In the UK, the government is discussing plans to use folic acid to prevent birth defects such as spina bifida.
Pregnant women are already advised to take folic acid, but many do not.
It is estimated that fortifying flour with folic acid can prevent up to 200 birth defects per year.
The charity Shine, which has been working for the move for 25 years, hoped that there would be no more 25 before that happened.
- Is folic acid ever added to British flour?
Women are advised to take 400 micrograms of folic acid per day at least one month before conception and up to the 12th week of pregnancy.
But about half of the pregnancies are unplanned and women are not always aware that they should take the supplement – or should forget.
Neural tube defects such as spina bifida (abnormal development of the spine) and anencephaly affecting the brain affect about 1,000 pregnancies per year in the UK.
Over 40% of cases are fatal. Most babies who survive must continue to be cared for.
A prescribed fortification would mean that anyone who consumes foods like bread receives more folic acid, but scientists have told the government that the recommended amount is safe.
"Women from the poorest areas are less likely to take folic acid supplements, and it is right that we do everything we can to protect the most vulnerable populations," said Seema Kennedy, Minister of Public Health.
"We all want to give our children the best start in life, and a birth defect diagnosis is devastating for the parents.
"Simply adding folic acid to flour would help save hundreds of families from such a life-changing event."
Kate Steele, Shine's director, said, "If it had been introduced 25 years ago when the National Scientific Advisory Committee on Nutrition recommended it, it could have saved several thousand British pregnancies from spina bifida or anencephaly.
"However, we do not see a gift horse in the mouth and are pleased that the government has initiated this consultation, we just hope that it will not take another 25 years for compulsory folic acid fortification to become a reality."
Folic acid is already added to flour in more than 60 countries. When Canada introduced obligatory fortification in the late 1990s, neural tube defects halved. And when the same change was made in Australia, the neural tube defects dropped by 14%.
The UK-wide consultation will take 12 weeks. Wheat flour ground in the UK already contains the vitamins thiamin and niacin as well as iron and calcium.
Good food sources for folic acid:
- Spinach, kale, Brussels sprouts, cabbage, broccoli
- Beans and legumes (eg peas, black beans)
- Yeast and beef extracts
- Oranges and orange juice
- Wheat bran and other whole grains
- Poultry, pork, shellfish and liver
- fortified foods (eg some breakfast cereals)
Source: British Dietetic Association