Fact
Folate (folic acid) taken before pregnancy can prevent 70% of all neural tube defects. About 1:500 pregnancies are affected by a neural tube defect (spina bifida, anencephaly or encephalocoele).

When Should Folate Be Taken?
At least one month before pregnancy and for the first three months into the pregnancy. 0.5 mg of folate or folic acid every day.

How Much Folate Is Necessary?
A daily folate intake of 0.5 mg is recommended for all women who may become pregnant. (See exceptions and warning).

Exceptions
The following people are at an increased risk for having a child with a neural tube defect:

A women or their partners with a close family history of neural tube defect i.e. those with a neural tube defect themselves; with an affected infant; sibling; close relative

B women with insulin dependent diabetes

C women on some forms of anticonvulsant medication.
(See WARNING below)

Women in groups B & C should seek medical advice before undertaking a pregnancy or a course of folic acid.

These people should be advised:

• to take periconceptual 5 mg of folic acid daily
  
• to obtain a referral for genetic counselling
  
• about the availability of prenatal diagnosis by:
  • early trans-vaginal ultrasound at 11-12 weeks gestation
  • maternal serum alpha fetoprotein estimation (blood test at 15-16 weeks gestation)
  • detailed ultrasound scan by an operator experienced in anatomical scans at (18-20 weeks gestation)

Warning
Avoid taking multivitamins and mineral tablets in high dose to obtain the right amount of folic acid as the intake of other vitamins could be too high and may have an adverse effect on the developing fetus.

Research is continuing into the efficacy of periconceptual folate in the prevention of neural tube defects where the mother has insulin dependent diabetes.

Women on some forms of anticonvulsant drugs, specifically carbamazepine and valproic acid (valproate), should take folic acid only under the supervision of their doctor.

Where can folate be obtained?
Folic acid tablets of 0.5 mg or 5 mg are available in chemists, health food stores and some supermarkets.
NO PRESCRIPTION IS REQUIRED.

Folate in the diet
0.5mg of folate can also be obtained through a daily diet containing:

• Folate rich fruit (2 servings): oranges, bananas, strawberries
  
• Folate rich vegetables (5 servings): asparagus, beans, beetroot, brussel sprouts, broccoli, cabbage, cauliflower, leeks, parsnips, peas, potato, spinach.
  
• Folate rich cereal (7 servings): wheat germ, wheat bran, wholegrain bread, pasta, cereals (some cereals and pasta contain added folate).
  

This diet is healthy for everyone
and can help prevent heart disease,
some cancers, diabetes and other diseases.