Increasing folic acid intake is recommended before and during the first 12 weeks of pregnancy. Studies have shown that it can greatly reduce the chances of spina bifida and other neural tube defects in babies, as it ensures healthy development of the baby's spine, which takes place very soon after conception.

What Is folic acid?

Folic acid is a B vitamin and is also known as folate when it occurs naturally in foods. Foods that naturally contain folic acid include:

High in folic acid:

• Brussels sprouts
• Cooked black eye beans
• Spinach
• Granary bread
• Spring greens
• Broccoli
• green beans

Medium in folic acid:

• Cooked soya beans
• Cooked chickpeas
• Cauliflower
• Iceberg lettuce
• Oranges and grapefruit
• Peas
• Parsnips
• Wholemeal bread
• Cabbage
• Eggs
• Brown rice
• yoghurt

Food with added folic acid:

• Some breads
• Some cereals

What Are the Risks?

Spina bifida and other neural tube defects are caused when the neural tube (which goes on to become the baby's spine), does not form properly. If a baby is born with spina bifida, one or two of the bones in the spine fail to develop properly and leave a gap, resulting in damage to the nerves and spinal cord. This can affect babies in different ways.

Medical studies have shown that women who increase their intake of folic acid at the time their baby's spine is developing, reduce the risk of having a baby with neural tube defects.

These defects can affect babies regardless of: the age of the mother, whether or not you already have healthy children, and even if spina bifida does not run in the family. Some evidence suggests that women with diabetes have increased risk of these defects.

How and When Should It Be Taken?

Folic acid should ideally be taken before conception and at least until the 12th week of pregnancy. However, do not worry if you are more that 12 weeks pregnant and have not taken folic acid. Remember that most babies are born in perfect health.

It is very difficult to get enough folic acid through the diet alone, as many foods lose their folic acid when food is stored for a long time, or through overcooking. The simplest way to ensure you get enough of this vitamin is through supplementation. It is recommended to take 400mcg of folic acid daily. This is available from pharmacies, health food stores and supermarkets.

Research has shown that folic acid has no side effects, even if taken for many years, and it is one of the vitamins that the body gets rid of naturally if more is taken than is needed.

References

• Lumley J, Watson L, Watson M, Bower C. 2002 Periconceptual supplementation with folate and/or multivitamins for preventing nueral tube defect Cochrane Review in the Cochrane Library Issue 1, Oxford: update software

• Pre-conception care of diabetes, congenial malformations and spontaneous abortions, 1996, diabetes Care, 19(5): 514-541

• Diabetes mellitus during pregnancy and the risks for specific birth defects : a population based case - control study, 1990, Paedeatrics, 85: 1-9

• Confidential Enquiry into Maternal and Child Health: Report into diabetes, October 2005

• Food Satndards Agency board discusses folate and health, www.food.gov.uk/news/pressreleases/2006

• Periconceptual folic acid and food fortification in the prevention of neural tube defects- Royal College of Obstetricians and Gynecologists, Scientific Advisory Committee, April 2003