Spina bifida and other NTDs form in the first month after conception, a time when some women are not even aware that they are pregnant. In addition to healthcare providers for women of childbearing age, The March of Dimes has long been trying to spread the word of how important taking prenatal vitamins and folic acid is prior to conceiving. However, since nearly half of all pregnancies are unplanned, many women are not on a folate supplement ahead of time. What should you do if this describes you? Start by taking a close look at your diet and talk with your healthcare provider about the best nutritional plan and necessary follow-up for your pregnancy.
Mention folic acid and most women think of prenatal vitamins, having learned of folate's importance in the diet during pregnancy. When breastfeeding, however, folic acid is still as important as ever. According to Dr. Diane Bales, an associate professor and human development specialist with the Cooperative Extension Service at the University of Georgia in Athens, women should not only take folic acid when trying to conceive, but also during pregnancy and into breastfeeding.
Because of its role in cell division and cell growth, folic acid is important during any period of rapid growth, such as gestation and infancy (and adolescence!). So nursing mothers are well advised to continue taking their prenatal vitamins.
Who Might Need Extra Folate?
Some women are at increased risk for having a baby with a neural tube defect compared to the general population. Those who have already had a child with NTD, or have had diabetes before pregnancy, epilepsy, or a family history of NTD, should take a higher dose of folic acid—up to 4,000 to 5,000 mcg.
Women with epilepsy need a higher dosage of folic acid because anti-seizure medicines interfere with the absorption of the nutrient. Women with diseases of the blood such as sickle-cell and thalassemia, or diseases relating to absorption of nutrients such as celiac, Crohn's disease, or diabetes may also call for an increased folic acid intake.