When the Canadian government made these decisions, Newfoundland had one of the highest rates of neural tube birth defects in North America. Neural tube defects are serious physical abnormalities. They can happen when a baby’s neural tube does not develop properly during the first four weeks of pregnancy.
The neural tube in an unborn baby will eventually develop into the brain and the spinal cord. Normally, during the first weeks of pregnancy, a layer of cells in the fetus (unborn baby) folds and closes to form this critical neural tube. The top of the tube develops into the brain. The bottom becomes the spinal cord. The spinal cord, a long, thin bundle of nerves and cells, starts at the brain and goes down, ending at the middle of the back. It is protected by the bones of the spine. The spinal cord acts as a highway for information connecting the brain to the nervous system throughout the body. If the neural tube of a baby does not close completely, the spinal cord or the brain will not develop properly. This is called a neural tube defect.
The two most common types of neural tube defects are anencephaly and spina bifida. Anencephaly occurs when the neural tube does not close properly at the baby’s head. The brain and skull bones do not develop normally. Spina bifida occurs when the neural tube does not close completely in the baby’s back. Sometimes the spinal cord or other membranes can push through this abnormal opening rather than developing properly in the back.
Some babies with neural tube defects are stillborn or die shortly after birth. Some suffer through life with serious physical and mental problems. Those with spina bifida have some amount of leg paralysis, which causes difficulty walking. They usually have problems with bowel and bladder control. In the most minor cases, spina bifida does not show and no one knows there is an abnormality.
All of these neural tube defects occur during the first 28 days of pregnancy. This is usually before a woman even knows she is pregnant. A lack of folic acid in a woman’s diet before and during early pregnancy is one of the causes of these serious birth defects.
Research shows that many cases of neural tube defects, perhaps up to 80 per cent, could be prevented if the mother consumes enough folic acid. Women can reduce the risk by taking a multi-vitamin that includes folic acid for at least one month before becoming pregnant, and during the first few months of pregnancy. Folic acid is especially important in the first four weeks of pregnancy, when the baby’s brain and spinal cord develop. However, many women do not even know they are pregnant this early. As well, many pregnancies are not planned. For this reason, all women of childbearing age should consider taking a daily multivitamin that contains 400 mcg (0.4 mg) of folic acid.
A healthy diet is also important before and during pregnancy. Extra folic acid is needed to build new blood cells for the mother and her baby. It also helps develop the placenta, which connects the baby to the mother, and to enlarge the uterus as the baby grows.
Some women are more likely to have a baby with a neural tube defect. These are women who had a previous pregnancy affected by this defect or a close relative with the condition. These women must take care to make sure they get enough folic acid. Also at greater risk are women who have poor quality diets, who diet chronically and follow low carbohydrate diets, and women who have a low socio-economic status or smoke. They may need more than 400 mcg (0.4 mg) of folic acid every day. Talk to a doctor to make sure you are taking the right amount of vitamins for a healthy pregnancy.
Fortifying grain products and recommending that all women who could become pregnant take a daily supplement containing folic acid has made a difference. Since 1998, the number of neural tube defects has dropped across Canada, and specifically in Newfoundland. Folic acid gives babies a better start.
Folic acid and folate are the two forms of this B-vitamin. Folate is naturally found in food, and folic acid is the form used in vitamin and mineral supplements. Good food sources of folate include:
All grain products in Canada, such as enriched breads, pasta and cereals, white flour and enriched corn meal are fortified or boosted with folic acid. The amount of folic acid added to grain products is safe and does not pose any risk to the general public.