Wheat flour milled in Nigeria will soon be fortified with folic acid, a
B vitamin known for preventing serious or fatal birth defects of the
spine and brain. Women who may become pregnant are encouraged to daily
choose foods fortified with this essential vitamin because it can
prevent the majority of these devastating birth defects known as neural
Foods already fortified with folic acid in Nigeria include Blue Brand
margarine made by Unilever, Dangote pasta, Bournvita, Ovaltine, and some
brands of powdered milk.
Flour has been fortified with iron and vitamin A in Nigeria for years.
Adding folic acid means that all the bread and pasta made with fortified
flour will also contain this vitamin. More than 60 countries fortify
wheat flour with folic acid, and they report 30 to 70 percent declines
in neural tube defects as a result.
Spina bifida is the most common birth defect that can be prevented with
folic acid. It causes the baby's spine to not form correctly, and it
cannot be cured. Children with spina bifida almost always have some form
of paralysis and problems controlling their bowel and bladder functions.
Children with spina bifida undergo a lifetime of surgeries and face many
Two other types of neural tube defects affect the brain. With
anencephaly, the brain does not form properly. These pregnancies are
often miscarried, but if the infants are delivered, the babies die
shortly after birth. Encephalocele is an opening of the skull which
allows parts of the brain and brain membrane to protrude through the
opening. The severity of encephalocele depends on its location.
It is difficult to determine exactly how many pregnancies in Nigeria are
affected by neural tube defects because no single group tracks birth
defects in the country. Also, pregnancies that are miscarried or
terminated due to a neural tube defect are often not reported.
Two studies at Lagos State University Hospital in Ikeja, Lagos, found
that more than half the children treated for defects of the central
nervous system had neural tube defects. In 2005, 33 of 61 children
treated had neural tube defects. A two-year study in 2008 and 2009
showed 54 children with neural tube defects among the 94 children
"The number of Nigerian children with neural tube defects reported in
these two studies may seem small compared to some of the other health
challenges our country faces, but that is because these are the only
ones out of the vast majority of the probable cases that reach our
attention." said Dr. Amos Olufemi Adeleye, Lecturer and Consultant
Neurosurgeon in the Department of Neurological Surgery at University
College Hospital in Ibadan. "Even so, the lifelong burden of these birth
defects in those who live with them after their initial medical and
surgical care, is just impossibly staggering. And this is both in human
and financial terms. The children need multiple surgeries and
rehabilitation, and in many cases this is more than the parents can
afford. The need for prevention could not therefore be more imperative."
The U.S. based March of Dimes estimates that more than 300,000 neural
tube defects happen every year worldwide, including an estimated 12,695
in Nigeria. Based on that estimate, the prevalence of neural tube
defects in Nigeria is 27 per 10,000 births. In countries where foods
fortified with folic acid are widely consumed, the prevalence is often
less than 10 per 10,000 births.
Women need folic acid within the first three weeks of pregnancy because
that is when the infant's neural tube is formed. Many women do not
realize they are pregnant during this time. Consequently, it is
important that women consume foods fortified with folic acid every day
if there is any chance they could become pregnant.
Women are still encouraged to take vitamin supplements with folic acid
and to eat a variety of healthy foods if they may become pregnant. Foods
fortified with folic acid provide a way for women to consume more folic
acid just by eating what they normally eat every day.
Foods fortified with folic acid will include the words folic acid or
vitamin B9 on the nutrition label. With more fortified foods on the
market, Nigerians can expect healthier infants if women consistently
read the labels on food products, then purchase and consume foods
fortified with folic acid.
Lagos State University Hospital