Folate and folic acid are important for pregnancy since they can help prevent birth defects known as neural tube defects, such as spina bifida. Folate is a B group vitamin needed for healthy growth and development.

Increase your folate intake by eating folate-rich foods.

This vitamin is known as ‘folate’ when it is found naturally in food, such as green leafy vegetables, and as ‘folic acid’ when it is added to food, such as bread and breakfast cereals, or used in dietary supplements.

Folate has been proven to be particularly important for the development of the nervous system and for preventing neural tube defects (NTDs) in babies.

Approximately one in 1,000 babies in Australia is born with a neural tube defect such as spina bifida.

Spina bifida is one of the most common birth defects in the Western world. About 150 babies are born with spina bifida in Australia each year. It occurs in the first weeks of pregnancy, when the brain and spinal cord are forming.

You can increase your folate intake by eating folate-rich foods, including folate-fortified foods in your daily diet or by taking a folic acid supplement. Good sources of folate include green leafy vegetables, fruit (citrus, berries and bananas), legumes and some cereals (many breakfast cereals now have added folate).

The voluntary fortification of several foods with folate has been permitted in Australia since June 1995 and mandatory folic acid fortification of all flour used for making bread (except organic bread) came into effect in September 2009. Three slices of bread (100 grams, or 100g) contains an average of 120 micrograms of folic acid.

Folic acid supplements are available in Australia over the counter from pharmacies and through your doctor at varying doses. Look for supplements that contain at least 400 micrograms of folic acid; these will generally be supplements containing only folic acid or special pregnancy supplements. Multi-vitamin supplements generally contain less. The best way to guarantee you get enough folic acid is to take a daily folic acid supplement at least one month before and three months after conception. You don’t need to take folic acid supplements after that.

Higher dose folic acid

Some women have an increased risk of having a pregnancy affected by a neural tube defect and are advised to take a higher dose of 5 milligrams (5mg) of folic acid each day until they are 12 weeks pregnant. Women have an increased risk if:

• they or their partner have a neural tube defect
• they or their partner have a family history of neural tube defects
• they have had a previous pregnancy affected by a neural tube defect
• they have diabetes.

In addition, women who are taking anti-epileptic medication should consult their doctor for advice because they may also need to take a higher dose of folic acid.

If any of the above applies to you, talk to your doctor since they can prescribe a higher dose of folic acid. Your doctor or midwife may also recommend additional screening tests during your pregnancy.

Folate in your diet

Many foods are naturally rich in folate. But note that folate is water-soluble and is easily destroyed by cooking. Vegetables are best lightly cooked or even eaten raw. Cooking by microwave or steaming is best.

The following are good sources of natural folate:

• vegetables (broccoli, brussels sprouts, cabbage, cauliflower, English spinach, green beans, lettuce, mushrooms, parsnip, sweet corn, zucchini)
• fruit (avocado, grapefruit, orange)
• legumes (chickpeas, soya beans, lima beans, red kidney beans, lentils, haricot beans)
• eggs
• nuts
• juices (many apple and orange juices).

Sources: , Centre for Genetic Education (Neural tube defects fact sheet) Department of Health (Folate facts) , Food Standards Australia New Zealand (Folic acid/folate and pregnancy) , NSW Health (Having a Baby)