Folic acid, iron and pregnancy

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

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:

• fatigue
• 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:

• broccoli
• cantaloupe
• citrus fruits and their juices
• kiwis
• mangos
• potatoes
• strawberries
• 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.