Are you trying to conceive or newly pregnant? Then folic acid is one of the most important vitamins to start taking. When exactly should you start, how much do you need, and until which week should you continue?
We have clearly outlined everything for you.
Are you planning to have a baby? Start taking 400 micrograms of folic acid every day. This is 0.4 milligrams. Take it from the moment you start trying to conceive (ideally at least four weeks before conception) until you are 10 weeks pregnant. If you are already pregnant and have not started yet, begin today.
If it takes longer to become pregnant, you can safely continue taking 400 micrograms every day. Continuing after 10 weeks of pregnancy is also not harmful at this standard dose. Do not take more than 1 milligram per day unless a doctor or midwife advises you to.
Would you like to prepare well for pregnancy and find out which advice applies to you? During a preconception consultation at 040verloskunde, we can discuss folic acid, nutrition, lifestyle, medication, your menstrual cycle, fertility and family history. Your partner is very welcome. If you live in Eindhoven, Aalst or Waalre, you can register online. The consultation is covered by Dutch basic health insurance.
Folic acid is vitamin B11. Your body uses it for cell division, growth and DNA production. It also contributes to the formation of red and white blood cells. During pregnancy, new tissue develops rapidly and your need for folate increases.
In the first weeks after conception, the neural tube develops. This structure later becomes the brain and spinal cord. If it does not close properly, a neural tube defect may occur, such as spina bifida or a serious defect of the skull and brain. Taking folic acid before pregnancy and during the first weeks reduces the risk of these conditions.
The nervous system starts developing immediately after conception, often before you know you are pregnant. Waiting for a positive pregnancy test may therefore be too late for the full protective effect. It is best to start when you decide to become pregnant and try for a baby or when you stop using contraception.
The natural form of vitamin B11 is called folate. It is found in foods such as green vegetables, pulses, wholegrain products, bread and fruit. A healthy, varied diet remains important, but food alone usually does not provide enough folate for the protective effect around conception. That is why the Dutch advice is to take a 400-microgram supplement.
An inexpensive own-brand supplement works just as well as a more expensive brand, provided the daily dose contains 400 micrograms of folic acid. You can take folic acid on its own or choose a pregnancy supplement that also contains vitamin D. Check the label and do not combine several supplements without advice. If you choose a multivitamin, use one specifically intended for pregnancy.
Some people are prescribed 5 mg of folic acid, for example because of a confirmed deficiency, a personal history of a neural tube defect, or a previous pregnancy affected by a neural tube defect. Certain medical conditions or medicines may also change the advice. Never start 5 mg on your own; discuss it with your doctor or midwife before pregnancy.
After fertilisation, the fertilised egg divides rapidly. Within a few days, a small cluster of cells travels to the uterus and implants in its lining. Some cells develop into the embryo, while others contribute to the placenta, membranes and umbilical cord. Many new cells must be produced during this early stage.
Folic acid supports rapid cell division
The body converts folic acid into folate compounds that are needed to build and repair DNA and to make new cells. This matters because the embryo grows very quickly during the first weeks and the foundations of different tissues and organs are formed. Folic acid does not build one particular organ; it supports essential processes throughout this phase of rapid growth.
From neural plate to brain and spinal cord
Very early in development, a thickened layer of cells forms along the embryo’s back. This neural plate folds into a groove and then closes to create the neural tube. The upper part develops into the brain, while the rest becomes the spinal cord. The surrounding structures later contribute to the skull and spine.
Closing of the neural tube
The neural tube closes during the first weeks after conception, often before a pregnancy test is positive. If part of it does not close completely, a neural tube defect can develop. In spina bifida, the structures around the spinal cord do not close fully. If the upper part fails to close, a severe defect of the brain and skull may occur. Folic acid cannot prevent every neural tube defect, but taking it at the right time clearly reduces the risk.
Why start four weeks before conception?
Starting before pregnancy gives the folate level in your body time to rise before the neural tube closes. Because the exact date of conception is often unknown and early development begins before a missed period, the Dutch Health Council advises 400 micrograms from at least four weeks before conception until eight weeks afterwards. In standard pregnancy dating, this means taking it until you are 10 weeks pregnant.
Also important for blood cells and the placenta
Vitamin B11 is needed to make red and white blood cells. Red blood cells carry oxygen through the body. During pregnancy, the mother’s blood volume increases while new tissues are being formed. The placenta also develops from rapidly dividing cells. Folic acid supports these normal processes, but it does not replace a healthy diet and is not a treatment for anaemia caused by iron deficiency.
If you would like personal advice about folic acid, nutrition, medication, family history or preparing for pregnancy, you can book a preconception consultation with 040verloskunde.
If your pregnancy test is positive and you live in Eindhoven, Aalst or Waalre, you can register directly for pregnancy care without a GP referral. Online registration is available 24 hours a day.
Folic acid is vitamin B11. Before and during your pregnancy, you need more folic acid. Folic acid reduces the chance of abnormalities early in pregnancy, especially the chance opans neural tube defects in the child. In an unborn child, the neural tube is the beginning of the spinal cord and brain. When something goes wrong with the construction and development of the neural tube, spinal cord or brain abnormalities such as spina bifida, open skull, harelip or cleft palate can develop in pregnancy.
Start as soon as you decide to try for a baby, ideally at least four weeks before conception. A practical time to begin is when you stop using contraception.
Take 400 micrograms every day. This is 0.4 mg.
Continue until you are 10 weeks pregnant. You may stop after that. Taking 400 micrograms for longer is not harmful.
Start straight away and take 400 micrograms folic acid every day until you are 10 weeks pregnant. If you have a medical condition or take medication, ask 040verloskunde, your GP, specialist or pharmacist for personal advice.
There is no standard Dutch recommendation for men to take folic acid. A healthy lifestyle is important for both partners, because egg and sperm quality both influence the chance of pregnancy. Partners are therefore very welcome at a preconception consultation with 040verloskunde.
Start folic acid on time, eat a healthy and varied diet, stay physically active, and avoid smoking, vaping, recreational drugs and alcohol. Discuss medication, chronic conditions, previous pregnancies and hereditary conditions before pregnancy. During a consultation, 040verloskunde can review what matters for you and your partner.
Do not smoke or vape, avoid recreational drugs and alcohol, eat healthily, exercise regularly and aim for a healthy weight. If either partner works with harmful substances or high temperatures, or has questions about medication or fertility, discuss this during a preconception consultation at 040verloskunde.
You are usually most fertile in the days before and around ovulation. With a regular cycle, ovulation often occurs about two weeks before your next period. Sperm can survive for several days, so having sex every other day during the fertile window is usually sufficient. If your cycle is irregular, 040verloskunde can help you understand it and advise whether further assessment may be useful.
Fertility may return quickly after stopping the pill, vaginal ring or contraceptive patch, although your cycle may take some time to become regular. After the contraceptive injection, fertility can take longer to return. Start folic acid before stopping contraception. 040verloskunde can remove an IUD or contraceptive implant and answer your questions about trying to conceive.
Never stop prescribed medication on your own. Ask your GP, specialist or pharmacist whether your medication is suitable when trying to conceive and during pregnancy. Include over-the-counter medicines and supplements. During a preconception consultation, 040verloskunde can review your health and medication and refer you if necessary.
Tell us if either partner has a hereditary condition, if congenital conditions or repeated miscarriages occur in the family, or if you and your partner are related by blood. A midwife at 040verloskunde can help assess whether you need additional advice or referral.
If you are unsure whether you are protected against infections such as rubella or chickenpox, discuss this with your GP or the Dutch public health service, the GGD, before pregnancy. Some vaccines are not given during pregnancy. 040verloskunde can help you identify which preparations may be relevant to your medical history.
A specialised midwife discusses your medical history, menstrual cycle and fertility, lifestyle, nutrition, folic acid, medication, work, travel and family history. The advice is tailored to your situation. After registration, 040verloskunde may ask you to complete the Dutch preconception questionnaire ZwangerWijzer in advance so that the consultation can be prepared properly.
Yes. Fertility and preparation for pregnancy concern both partners, so your partner is very welcome. The preconception consultation at 040verloskunde is available to anyone planning a pregnancy and is covered by Dutch basic health insurance.
