Can Spina Bifida Be Prevented?

Folic acid, also called folate, is an important vitamin for the development of a healthy fetus. Although taking this vitamin cannot guarantee that a mother will have a healthy baby, most experts believe that it can help. Recent studies have shown that by adding folic acid to their diets, women of childbearing age greatly reduce the risk of having a child with a neural tube defect such as spina bifida. Research has demonstrated that if a woman takes 400 mcg (micrograms) of folic acid every day before and after she becomes pregnant, she reduces her risk of having a baby with spina bifida or another neural tube defect by as much as 70 percent. Foods that are naturally high in folic acid include dark green vegetables such as broccoli and spinach, egg yolks and citrus fruits. Many foods – including some breakfast cereals, enriched breads, flours, pastas, rice and other grain products – now have added folic acid, thanks to a ruling from the FDA (Food & Drug Administration). While it would be nice to think that eating a healthy diet including all these foods would guarantee an adequate supply of folic acid, the truth is that most people do not take in the recommended amount of folate from food alone. It also is true that our bodies do not absorb folate from food as well as they absorb synthetic folic acid. That is why supplements are necessary to prevent spina bifida. A lot of multivitamins contain the recommended dosage of folic acid.

How Much is Enough?

Because folic acid plays such a key part in the development of the spine and brain in early pregnancy, it must be taken in supplement form daily for at least one month before conception and then daily for at least for the first trimester of pregnancy. That is the critical period to prevent spina bifida. According to the Centers for Disease Control & Prevention (CDC), the Institute of Medicine, and the March of Dimes, many women do not even know that they are pregnant during this time. That is why those organizations recommend that all women of childbearing age take a daily supplement with 400 micrograms (mcg) of folic acid or consume breakfast cereals fortified with 100 percent recommended daily allowance (400 mcg) of folic acid per serving. Check package labels to be sure that you are getting the right amount. Bear in mind that folic acid may be listed as folate, which is the natural form of folic acid found in food.

Women who already have a child with spina bifida, have spina bifida themselves, or have already had a pregnancy affected by any neural tube defect have a greater chance than other women of having a child with spina bifida or another neural tube defect. These women may need to take high doses of folic acid before they become pregnant. Other women who may also require doses higher than 400 micrograms per day are those taking certain anti-seizure medications or women who have diabetes. For these women, the recommended daily dose of folic acid of 4,000 mcg (4 mg), starting one to three months before conception and continuing for the first trimester of pregnancy. This level of folate supplementation requires prescription so high risk women should seek guidance from a clinician before becoming pregnant.

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