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20 March 2014

UK: Add folic acid to flour, urges BPAS

British Pregnancy Advisory Service is urging the government to fortify flour with folic acid to reduce the risk of babies developing defects such as spina bifida.

BPAS said it was time recommendations to fortify flour with the vitamin were implemented to reduce neural tube defects, which it said can lead to the “difficult decision” to choose abortion, Nursing Times reports.

Spina bifida is caused by a fault in the development of the spine and spinal cord, which leaves a gap in the spine. There are a number of different types of spina bifida, the most serious being myelomeningocele, which affects one pregnancy in every 1,000 in Britain.

Anencephaly is a neural tube defect caused by the bones of the skull not forming properly. This results in severe damage to the baby’s brain when it is developing. Anencephaly occurs in about one to six of every 1,000 pregnancies. The baby cannot survive after birth for more than a few hours.

In the UK, women are advised to take folic acid supplements before conception and for the first three months of pregnancy to cut the risk of neural tube defects. But BPAS said almost half of pregnancies are unplanned, meaning many women do not manage to take the supplement in time.

In May 2007, the Food Standards Agency agreed that fortifying flour with folic acid should be mandatory following recommendations from the Scientific Advisory Committee on Nutrition. The committee estimated there were between 700 and 900 pregnancies affected by neural tube defects every year in the UK.

Health ministers in England, Wales, Scotland and Northern Ireland are considering their current position on the recommendations.

Ann Furedi, chief executive of BPAS, said: “Unplanned pregnancy is a fact of life and often a wonderful and welcome surprise. But it is unrealistic to expect women to be taking folic acid supplements on the basis that they might conceive,” she said.

“The fortification of flour with folic acid is a straightforward public health intervention which could spare hundreds of women every year from the painful decision to end a wanted pregnancy after a diagnosis of a neural tube defect.

“Many politicians problematize abortion, but show little interest in addressing some of the issues which result in a woman needing to end a pregnancy. Whatever our differences on abortion, we should all be able to unite behind a simple measure with huge benefits,” Ms Furedi said. “We call on the UK’s health ministers to make the necessary changes to protect the health of pregnant women and their babies and we urge them to do this as a matter of urgency.”

A Department of Health spokeswoman said: “We are currently considering the case of mandatory fortification of flour with folic acid and will reach a decision in the light of new data from the national diet and nutrition survey.”

Add folic acid to flour to prevent spina bifida, says BPAS. Nursing Times, 19 March 2014

Folate and Disease Prevention. Scientific Advisory Committee on Nutrition, 2006

bpas urges that ministers act to reduce avoidable birth defects. BPAS, 19 March 2014