We're disappointed, to say the least, by the government's delay and lack of courage on this issue

Andrew Russell, ASBAH

Women are advised to take folic acid supplements when they try to conceive, but some doctors are concerned many pregnancies are unplanned, and the advice is not always followed.

ASBAH says the government has failed to act despite recommendations from the Committee on Medical Aspects of Food and Nutrition (COMA).

COMA said spina bifida incidence would be cut by 41% if 240 micrograms of folic acid was added to every 100 grams of flour.

Last week, Helen Clark, MP for Peterborough, tabled an Early Day Motion in the Commons calling on the government to say what it was going to do.

Development problem

One thousand pregnancies are affected by spina bifida each year in the UK.

It develops very early in pregnancy, and is caused by the failure of the vertebrae of the spine to develop properly and enclose the delicate spinal cord to protect it.

The resulting damage can lead to paralysis, which can make the child reliant on a wheelchair or crutches. There can also be bowel or bladder difficulties.

Around 80% of children with this condition also have hydrocephalus, or water on the brain.

In around nine out of 10 cases where spina bifida is detected, parents choose to terminate the pregnancy.

Delay

Andrew Russell, executive director of ASBAH, said the government had "shilly-shallied".

He added: "We're disappointed, to say the least, by the government's delay and lack of courage on this issue."

The US introduced folic acid into flour in 1998, at lower levels than ASBAH is calling for in the UK.

A study published this year estimated the measure has reduced spina bifida affected pregnancies by 19% annually.

A Department of Health spokesman said because of issues such as the vitamin B12 deficiency in the elderly, more research had been undertaken since the consultation period on COMA's recommendations closed almost a year ago.

'Learn from US'

The medical research charity Action Research funded a study 30 years ago which discovered that folic acid was a key ingredient in helping prevent neural tube defects

Professor Richard Smithells, who led the original studies into folic acid and NTDs says he 'wholeheartedly' supports fortification, especially as about 50% of pregnancies are unplanned.

John Grounds, the charity's director of campaigns and communications said: "Babies deserve to be given the best chance in life, and improving the population's intake of folic acid is crucial.

"We have already seen the success of fortification in the States. It's time the UK learnt from this."

He said a MORI poll carried out last year had found 72% of women aged 15-55 were in favour of such a move.