More Than 2,000 Babies Suffered Serious Defects 'Because Of Failure To Add Folic Acid To Flour', Research Suggests | HuffPost Life

2,000 Babies Suffered Birth Defects 'Because Of Failure To Add Folic Acid To Flour'

Amy Packham— The Huffington Post UK

More than 2,000 babies have suffered serious birth defects due to the Government’s failure to add folic acid to flour, researchers have said.

These cases, which go back to 1998, could have been avoided if the UK had followed 78 other countries and added the key vitamin to flour, researchers have said according to PA.

Rates of neural tube defects - birth defects of the brain, spine or spinal cord - are not falling across the UK, resulting in death of the foetus or newborn baby, or life-long disability in those who survive.

Last month, Government advisers wrote to ministers expressing their concern that recommendations made in 2000, 2006 and 2009, to improve levels of folic acid intake had still not been taken on board.

Women are urged to take 400mcg of folic acid daily whilst trying to conceive and for the first three months of pregnancy

Members of the Scientific Advisory Committee on Nutrition (SACN) pointed to a rising number of abortions in England and Wales for neural tube defects, with 420 in 2013, up from 390 in 2012, and 299 in 2009.

Women are advised to take 400mcg of folic acid daily whilst trying to conceive and for the first three months of pregnancy to reduce the chance of neural tube defects, which include spina bifida and anencephaly.

In the US, fortifying flour with folic acid has led to a 23% reduction in neural tube defects.

The new research, published online in the Archives of Disease in Childhood, estimates the number of defects that could have been avoided if the UK had adopted a flour fortification policy in 1998, the same year the US adopted the policy.

Researchers said 2,014 cases of defects could have been prevented - equivalent to a 21% drop in cases. They said asking women to take supplements was not working and that fortifying flour was "remarkably safe".

They said, according to PA: "Our results show that in the UK between 1998 and 2012, there was little, if any, change in the prevalence of pregnancies with a neural tube defect, while in the USA, quickly following the introduction of mandatory fortification of flour with folic acid in 1998, there was an approximate 23% reduction in the occurrence of affected births.

"Given the evidence from the Medical Research Council Vitamin Study regarding the efficacy of folic acid in preventing neural tube defects, the failure of Britain to fortify flour with folic acid has had significant consequences.

"The recent evidence that only 28% of pregnant women in England in 2012 took folic acid supplements at the correct time indicates that, in practice, recommending folic acid supplementation is largely ineffective."

From 1998 to 2012, some 1.28 pregnancies per 1,000 births were affected by a neural tube defect, of which 81% resulted in an abortion.

The research was carried out by researchers from Queen Mary University London, Public Health England (PHE) and Oxford University.

They compared the situation with thalidomide, which resulted in the births of 500 people with disabilities in the UK.

"Justifiably, steps were introduced to immediately halt the epidemic, and regulatory precautions were introduced to avoid another similar epidemic," they said. "Unfortunately, no such sense of urgency has been applied to the prevention of spina bifida.

"It is a public health failure that Britain has not implemented the fortification of flour with folic acid for the prevention of spina bifida and other (neural tube defects)."

SEE ALSO:
Should You Take Supplements During Pregnancy? Midwife's Advice On What Vitamins Women Should Have
Midwife Advice: 3 Things Pregnant Women Can Do To Make Giving Birth 'Shorter And Faster'
Protecting Pregnancies With a Slice of Bread - Why We Should Back Flour Fortification

They said this failure "has caused, and continues to cause, avoidable terminations of pregnancy, stillbirths, neonatal deaths and permanent serious disability in surviving children".

Dr Alison Tedstone, chief nutritionist at Public Health England, said: "Implementing the Scientific Advisory Committee on Nutrition's advice to add folic acid to flour would reduce the risk of birth defects, such as spina bifida, in pregnancy.

"PHE's analysis shows that 85% of 16 to 49-year-old women have folic acid levels below the new World Health Organisation recommendation for women entering pregnancy.

"This highlights the importance for pregnant women, and those trying or likely to get pregnant, of taking a daily folic acid supplement of 400 micrograms - before and up to the 12th week of pregnancy."

Professor Alan Cameron, vice president of clinical quality for the Royal College of Obstetricians and Gynaecologists (RCOG), said: "There is strong evidence to suggest that folic acid supplementation before pregnancy reduces the number of pregnancies affected by neural tube defects, such as spina bifida.

"The RCOG is calling for mandatory fortification of bread or flour with folic acid in the UK with the appropriate safeguards, such as controls on voluntary fortification by the food industry and better guidance on supplement use.

"Food fortification will reach women most at risk due to poor dietary habits or socio-economic status as well as those women who may not have planned their pregnancy."

9 Birth Practices From Around The World

Government-sponsored baby showers(01 of09)

Since the 1930s, expectant mothers in Finland have received what amounts to a "welcome to the world, baby!" care package from their government. It includes clothing, a sleeping bag, bibs, first aid basics and, yes, even a cardboard box that can be used as a crib.

"Mothers have a choice between taking the box, or a cash grant, currently set at 140 euros," according to the BBC, "but 95 percent opt for the box as it's worth much more." (credit:Associated Press)

Sitting up for labor(02 of09)

Though the practice of requiring women to lay flat on their backs has increasingly come under fire ("These days enlightened practitioners -- and better informed moms-to-be -- aren't taking labor lying down, or even in one place," What To Expect says), it's still the norm in many hospital across the United States, as well as in parts of Europe.

Not so in parts of Asia, Africa and Central and South America, the World Health Organization reports. In these countries, women move through various upright positions or squat while in labor. And that's a good thing: According to Rodale, research has shown that sitting, standing and kneeling during labor (or all of the above) can shorten early labor, and also decrease the need for epidural anesthesia. (credit:Getty)

A laughing (gas) matter(03 of09)

Though epidural or spinal anesthesia is the most common type of pain medication used by laboring women in the U.S. (CDC data from 2008 showed 61 percent of women from 27 states who gave birth vaginally had epidural or spinal anesthesia), nitrous oxide, or "laughing gas," is far more popular overseas. It's used by roughly 60 percent of women in the United Kingdom, and up to half of laboring women in Australia, Finland and Canada. According to a 2012 review by the Cochrane group, it's a safe and effective option, but experts say it is unlikely to become popular in the U.S. anytime soon, in part because hospitals do not have the correct equipment or ventilation.

As Slate reports, women who use laughing gas during childbirth -- inhaling it through a mask -- say it doesn't altogether eliminate the pain, but distracts them from it. (credit:Getty)

Seaweed soup, anyone?(04 of09)

Many cultures have customs dictating what women should and shouldn't eat during pregnancy, childbirth and beyond, but few foods are as closely tied to labor and delivery as miyeokguk, or Korean seaweed soup. Also called "birthday soup," the nutritious, hearty broth continues to be one of the first things women eat after delivery. "In the olden days," women also used to eat it for a month prior to giving birth -- and some still do, the Korea Tourism Organization explains. (The tradition in Korean culture was inspired by whales eating seaweed -- which is high in various vitamins and nutrients -- after giving birth, Time reports.) "Eating [this soup] on birthdays is seen as a way to remind children not to forget the pain of childbirth and to appreciate the care given to them by their mother." (credit:Stacey Newman via Getty Images)

Pride of place for the umbilical cord and placenta(05 of09)

In many places around the world, the umbilical cord and placenta -- which support the baby by providing oxygen and nutrients during pregnancy -- also have strong symbolic significance, and are treated accordingly after birth. In Turkey, for example, it's not uncommon for women to bury babies' umbilical cords at schools or mosques -- in the hope that their children will be devoted to education or religion -- or keep them at home, to ensure devotion to the family. In some parts of Africa, the placenta is buried in an important spot -- often under a tree, at home or in an open field.

In the U.S., the placenta is generally discarded by the hospital or birthing center where a woman delivers, although some women save theirs and consume it in pill form, believing it helps boost well-being (a controversial claim). (credit:Getty)

A month to rest(06 of09)

"Sitting the month,” a custom observed in China and Vietnam, mandates that women stay largely confined to their homes for at least the first few weeks after giving birth. "New mothers are pretty much expected to just sit around in pajamas for a month to recover from childbirth," NPR reports. Moms also follow specific guidelines about what they can and can't eat and drink (nothing too hot or cold) or do (take a shower).

As The Daily Beast explained in its takedown of the U.S.'s postpartum practices, "some version of the lie-in is still prevalent all over Asia, Africa, the Middle East and particular parts of Europe; in these places, where women have found the postpartum regimens of their own mothers and grandmothers slightly outdated, they've revised them." Definitely trickier to pull off in the U.S., one of the few countries left with no federally-mandated paid maternity leave. (credit:Getty)

Postnatal care down there(07 of09)

Postnatal care is pretty robust in France, as writer Claire Lundberg discovered when she delivered abroad, and can include something known as "la rééducation périnéale" -- therapy designed to help strengthen or "re-train" the vagina in the hopes of avoiding the pelvic problems that can plague women after birth. The service has been funded by French social security since 1985. (credit:Getty)

Saying "no" to sex(08 of09)

Here in the U.S., many women get the green light to have sex again at their six week postpartum check-up, but in Papua New Guinea, mothers wait much longer before they have intercourse. It is a common cultural practice for women to remain abstinent until they wean their babies, whether that takes weeks, months or even years. (credit:Getty)

Paid leave, guaranteed(09 of09)

Unlike their peers in the U.S. -- where, again, there is no federally-mandated paid maternity leave and many women are guaranteed a mere 12 weeks of job protection -- new mothers (and increasingly also fathers) elsewhere in the world are sometimes guaranteed more than a year of paid time off. In Sweden, Germany, Norway and Denmark, parents are offered more than 50 weeks of paid leave, which they can divvy up between mom and dad after birth or adoption, while in the Czech Republic, mothers or fathers are able to take up to 48 months of paid parental leave, according to Mercer, the global consulting firm. (credit:Getty)

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