Q: My husband and I want to start a family. I know folic acid is important but can you clarify why, the amount and when to take it?
Folic acid (vitamin B9) is vital for its role in preventing spina bifida and other neural tube defects, which can limit or seriously impact on a baby’s life.
In 1991, research established that supplementing with 400 micrograms (mcg) of folic acid daily can reduce the risk of spina bifida (SB ) and other neural tube defects (see below) by up to 72 per cent. New research suggests that adding a daily 2.5mcg (minimum) of vitamin B12 is key to further reducing the risk. Vitamin B12 is essential for cells to take up folic acid, but some 60 per cent of women may not have enough.
SB is due to a fault in the development of the spinal cord, which runs down the centre of the spinal column, and also the surrounding vertebrae, which protects the spinal cord and anchors muscles so they move as instructed.
The fault occurs when the neural tube fails to close correctly. The neural tube is the group of cells that becomes the central nervous system, which comprises the brain and spinal cord. The spinal cord carries messages from the brain to different parts of the body. If the cord is damaged or not properly developed, as with SB, there is usually some degree of paralysis and loss of sensation below the damaged bit.
The extent of disability depends on where the split is and the amount of nerve affected. Bladder and bowel problems are frequent as those nerves come from the bottom of the spinal cord, which is always below the split. Also, any break in the nerve pathways from the brain means reduced control and sensation.
Around 750 to 1,000 babies are born every year in this country with SB and other neural tube defects, including encephalocele, which causes brain damage, anencephaly, where the brain does not develop properly, and hydrocephalus, or water on the brain (see shinecharity.org.uk for more information).
The neural tube closes in the first 28 days of pregnancy. If the pregnancy is planned, the advice is to start taking folic acid and vitamin B12 at least three months before conception and for three months after: Vitabiotics Pregnacare, £13.22 for three months’ supply; includes folic acid, vitamin B12 and vitamin D.
However, many pregnancies are unplanned and women do not realise they are pregnant until after 28 days, thus missing the window for preventing SB. GP Dr Rob Hicks, a patron of Shine, which supports people facing the challenges of SB , advises every woman of reproductive age who may get pregnant to take a supplement containing folic acid and vitamin B12: ‘These are useful vitamins anyway, particularly in the formation of red blood cells, there are no risks and the potential benefit is incalculable.’
the Feel-good gift guide
Aromatherapy Associates De-Stress Mind Bath & Shower Oil, £37 for 55ml (enough for 20 baths). With wild camomile, frankincense and petitgrain essential oils, this fragrant, moisturising oil wafts away tension. Also try De-Stress Muscle.
Gloves in a Bottle, £5.15 for 60ml. Indispensable hand and body lotion for gardeners, hairdressers, swimmers, and anyone with dry, sore skin.
Dr Bronner’s Magic Soaps, £1.99 for 59ml. Loved by Sandra Bullock, these organic and fair-trade liquid soaps are perfect for green girls. We love Rose…and Lavender…the new Green Tea – the lot, really.
Tamaris Glitter Boots, from £69.99, amazon.co.uk. These glam, super-comfy ankle boots feature a shock absorber in the heel.
Uniqlo Heattech T-shirts, from £9.90, uniqlo.co.uk. Perfect for chaps, these tees are made of a high-tech fabric designed to retain warmth. The women’s range also comes in fab Orla Kiely designs.
Blingbacks Shoe Jewellery, £15, from Dorothy Perkins and Debenhams. These gorgeous gewgaws not only jazz up a dull pair of shoes but save your heels from blisters via a tiny rubber lip.
Hunter’s Puddings, £15 for a pack of four (each serving two or three), from hunterspuddings.co.uk. Award-winning, gluten- and wheat-free puds made in Cumbria.
Homedics Gel Shiatsu Back Massager, £199.99, from currys.co.uk. Our male tester was very impressed with this sit-on gizmo, which fits most upright chairs. Choose from three speeds and five programmes – including shiatsu, rolling spot or vibration, via the remote control. ‘Not cheap but good value,’ he says.