Folic Acid. What Is It, and Why Is It Important?

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This infographic provides clinical guidance about the vitamin folic acid, and the recommended consumption for children ages 0-13. Designed to be easy to comprehend, the infographic illustrates exactly what the B vitamin is, what it does, and why it is a critical component of a child’s healthy diet.

Folic Acid. What is it, and why is it important?

Folic Acid. What is it, and why is it important? – An infographic by the team at Colic Calm

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What is Folic Acid and Why is it Important?

Folic acid (sometimes called folate) is a water-soluble B vitamin that is naturally present in some foods and added to enriched bread, cereals, pasta and other flour based products. The main function of folic acid is to promote red blood cell synthesis and prevent anemia. Folic acid deficiency in infants and small children can slow growth rate, but the incidence of folic acid deficiency in the US is rare. Folic acid deficiency is usually only seen in children who have celiac disease (a condition which impairs intestinal absorption of nutrients) or those are receiving medications for the treatment of epilepsy.

How Much Folic Acid Should My Child Have?

The recommended dietary allowance (RDA) for folic acid is set at 65 micrograms (mcg) per day for infants 0 to 6 months of age, 80 mcg/day for infants 6 to 12 months, and 150 mcg/day for children ages 1 to 3.

How Do I Ensure My Child Gets Folic Acid?

For infants, breast milk or formula supply all of the folic acid that is needed. It is well known that pregnant women need to contain adequate amounts of folic acid to prevent birth defects and promote healthy fetal development, but fewer breastfeeding mothers know that they need to consume plenty of folic acid to promote adequate folic acid levels in their milk.

For children aged 1 to 3, the best way to get folic acid is from foods. Rich diet sources for 0 to 3 year-olds are:

FoodServing SizeFolic Acid (mcg/serving)

Fortified Cereals
Read the nutrition label to determine whether the cereal is fortified.

 

¾ cup200-300
Spinach½ cup131
Asparagus¾ cup89
Avocado½ cup59
Broccoli½ c52
Green peas½ c47

Beans
Navy, pinto and kidney beans are best.

¼ c65
Bread made from enriched flourOne slice43
Orange1 small29
Banana1 medium24
Egg122

There are smaller amounts of folic acid in fish, poultry, meats and milk. About 1/3 of the folic acid in the average American diet comes from enriched and whole grains, 1/3 from fruits and vegetables, 1/3 from meats and fish. Children’s vitamins generally provide 200 – 300 mcg of folic acid per day, more than the recommended amount for younger children.

How Do I Know How Much Folic Acid is in Food?

To find out how much folic acid is provided by an enriched grain or fortified grain product like cereal, parents can read the Nutrition Facts Label. It is important to know that food labels give nutrient information in terms of % DV (the daily value, or, the amount needed on a 2,000 calorie diet for adults and children 4 years of age and older). So 50% of the DV (which is 400 mcg of folic acid) would equal 200 mcg. Therefore, just one serving would supply all of the folic acid for young children.  

Tip: Look for a cereal or supplement with no more than 100% DV of folic acid. 

Serving size is also important. The serving size of ready to eat cereal for children is ¾ cup but serving sizes are not really standardized and most labels report adult (1 cup) serving sizes. 

Will Too Much Folic Acid Harm My Child?

Although scientists do not agree on whether high levels of folic acid (from fortified food or vitamin supplements) can be harmful, it is true that too much folic acid can mask B12 deficiency.  B12 deficiency leads to pernicious anemia, a condition characterized by low red blood cell counts (RBC’s) and also nervous system disorders.  An important clinical deficiency sign, anemia or low blood cell count, can be masked by folic acid because either folic acid or B12 can function in the synthesis of RBCs; however B12 is necessary for nervous system development and by masking the early symptom of anemia, B12 deficiency will go undetected and can lead to permanent nerve damage. Many small children’s intakes exceed the upper limit of safe intake intake (UL) estimated by the Institute of Medicine. When folic acid from both food and dietary supplements are considered, 30% to 66% of children aged 1 to 13 years have intakes exceeding the UL. Of 300 – 600 mcg/day depending upon their age.

What About Preterm and Low Birth Weight Infants?

Supplementation of low birth weight infants is routine practice in some NICUs. Formulas designed for preterm infants provide adequate amounts of folic acid.  Low birth weight infants would seem to need more since folic acid is accumulated during the last three to six weeks of pregnancy, however clinical trials show that supplementing with folic acid does not increase hemoglobin and red blood cell counts very much.  Currently, there is no scientific evidence for recommending folic acid supplements for all preterm and low birth weight infants.

Practical Tips for Ensuring Children Get Folic Acid in Their Diet

Most healthy children age 1 to 3 can get all the folic acid they need from a well-planned diet, which includes 3-4 servings of enriched grains, 4-5 servings of fruits and vegetables (about 1/4 cup each), 2 servings (1-2 ounces each) of meat, poultry, fish or alternate protein and 2 cups of milk per day.

Good eating habits begin in early childhood. A healthful menu for a preschooler could look like this:

BreakfastMorning snackLunchMid-afternoon snackDinner Bed-time snack
¾ ready to eat cereal
½ to ¾ cup 2% milk
1 small banana
3 vanilla wafers
½ cup unsweetened fruit juice
½ – ¾ cup 2% milk
½ tuna salad sandwich
¼ c  lightly steamed carrot sticks
¼ c  diced melon
2 whole wheat crackers (unsalted tops)
1 TBSP peanut butter
½ to ¾ c 2% milk
1 ½ ounce diced chicken breast
¼ c steamed broccoli
¼ cup rice
½ slice whole grain bread
1 tsp margarine
¼ c applesauce
½ c 2%milk
2 graham crackers

 

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