Choline in Pregnancy and Breastfeeding: Needs, Official Intake Levels and Fetal Brain Development
Official choline intake levels for pregnancy and breastfeeding in the US, Canada and EU, and what trials and reviews found about choline and infant brain development.
Content last updated . This page has not been medically reviewed.
Choline needs are higher in pregnancy and breastfeeding, and surveys suggest many women eat less than the published levels. Whether extra choline improves a child's brain development is not settled: a 2025 systematic review of trials and observational studies concluded that current evidence is insufficient to support or refute the idea. [1] This page is information only. Decisions about supplements in pregnancy belong with your midwife, obstetrician or prenatal clinician.
How common is low intake?
A 2026 controlled-feeding paper states that habitual choline intake in the US remains below the AI. [6] The 2025 systematic review also says most pregnant women have intakes below recommendations. [1] Reviewers note that eating less than an AI does not by itself prove a person is short of choline. [4]What trials and reviews found
| Question | What the source found | Label |
|---|---|---|
| Extra choline in the third trimester and infant processing speed | In a controlled feeding trial, 26 women were randomized to 480 or 930 mg of choline a day until delivery. Infants of the 930 mg group had faster average reaction times on tests between 4 and 13 months. [7] | Promising but limited (very small trial, tightly controlled diets) |
| The same trial at age 7 | In 20 children, the 930 mg group did better than the 480 mg group on the main sustained-attention score. [8] | Promising but limited (20 children) |
| Phosphatidylcholine supplement in a typical diet | In 140 women eating about 360 mg of choline a day, 750 mg of phosphatidylcholine versus placebo from 18 weeks of pregnancy to 90 days after birth made no significant difference to infant memory, language or global development at 10 and 12 months. [9] | Mixed against the trial above |
| All trials and observational studies together | The 2025 review found four randomized trials and five observational studies; most outcomes did not support a benefit, some trials had isolated better scores, and limitations prevented confidence. [1] | Insufficient evidence |
| Neural tube defects | A review reports an inverse relationship between neural tube defect risk and maternal choline intake or blood level, independent of folate. [4] This is observational. | Insufficient evidence for supplements |
The two trials used different amounts, forms (food-controlled choline versus a phosphatidylcholine capsule), timing and outcomes, so their results should not be combined. Study amounts are not advice. Trial participants are not typical patients, and test results in babies are not the same as school performance or health.
Breastfeeding and infants
Human milk is the only source of choline for exclusively breastfed infants in the first six months. [4] Most commercial infant formulas add choline as choline chloride, with a little from soy lecithin. [4] For feeding questions, ask your pediatric clinician; see also vitamins while breastfeeding.Related
Choline overview · Choline intake levels by age and country · Vitamins in pregnancy · Folic acid in pregnancyFrequently asked questions
How much choline do pregnant women need?
The US and Canada list an AI of 450 mg a day in pregnancy; EFSA lists 480 mg. [2] [3]
Does choline in pregnancy make babies smarter?
That is not established. A 2025 systematic review found current evidence insufficient to support or refute benefit. [1]
Is choline in prenatal vitamins?
Proper evidence not found in the sources read about typical products. The label shows whether and how much choline is included.
What is the upper limit during pregnancy?
In the US and Canada the UL is 3,500 mg a day for ages 19 to 50 and 3,000 mg for 18 or younger. [2]
Which foods supply choline in pregnancy?
Eggs, meat, fish and milk are among the foods with the most per weight. [4] See foods high in choline.
More details: evidence, limits and cautions
The details behind this page: cautions, limits of the evidence and where sources disagree. Open any note to read it.
How to read the evidence labels
Labels used on this page: established nutritional role, promising but limited, mixed, insufficient evidence, Proper evidence not found.
Official intake levels in pregnancy and breastfeeding
| Group | AI | UL | Source and year |
|---|---|---|---|
| Pregnancy, 18 or younger (US and Canada) | 450 | 3,000 | Health Canada DRI table page, 2025 [2] |
| Pregnancy, 19 to 50 (US and Canada) | 450 | 3,500 | Same [2] |
| Lactation, 18 or younger (US and Canada) | 550 | 3,000 | Same [2] |
| Lactation, 19 to 50 (US and Canada) | 550 | 3,500 | Same [2] |
| Pregnant women (EU) | 480 | not listed in the source | EFSA, 2016 [3] |
| Lactating women (EU) | 520 | not listed in the source | EFSA, 2016 [3] |
Non-pregnant adult women have an AI of 425 mg in the US and Canada and 400 mg in the EU. [2] [3] The two bodies explain the pregnancy figures differently. The US and Canadian value was the adult-woman AI plus the choline that builds up in the fetus and placenta, based on animal data. [4] EFSA's draft scaled the non-pregnant AI by the average weight gain in pregnancy, and for lactation added the choline lost in breast milk. [5] Neither figure is a personal target. A clinician decides what suits an individual.
Safety and who should ask a clinician
- Upper levels: see the table. Staying under the UL is a published guide for groups, not proof that a given amount is right for you. [2]
- Supplement safety in pregnancy: the phosphatidylcholine trial reported that the supplements were well tolerated. [9] Proper evidence not found in the sources read for safety of other forms or higher supplement amounts in pregnancy.
- Medicines, kidney or liver disease, gestational diabetes or other conditions: Proper evidence not found in the sources read. Tell your prenatal clinician about every supplement; see medication interactions and pregnancy and breastfeeding safety.
- Before surgery or a cesarean: tell the surgical team about supplements (vitamins before surgery).
- Prenatal products: how much choline a given prenatal vitamin contains is on its label; the sources read do not say what typical products contain. See prenatal vitamins and check the label (quality testing).
References
- Choline During Pregnancy and Child Neurodevelopment: A Systematic Review of Randomized Controlled Trials and Observational Studies. Nutrients 2025. Read 2026-10-23.
- Health Canada. Dietary reference intakes tables: Reference values for vitamins. Page dated 2025-11-19; the choline values are the US and Canada Dietary Reference Intakes. Read 2026-10-23 through a web-fetch tool.
- European Food Safety Authority (EFSA). Dietary reference values: EFSA publishes advice on choline. Published 17 August 2016. Read 2026-10-23.
- Dietary Choline Intake: Current State of Knowledge Across the Life Cycle. Nutrients 2018 (review). Read 2026-10-23.
- European Food Safety Authority (EFSA), NDA Panel. Draft scientific opinion on Dietary Reference Values for choline (public consultation draft, February 2016). A consultation draft, not the final opinion; the final opinion page could not be read. Read 2026-10-23.
- Choline and betaine concentrations in plasma discriminate levels of dietary choline intake in healthy adults. Am J Clin Nutr 2026 (controlled feeding study). Read 2026-10-23.
- Caudill MA et al. Maternal choline supplementation during the third trimester of pregnancy improves infant information processing speed: a randomized, double-blind, controlled feeding study. FASEB J 2018. Read 2026-10-23.
- Prenatal choline supplementation improves child sustained attention: A 7-year follow-up of a randomized controlled feeding trial. FASEB J 2022. Read 2026-10-23.
- Phosphatidylcholine supplementation in pregnant women consuming moderate-choline diets does not enhance infant cognitive function. Am J Clin Nutr 2012. Read 2026-10-23.