Question of the Month: My sister has a baby with Spina Bifida, should I increase my folic acid intake?

Thank you for your excellent question. This is an important question for all women who could potentially become pregnant. It is now an established fact that taking a vitamin with folic acid is an important step women can take to ensure a healthy baby. Well-conducted research has demonstrated up to a 70% reduction in births of babies with Spina Bifida when women take 400 micrograms (0.4mg) of folic acid daily. This applies to all women, not just those who have already had a baby with Spina Bifida.

Some women need more folic acid
If a woman has delivered a child with Spina Bifida, she should take 10 times the typical dose of folic acid - 4mg daily. Taking this dose of folic acid can reduces the recurrence of Spina Bifida in subsequent pregnancies.

Less is known about the likelihood of delivering a baby with Spina Bifida for women related to mothers of children with Spina Bifida. These women should take at least the regular daily dose of folic acid - 400 micrograms (0.4mg). Some would suggest that these relatives of children with Spina Bifida take the higher 4mg dose of folic acid for 3 months before attempting pregnancy and for at least 3-4 months into the pregnancy.

How to get more folic acid
The high dose of folic acid (4mg) should not come from taking extra multivitamins or prenatal vitamins because this could provide excessive amounts of the other vitamins. Instead, folic acid-only vitamins, which can be purchased at most pharmacies and health food stores, should be taken in a quantity that equals 4mg daily.

Although there is less science behind recommending 4mg folic acid for relatives of mothers having children with Spina Bifida, the risk to women taking this dose is minimal and the potential benefit is considerable. Therefore, I would suggest that the 6-8 months of high folic acid use is something to consider for women in this unique situation.

For more information on genetics, folic acid and why only increasing dietary folate may not be as good as folic acid supplements, please visit the Spina Bifida Associationfact sheet.

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