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Question: I came across a message in the social media that pregnant mothers should not take folic acid. It is given for mothers to increase the baby’s weight. Then the doctors will say that the baby is too big to go for normal delivery. They will force to us to do Caesarean delivery. Is this true? Answer: Folic acid is an important vitamin. It belongs to vitamin B group. Research studies indicate that insufficient intake of folic acid in the mother’s diet is a key factor in causing some major developmental problems in baby’s brain such as spina bifida (underdeveloped spine) and anencephaly (underdeveloped brain and small head). Research has also shown that adequate amount of folic acid in a pregnant mother can prevent these problems and many other developmental defects. For this purpose, women should start taking this vitamin when they are planning to become pregnant. It could be started as early as 3 months before becoming pregnant. (Details about the birth defects and the benefits of taking folic acid is described in the answer to question 006.) Normal dose of folic acid for pre-pregnant or pregnant mothers will be 0.4 mg (400 micrograms) per day. But some women would require much higher doses (5mg). This includes women who have a baby with neural tube defects, or have a family history of neural tube defects, diabetes or history of epilepsy. World Health Organisation (WHO) and many other health organisations recommend folic acid for women before and during early pregnancy to avoid those major birth defects. In countries where there is increased risk of anaemia, folic acid and iron combination is continued throughout the pregnancy and 3 months after delivery. There is no evidence to suggest that this vitamin increases the birth weight of the baby. There are many causes for large baby. The important causes are; - Maternal diabetes - Advanced maternal age - High body mass index (BMI) of the mother - Excessive weight gain during pregnancy - Prolonged (post-term) pregnancy. - Male infant - Multiparity (having had more than 1 child previously) - Previous large baby - Maternal birth weight more than 4.0kg If a baby is found to be too large for its gestational age, the obstetrician would normally do further assessment to determine the cause. If a baby is large due to any reason, it may need to be delivered by Caesarean section. This is to avoid certain complications for the mother as well as for the baby. For instance, the large baby may not pass through mother’s birth canal easily. This can cause damage to structures in the mother’s birth canal. The baby also can sustain some injuries to the shoulder and nerves in the neck area. Therefore, the claim that the folic acid is given to increase baby’s weight is false. Rather it is given to prevent some major developmental defects in the baby. References - Greenberg, James A, Stacey J Bell, Yong Guan, and Yan-hong Yu. 2011. “Folic Acid Supplementation and Pregnancy: More Than Just Neural Tube Defect Prevention.” Rev Obstet Gynecol. - Mandy, George T, Leonard E Weisman, and Melanie S Kim. Large for gestational age newborn. October 15. Accessed November 6, 2019. https://www.uptodate.com/contents/large-for-gestational-age-newborn.
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