Folic acid is a B vitamin found in many supplements and fortified foods. It’s the synthetic form of folate. Folic acid is used by your body to make new cells and produce DNA. It’s required for normal growth and development throughout your life.

Taking folic acid is particularly vital before and during pregnancy. It’s important for the proper organ development of a developing baby.

Research shows that taking folic acid before you get pregnant may help prevent birth defects including serious neural tube defects such as spinal bifida, encephalocele (rarely), and anencephaly.

Approximately 3,000 babies are born with neural tube defects in the United States each year. Normally, the neural tube develops into the spinal cord and brain by 28 weeks after conception.

If the neural tube doesn’t close properly, neural tube defects occur. Anencephaly is a condition in which the brain doesn’t develop properly. Babies born with anencephaly cannot survive. Babies born with spinal bifida or encephalocele may face multiple surgeries, paralysis, and long-term disability.

According to a 2015 meta-analysis, maternal folic acid supplementation significantly decreases the risk of congenital heart defects. These defects occur in 8 out of every 1,000 births in the United States each year. According to the American Heart Association, they happen when the heart or blood vessels don’t grow normally before birth. They may impact the interior walls of the heart, the heart valves, or the arteries and veins of the heart.

Research also shows folic acid supplementation in early pregnancy may help prevent cleft lip and cleft palate. These birth defects occur if parts of the mouth and lip do not merge together properly during the first six to 10 weeks of pregnancy. One or more surgeries are usually needed to correct the condition.

All pregnant women should take at least 400 micrograms (mcg) of folic acid daily. Many pre-natal vitamins contain 600 mcg of folic acid.

Taking folic acid after you discover you’re pregnant may not be soon enough. Many women don’t realize they’re pregnant until six weeks or more after conception. Neural tube defects occur during the first month of pregnancy, often before you realize you’re pregnant.

To make sure you have enough folic acid in your body to prevent neural tube defects, the CDC recommends women who plan to become pregnant or who are of childbearing age take 400 mcg of folic acid daily.

If you’ve already given birth to a child with a neural tube defect, you may need higher doses of folic acid in the months leading up to your next pregnancy and during the first few months of pregnancy. Your doctor can advise you on the right dose.

You may also need higher doses of folic acid if you:

  • have kidney disease and are on dialysis
  • have sickle cell disease
  • have liver disease
  • drink more than one alcoholic beverage daily
  • take medications to treat epilepsy, type 2 diabetes, lupus, psoriasis, rheumatoid arthritis, asthma, or inflammatory bowel disease

Natural folate is found in many foods including leafy greens, beets, and broccoli. Some foods in the United States are fortified with folic acid. These include:

  • cereals
  • rice
  • orange juice
  • pasta

Many servings of fortified breakfast cereals contain 100 percent of the folic acid you need. Even so, it may be hard to know exactly how much you’re getting unless you track the amounts of folate and folic acid in everything you eat. There’s no guarantee that you will get enough folic acid from food alone, so a supplement is important.

If you have morning sickness in early pregnancy, it may be difficult to eat enough fortified foods to get the folic acid you need. To make sure you get enough folic acid, doctors will usually recommend taking a folic acid supplement or a prenatal vitamin which contains folic acid before and during pregnancy.

You can’t get too much natural folate from foods. However, you should not consume more than 1,000 mcg (1 mg) of folic acid (from vitamins, fortified foods, or a combination of both) daily.

There’s no way to prevent all birth defects with 100 percent certainty. Taking adequate amounts of folic acid before and during pregnancy may help decrease your risk of:

  • neural tube defects
  • congenital heart defects
  • cleft palate
  • cleft lip

If pregnancy is in your future, consider adding a prenatal vitamin to your daily routine. Prenatal vitamins are available in capsule, tablet, and chewable forms. To avoid stomach upset, take prenatal vitamins with food. Always talk to your doctor about taking the correct dose of prenatal vitamin because taking too many supplements can be toxic for your baby-to-be.

You should also add foods fortified with folic acid to your diet. Don’t wait until you find out you’re pregnant to get serious about folic acid. By then, it may be too late. Talk to your doctor to determine the right amount of folic acid you’ll need.