Dr P Anand MBBS Bsc MRCGP

(Partner – Lakeside Medical Practice)

(References: BMJ 3/3/2007 / www.gpnotebook.co.uk)

Folic Acid or Folate is a water-soluble vitamin. We need anything from 25mcg a day in an infant to 50-100mcg a day in children, females need 150-180mcg, and males 150-200mcg a day. Pregnant women need the most at 400mcg a day and about 300mcg a day when breast feeding.

Folic Acid is found in fresh green leafy vegetables, fruits, organ meats – liver, and dried yeast. In general a low level can lead to anaemia (low blood amounts), and affect cell formation and protein metabolism generally. BUT the real object here is to highlight the need for adequate Folic Acid before a lady gets pregnant and during pregnancy.

The reasons are Folic Acid Supplements do two IMPORTANT THINGS: -

1) Taken at the time of conception, Folic Acid helps prevent NEURAL TUBE DEFECTS – anencephaly (no brain) and spina bifida (abnormality of back bone so parts are absent, exposing the spinal cord and nerves of the back).

2) Folic Acid Supplements during early pregnancy has a positive effect in preventing by a third, the formation of isolated CLEFT LIP (with or without cleft palate) malformations in babies. There may be some influence also from other vitamins and dietary factors.

Folic Acid can be bought in tablet form from chemists. 400mcg a day is recommended to prevent first occurrences. 5mcg a day is recommended to prevent a recurrence. 

It is a very good idea to start taking Folic Acid before pregnancy, possibly by 12 weeks, and also for the first 12 weeks of any ongoing pregnancy as well – i.e. before and after, and altogether for 6 months.   

A 5mcg dose is also recommended when a pregnant woman is using anti-epileptic drugs. 

This dose of 5mcg is to be taken by all women with SICKLE CELL DISEASE. The dose for cleft-lip prevention is at least 400mcg, but may need increasing if there are other risk factors, such as smoking. 

This information is very important and should be widely publicised in all media outlets and to everyone at secondary school, not just girls. Sometimes boys can be responsible and help their partners around pregnancy matters, so information such as this should be given to all!

Doctors, Health Visitors, and Midwives are also well placed to give advice.

In many countries such as the USA, Folic Acid is put into certain basic foods eaten by all to help. This does not happen in this country. Perhaps a few words to the MP and Government are in order.

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