Pregnancy is a period during which a woman goes through serious physical, emotional, and cognitive changes. This new phase of life brings with it a plethora of changes that might challenge you. The most important of all the changes is with regards to nutrition. You can no longer afford to skip meals or take chances on eating whatever you like. Your entire nutritional focus should fall on the developing fetus that is dependent on you for nutrition.

You are probably aware of the importance of the first few weeks of pregnancy when organogenesis takes place. This phase is significant because it is during this time that the fertilized ovum develops into a fetus. It changes from a single-celled organism to a more complex organism – with organs like a heart, a brain, etc. Any damage sustained in this period would be permanent and could result in a miscarriage. Even if the fetus manages to survive, it will face developmental problems that will result in severely debilitating conditions throughout life.

So, having understood the significance of the organogenesis, let us now delve into one nutrition element during pregnancy that is particularly crucial, namely Folic acid.

What is folic acid?
An important vitamin B, folate (Vitamin B9) is essential for the sustenance of the red blood cells. Deficiency of folate leads to anaemia. In pregnancy, folate plays an important role in the development of the neural tube. The neural tube metamorphoses into the brain and spinal cord, and the entire process is orchestrated by folate, along with other factors.

What happens when folic acid is deficient?
When folic acid is deficient, the neural tube that depends on folic acid fails to develop into the brain and spinal cord. As a result, the process of organogenesis halts at various levels, depending on the amount of folic acid present. Some parts of the brain fail to develop, which is called anencephaly, and if the spinal cord or the backbone (vertebrae) fails to develop, it is called as spina bifida (the spine is actually split in two). Congenital heart defects are also common among infants with folic-acid-deficient mothers. These are collectively referred to as neural tube defects. This results in the death of the fetus in severe cases. But in less severe cases, the child may be actually born with a smaller brain and spinal cord defects, resulting in serious physical, emotional, psychological and financial trauma.

In addition, folic acid is also known to prevent the occurrence of cleft lip and cleft palate abnormalities, low birth weight, premature birth, abortions, miscarriages, and growth defects. Furthermore, complications of pregnancy, stroke, Alzheimer’s disease, cardiovascular diseases and some cancers are all prevented by adequate folic acid intake.

Recommended intake of folic acid per day
For any woman anticipating pregnancy, it is recommended to take 400 micrograms of folic acid each day before and during pregnancy. This dosage increases to 4000 micrograms if you have had a child with neural tube defects or an established folic acid deficiency.

Sources of folic acid
Nature has richly supplied us with folic acid in green leafy vegetables, citrus fruits, and fortified cereals. If you are planning to have a baby, it is recommended that you start including lots of fortified cereals and green leafy vegetables in your daily diet. An orange a day, or a lemonade, will also help you. Beef liver and great northern beans are also rich in folic acid.

How do I know if I need folic acid?
If you are constantly facing tiredness, fatigue, breathlessness, poor skin and hair health, or ulcers in the mouth, then you might be suffering from folic acid deficiency. These symptoms are mainly caused by abnormal red blood cells that have failed to mature. You have to visit your physician who will help you ascertain whether you have adequate folic acid or not. Folic acid deficiency usually occurs in tandem with other vitamin and mineral deficiencies.

What if I am deficient in folic acid?
If you have an established deficiency of folic acid, you have to start supplementing your diet with multivitamin tablets or folic acid tablets. It is also important to find out if you have any other deficiencies. You can leave this task to your physician. He or she will decide how to put you on supplements, in terms of whether you just require natural supplements or if you need tablets. If it is only a folic acid deficiency that is not severe, then you can opt for natural foods; but if the deficiency is severe, then folic acid supplements are a must.

Folic acids supplements can be taken during different times:

• When you reach a child bearing age and have other nutritional deficits: take 400 micrograms a day.
• One month prior to pregnancy and during first three months of pregnancy: take 400 micrograms a day.
• The remaining part of pregnancy from the fourth month till term: take 600 micrograms a day.
• You can continue with the supplements into lactation with 500 micrograms a day
• Most importantly, it is crucial that you take folic acid supplements during the first six weeks of pregnancy, as organogenesis takes place during that time.
• If you have any further doubts, visit your obstetrician for more information. Start as early as possible and have a happy motherhood. Remember that prevention is better than cure.