SGA babies.
How Does This Apply to Me?
My daughter was born small for gestational age. Right on her due date – the beginning of one of the coldest winters on record (trust me, not fun) – she weighted 5 pounds, 7 ounces – just one ounce away from being considered “normal”. I did take a prenatal vitamin before I became pregnant with her, so, as mentioned above, folic acid supplementation is not a 100% guarantee of getting a healthy-sized baby, but it can help reduce the chance of delivering a small one. This, combined with the already known health benefits of folic acid, makes supplementation a win-win.
Folate gets it’s name from “foliage”, so it’s no surprise that green-leafy veggies, like spinach and broccoli, are near the top of the list! Citrus fruits and juices rank pretty high as well. Other foods include: lentils, chickpeas, lima beans, and enriched pasta, cereals, and breads (be sure to check the labels for exact nutrition information).