Egg Nutrition Center Blog

Concentrating on Choline During National Birth Defects Prevention Month

Eighteen babies in the US die every day as a result of a birth defect. Unfortunately, birth defects are much more common than many might think, affecting 1 in 33 babies every year and causing 1 in 5 infant deaths. They have been the cause of over 139,000 hospital stays over the course of a year, resulting in $2.5 billion in hospital costs (1).

Mothers play an essential role in ensuring the healthy growth of their babies, and nutrition during pregnancy and lactation is particularly critical. During development, fetuses and infants have high needs for a range of nutrients, among which choline is notable for its role in reducing the risk for birth defects. In addition, choline is an essential nutrient required for life’s most basic functions, such as normal cell activity, liver function and transporting nutrients throughout the body. The nutrient is so important that the Food and Nutrition Board of the Institute of Medicine has set daily choline recommendations for all life stages (2):

Population Adequate Intake (AI) of Choline
Birth to 6 months 125 milligrams (mg)/day
7 – 12 months 150 mg/day
1 – 3 years 200 mg/day
4 – 8 years 250 mg/day
9 – 13 years 375 mg/day
14 – 18 years 400 mg/day (Females); 550 mg/day (Males)
Adults:(19 and older) 425 mg/day (Females); 550 mg/day (Males)
Pregnant women 450 mg/day
Breastfeeding women 550 mg/day

Pregnant and breastfeeding women merit some of the highest recommendations for daily choline intake. In January, National Birth Defects Prevention Month, this is particularly meaningful. In a previous blog post by Dr. Tia Rains, PhD, highlighted recent research that found during pregnancy, and particularly during the third trimester, large amounts of choline may be needed to support fetal development.  Researchers therefore concluded that while they are higher than those of other life stages, the current choline recommendations for pregnant and breastfeeding women might be below what is truly optimal for the health of mothers and their infants.

This study, suggesting a potential need to increase choline recommendations, adds to an already impressive body of evidence supporting the importance of dietary choline for pregnant and breastfeeding women. Research has shown that choline may help prevent neural tube defects, among the most grave of birth defects. Choline has been shown to play an important role in fetal and infant brain development, affecting the areas of the brain responsible for memory and life-long learning ability, and compared with women who get sufficient choline in their diets, women with diets low in choline have a four times greater risk of having babies with neural tube defects such as spina bifida (3).

Fortunately, modest nutritional adjustment can help minimize this risk. The best way to meet your needs is to eat foods with choline, and eggs have one of the highest amounts of choline of any food. One large egg – including the yolk – contains about 147 milligrams of choline. Two large eggs contain more than half of the recommended intake for pregnant women and can help them meet their needs Most prenatal and regular multivitamins provide far less than the Adequate Intake for choline, so including eggs as part of a healthy eating pattern is a simple and effective solution. If your clients are looking for easy ways to increase their choline intake, offer appealing egg recipes like this Creamy Pasta & Egg Skillet for the whole family to enjoy.


What nutritional tips do you provide to your pregnant and breastfeeding clients? Does your practice recognize National Birth Defects Month? Please share your thoughts in the comments section below.


1)      National birth defects prevention month. National Birth Defects Prevention Network Web site. Updated 2014. Accessed Jan 21, 2014.

2)      Institute of Medicine and National Academy of Sciences USA. Dietary Reference Intakes for Folate, Thiamin, Riboflavin, Niacin, Vitamin B12, Panthothenic Acid, Biotin, and Choline. National Academy Press; Washington, DC: 1998.

3)      Shaw GM, et al. Periconceptional dietary intake of choline and betaine and neural tube defects in offspring. Am J Epidemiol 2004; 160:102-9.

Author: Anna Shlachter MS, RDN, LDN