Folic Acid and Vitamins Before and During Pregnancy
If you could become pregnant or are trying for a baby, take 400 micrograms of folic acid every day, ideally starting 3 months before conception and continuing until 12 weeks of pregnancy. It lowers the risk of neural tube defects such as spina bifida. Some people need a higher, prescribed dose. Vitamin D is also advised, while vitamin A supplements should be avoided.
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Key takeaways
- Take 400 micrograms of folic acid a day, ideally from 3 months before pregnancy until week 12.
- Neural tube defects develop in the first weeks, often before you know you're pregnant.
- A higher 5 mg dose is prescribed for some people, for example with diabetes or a family history of neural tube defects.
- Avoid vitamin A (retinol) supplements, including cod liver oil, during pregnancy.
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Why folic acid matters
Folic acid is a form of folate (vitamin B9) that helps the body make new cells. In early pregnancy it helps the neural tube, which becomes the baby's brain and spine, to develop. Taking it lowers the chance of neural tube defects such as spina bifida. The NHS adds that it may also help prevent other problems, such as cleft lip and palate and some heart conditions.
Neural tube defects happen in the first few weeks of pregnancy, often before people know they are pregnant. That's why the CDC recommends that anyone who could become pregnant gets 400 micrograms of folic acid daily.
How much and when
| Situation | Recommendation |
|---|---|
| Trying for a baby, or could become pregnant | 400 micrograms a day, ideally from 3 months before conception |
| Already pregnant | Start straight away and continue until 12 weeks |
| Higher-risk groups (see below) | 5 milligrams a day, prescribed by a doctor |
Taking folic acid beyond 12 weeks won't harm your baby.
Who needs a higher dose
The NHS recommends a higher, 5 mg prescribed dose if you're planning a pregnancy or are less than 12 weeks pregnant and:
- you or the baby's biological father has a neural tube defect, or a relative with one
- you have had a previous pregnancy affected by a neural tube defect
- you have diabetes
- you have a blood condition such as sickle cell anaemia or thalassaemia
- you take medicine for epilepsy or HIV
Talk to your doctor before you start trying for a baby if any of these apply.
Vitamin D
Vitamin D helps your baby's bones and teeth develop. The NHS recommends 10 micrograms (400 IU) a day during pregnancy, at least through autumn and winter, and all year if you usually cover most of your skin outdoors, spend a lot of time indoors, or have black or brown skin. Don't take more than 100 micrograms a day. See our vitamin D guide.
Iron
Iron levels are usually checked in routine blood tests during pregnancy. If they're low, your midwife or doctor may recommend iron supplements. Learn the signs in our guide to iron deficiency anaemia.
Supplements to avoid
Don't take vitamin A (retinol) supplements or cod liver oil during pregnancy. Too much vitamin A can harm a baby's development. Avoid foods very high in vitamin A, such as liver. Always check supplement labels, and ask a pharmacist if you're unsure.
Pregnancy multivitamins
Many pregnancy multivitamins contain 400 micrograms of folic acid and 10 micrograms of vitamin D without vitamin A. Check the label, and don't take two multivitamins together.
Talk to your care team
This guide is general information. Your midwife, doctor or pharmacist can advise on supplements that suit your health, diet and medicines.
Common questions
I didn't take folic acid before I got pregnant. Is it too late?
Start as soon as you find out you're pregnant and continue until 12 weeks. The NHS recommends this, and your midwife or doctor can advise you.
Can I get enough folic acid from food?
Leafy greens, beans and fortified cereals contain folate, but the NHS notes it's difficult to get the amount you need from food alone, so a supplement is recommended.
Is it harmful to keep taking folic acid after 12 weeks?
No. The NHS says taking it for longer than 12 weeks will not harm your baby.
Sources
- Pregnancy vitamins and supplements (opens in a new tab) — NHS
- About Folic Acid (opens in a new tab) — Centers for Disease Control and Prevention (CDC)
