Friday, October 30, 2015
It's important to have a good diet, especially while trying to conceive and during pregnancy.  The nutrients in your food help meet the needs of a growing baby and the more well nourished you are, the less complications you'll experience during labor as well as delivery.  However, even with a healthy diet, it's hard to get all the extra vitamins and minerals necessary to help you and baby thrive.  Prenatal multivitamins are usually recommended so you can meet the daily recommendations. Recommended Daily allowance of folic acid for women planning or capable of pregnancy is 400-800 mcg according to the US Preventative Services Task Force (1).
Folate is also known as B9- a B complex vitamin that naturally occurs in certain foods such as chicken liver, beans, lentils, spinach and other dark leafy greens, strawberries, asparagus, avocado, broccoli, grapefruit, beets, oranges, sunflower seeds, plus many others. Folic acid is an oxidized form synthetically produced in laboratories. This form has been added to foods through a food fortification process,"The United States implemented mandatory folic acid fortification of enriched cereal grains in 1998." (2). Recently it's been estimated that 60% of the population have the MTHFR gene, making it more difficult to metabolize folic acid to the necessary form L-methylfolate (3). Basically, if you have the MTHFR gene, you need to find another source- a more pure source- to ease the breakdown process and prevent the negative outcomes associated with the known folic acid deficiencies.

Folic Acid vs. Folate- What is BEST?
It makes sense to choose the closest source to nature first.  If you're already eating several servings of the foods mentioned above, you may be ok to go without supplementation.  Definitely talk to your midwife or care provider about your diet as well as discussing the blood tests used to see if your body metabolizes folic acid.  Take into consideration that if you can't get several portions of these foods into your daily diet, the next best bet is a multivitamin containing 5-MTHF or L-methylfolate.  If it just lists folate, be sure to further investigate their process.
While I've been researching this topic, I've found research associating condition after condition to folate deficiency (most likely due to MTHFR).  So I think it's a good idea to list my findings here with you as well.

I'm going to elaborate on tongue ties (ankyloglossia) and lip ties because the prevalence of each is being recognized in our communities more and more.  Dr. Ghaheri, a respected otolaryngologist, has an article titled The Evidence Supports Treating Tongue Tie For Breastfeeding Problems that shares how ties drastically effect breastfeeding.  My two girls have tongue ties and lip ties, the youngest's oral anatomy issues have been super challenging, especially when it came to breastfeeding. HERE is the post elaborating on our experience releasing ties. If there's a chance of experiencing a similar circumstance with baby #4, I want to do everything I can to make it easier, at least.  I'm looking into MTHFR testing for my entire family. Also, I find it essential to seek out a raw source of folate supplementation while TTC, pregnant and breastfeeding.  Read my review of Garden of Life RAW Prenatal vitamins for further information.




References:
(1) Final Recommendation Statement. Folic Acid to Prevent Neural Tube Defects: Preventive Medication, May 2009
(2) Near-elimination of folate-deficiency anemia by mandatory folic acid fortification in older US adults: Reasons for Geographic and Racial Differences in Stroke study 2003-2007. Odewole
(3) Folic Acid Supplementation and Pregnancy: More Than Just Neural Tube Defect Prevention. 2011 Greenberg

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