Folic acid, iron and pregnancy
When you are pregnant, you can meet most of your nutritional needs by eating according to Canada's Food Guide. However, your diet alone cannot give you high enough levels of some nutrients. You will need to take a multivitamin that includes folic acid and iron. Make sure to take your multivitamin daily before and during pregnancy.
Your daily multivitamin needs to have 0.4 milligrams (mg) of folic acid and 16 to 20 mg of iron. Visit Health Canada for more information on nutrition guidelines for pregnant and breastfeeding women.
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Folic acid, or folate, is an important B vitamin for the health of your unborn baby. It helps to prevent certain malformations of the brain, skull and spine called neural tube defects. Neural tube defects include spina bifida and anencephaly.
It is important for all women who could become pregnant to take folic acid. You should take folic acid daily even if you are not pregnant or planning on becoming pregnant.
Neural tube defects happen in the first four weeks of pregnancy. You may not know you are pregnant when your baby is most at risk. Since pregnancy is often unplanned, taking a daily folic acid supplement is an important precaution.
How much folic acid do you need?
Your daily folic acid supplement can be part of a multivitamin. Make sure it contains 0.4 mg of folic acid along with vitamin B12 and iron. If you wish to increase or decrease your dose, speak to your health care provider first.
If you are planning to become pregnant, take folic acid for at least three months before pregnancy. During pregnancy, keep taking your daily folic acid supplement with iron.
If you were not taking folic acid when you became pregnant, start taking it as soon as possible. If you are already taking a folic acid supplement, talk to your health care provider before changing your daily dose.
Dietary sources of folate
Folate is the type of folic acid that you can get through your diet. Dietary sources of folate are part of a healthy pregnancy, along with a daily folic acid supplement.
Good sources of folate are dark green vegetables, corn, legumes (dried beans, peas and lentils), oranges and some grain products. Health Canada's prenatal nutrition guidelines provide a complete list of foods containing folate.
Risks for neural tube defects
If you take enough folic acid before and during pregnancy, you can reduce your risk of neural tube defects. Studies show that cases of neural tube defects could be cut by 50% if women were to take adequate folic acid.
To reduce the risk of neural tube defects:
- take folic acid for at least three months before pregnancy
- continue taking folic acid during pregnancy
- eat foods that are high in folate every day
When you are pregnant, iron is important to support the healthy growth of your baby. Vitamin C helps you absorb iron. Your growing baby needs to build up a store of iron to be healthy after birth and to reduce the chance of iron deficiency.
Make sure you take a daily multivitamin with 16 to 20 mg of iron. If you have a low level of iron or anemia before pregnancy, see your health care provider. You may need more than the recommended daily supplement of 16 to 20 mg.
Risks of low iron
Iron deficiency is the most common nutritional deficiency during pregnancy. It happens most often during the third trimester.
During pregnancy, you might have a low level of iron because:
- you need more iron than you did before you were pregnant
- your diet is low in iron-containing foods
- your diet may not have enough of the type of iron you can absorb easily
If you do not get enough iron when you are pregnant, you and your growing baby can both have health problems.
Low iron during pregnancy can cause:
- reduced work capacity
- cardiovascular stress
- lower resistance to infection
- iron deficiency--which can lead to anemia
Iron deficiency can cause serious risks for your baby, including:
- premature delivery
- low birth weight
- infant mortality
If you had low iron or anemia before pregnancy, see your health care provider about your needs. Your health care provider will assess how much extra iron you need from supplements.
Dietary sources of iron
When you are pregnant, you can get a lot of your iron from healthy foods in your diet. Iron-rich foods include:
- red meat
- eggs and poultry
- whole-grain and enriched breads and cereals
- dried beans (cooked or canned), peas and lentils
The iron in meat, fish and poultry is the easiest for our bodies to absorb and use. Even including small amounts of animal-based iron can help you absorb the iron from other foods in your meal.
You can also choose foods that are fortified with iron. Look for the term "iron" in the ingredient list when you choose grain products like cereals, bread and pasta. See Health Canada's prenatal nutrition guidelines for a list of foods rich in iron.
Get the most from iron
Certain foods, drinks and supplements can get in the way of absorbing iron. Take your iron supplement an hour or two before or after coffee, tea, calcium supplements or other food items.
When you eat foods rich in vitamin C at each meal, you can absorb more iron. This is important if your meal does not contain meat.
Great sources of vitamin C are:
- citrus fruits and their juices
- sweet peppers
- tomatoes and tomato sauce
Make sure your daily multivitamin contains 16 to 20 mg of iron. If you are healthy, the total amount of iron for your daily diet should be 27mg.
In general, you need a total of 27 mg of iron per day if:
- you already have healthy iron levels before pregnancy
- your diet has sources of animal-based and plant-based iron
- your diet has sources of vitamin C
If you have low iron or anemia, or if you are a vegetarian, see your health care provider. You may need a different supplement dose.
For more information
- Folic Acid Use among Pregnant Women in Canada Fact Sheet
- Folic Acid and Birth Defects
- Prenatal Nutrition Guidelines for Health Professionals: Folate Contributes to a Healthy Pregnancy archived)
- Prenatal Nutrition Guidelines for Health Professionals - Iron Contributes to a Healthy Pregnancy (archived)
- Prenatal Nutrition Guidelines for Health Professionals - Frequently Asked Questions
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