What’s the big deal about folic acid anyway?

World over lobbying for iron and folic acid (IFA) supplementation is growing. Folic acid is a B vitamin which aids in development of new cells.

In Kenya, the latest micro-nutrient survey shows prevalence of anaemia among pregnant women to be at 55.1 per cent and 46.4 per cent among non-pregnant women.

Early this year, Scaling Up Nutrition Civil Society Alliance organised a workshop on the importance of nutrients at every stage of fetal development.

Centre for Disease Control and Prevention urges women to take 400mcg of folic acid every day, starting at least one month before getting pregnant. This is to prevent major birth defects of the baby’s brain and spine which include spina bifida and anencephaly.

Medics say the neural tube (a hollow structure from which the brain and spinal cord form) closes by day 28 of pregnancy hence folic acid supplementation is most needed during this time to ensure proper formation of the brain and spine. Taken after this period, it will not prevent neural tube defects but it does contribute to other aspects of maternal and fetal health.

“Research has concluded that babies born to mothers with enough iron and folic acid are not predisposed to spina bifida,” says Dr Stephen Musau of Kenyatta National Hospital.

He adds: “It is, therefore, imperative that every woman who is planning to have a baby adheres to IFA supplementation for the benefit of their offspring.”

This increased lobbying for IFA supplementation comes at a time when UK’s Scientific Advisory Committee on Nutrition has written to the British government urging for legislation to make folic acid mandatory for all mothers-to-be.

Researchers pointed to the damning statistics that showed rising number of abortions in England and Wales due to neural tube defects, with 420 in 2013, up from 390 in 2012, and 364 in 2011.

According to a British publication, researchers have warned that rates of birth defects of the brain, spine or spinal cord are still too high and countries should consider adding folic acid to bread and flour.

So far, the USA has been fortifying flour with folic, a move that has been referred to as positive with reduction in neural tube defects already being witnessed.

In a research published in the British Medical Journal, experts said voluntary measures were failing in the UK. The study found no clear evidence of a downward trend in neural tube defects over a 20-year period across Europe.

Another study, published by PLOS ONE journal, found that fewer women still voluntarily take folic acid supplements, thus the current proposal to make IFA supplements mandatory.

In accordance with Kenya’s national policy, IFA supplementation for pregnant women is routinely delivered in all public health facilities through Maternal and Child Health clinics as part of the Focused Antenatal Care. However, demand and uptake of IFAs still remains low despite general awareness of their availability at no cost in public health facilities.

In 2013, a study authored by researchers at Jomo Kenyatta University of Science and Technology, led by Lucy Nyandia and conducted at Nyeri Hospital, found that about 80.7 per cent women were initiated on folic acid after 12 weeks of gestation. This is despite the fact that folic acid is crucial in the first one month after conception.

Kenya Aids NGOs Consortium nutritionist, Manaan Mumma says apart from supplements, the only other way an expectant mother can receive folic acid and iron in her body is through proper nutrition that embraces a balanced diet of natural organic foods.

Folic acid is a B vitamin which aides in development of new cells.