Reducing the risk of Spina Bifida – What is Folic acid?

6 Min Read

Folic acid is the man-made version of the vitamin folate (also known as vitamin B9). Folate helps your body make healthy red blood cells and is a naturally occurring source in some foods, such as broccoli, leafy green vegetables, chickpeas and kidney beans.

In pregnancy, Folic acid helps your unborn baby’s brain, skull and spinal cord develop properly to avoid development problems such as spina bifida.

What is the neural tube?

The neural tube is what forms your baby’s early brain and spine. The process of the tube closing is a key early event in your baby’s brain and spinal cord development, where the body fuses together forming the neural tube. The tube begins to close at the spinal cord and then extends to the brain. Neural tube defects can occur when the mother is not getting enough folic acid – this is explained in more detail later on.

How do I take Folic acid?

 It comes in liquid or tablet form. For women trying to get pregnant and during the first 12 weeks of pregnancy, the usual dose is 4mg once a day. However, if your doctor has advised you there is a higher risk of neural tube defects during your pregnancy, your doctor will recommend a higher dose of 5mg. Some of the reasons you may be considered at a higher risk are:

  • You have had a previous pregnancy affected by a neural tube defect
  • Your or your partner have a neural tube defect, or a family history
  • You have diabetes and are very overweight
  • You are taking anti-epilepsy medicine


What are the main benefits of taking Folic acid whilst trying to conceive and during pregnancy?

When you are pregnant or trying for a baby, it is recommended that you take Folic acid until you are 12 weeks pregnant. This helps your baby grow normally and reduce the risk of neural tube defects – severe birth defects of your baby’s brain and spine that occurs when the neural tube does not close properly.

Such birth defects develop in early pregnancy and often before a woman is aware she is pregnant. The most common defects are:

  1. Spina bifida (a spinal cord defect)
  2. Anencephaly (a brain defect)

Whilst the risk of developing neural tube problems cannot be eliminated, it can be reduced by up to 70% by taking Folic acid. Not having enough folic acid during pregnancy is one of the most important factors that can increase your chances of having a child with spina bifida. Most children with spina bifida will require some support with any learning disabilities they have, as well as any physical problems, such as reduced lower body strength and incontinence.

Some flour on a bread board

UK Campaign – should flour be fortified to contain Folic acid?

 It is estimated that around 1,000 pregnancies in the UK each year are diagnosed with neural tube defects, which result in termination, miscarriage, death shortly after birth or long-term disability to the baby of varying severity.

For over 25 years, charities (including SHINE) and many others have been campaigning to the UK government to introduce mandatory fortification of flour with folic acid. The overall aim of this campaign is to help reduce defects before a woman is pregnant and during pregnancy by making the availability of folic acid almost universal. Attempts to increase folate levels through education have had limited effect, which has led to calls for mandatory fortification. Fortification of folic acid in flour has been adopted by around 60 countries worldwide, including Australia and the USA – these countries have been a vast reduction in the rates of neural tube defects, up to 58%.

Although there are potential risks associated with increased folic acid intake, the proposal seeks to recommend the mandatory fortification is accompanied by clear restrictions on voluntary fortification of other foods containing folic acid and provide clear guidance on the use of folic acid supplements.

The UK does not currently have a policy of mandatory fortification of flour with folic acid, however the campaign is ongoing with the Government considering the proposals since mid-2019. You can keep up to date with any developments here.

Are you considering whether you need legal support?

These questions do not cover all the benefits and risks of taking Folic Acid, but we hope it gives you an understanding of how it can help your baby grow and reduce the risk of serious birth defects such as spina bifida.

If you have any worries and concerns about whether your child has an injury because something went wrong in the care either you or they received, investigating whether there is a negligence claim can help to find answers. This is a detailed process and if successful, will provide your child with additional resources to ensure their care, aids and equipment and therapy needs are met for life and a suitably adapted property purchased for them to live in with you.

Our team at Enable Law will work with you to determine what happened, whether the care provided was substandard  and, if it was, the specific care, therapy and equipment needs your child is likely to have to make it possible for them to achieve their maximum potential during their life.

If you have questions about the care you or your child received and believe mistakes were made, we are here to help. Contact us today.

Spread the word, it is Spina Bifida awareness week!

Shine are a national charity who dedicate their time to seek to improve the lives of people with spina bifida and/or hydrocephalus. Anyone living with these conditions or their family and friends can become a Shine member for free. Membership includes the provision of specialist support to help people make sense of the conditions and increase their knowledge.

This week is Spina Bifida awareness week, which runs from 23rd October to 31st October 2020. Awareness week is a great opportunity to help raise awareness of the condition and bring the ‘Back to the Front’ of people’s minds.

For information on how you can support Shine by getting involved, visit their website or join in the conversation online using the hashtag #BacktoFront and by tagging @ShineUKCharity on Facebook or Twitter.