smoke but, as there are no data directly relating cotinine levels to risk of death, it is not possible to predict the likely effect of a reduction of this magnitude on the risk of sudden infant death. Our results also suggest that harm reduction measures short of a total ban on smoking in the home are likely to have little effect on the exposure of infants to tobacco smoke, but this requires verification with a larger sample.We thank the parents who participated; the health visitors, their managers, and staff in the child health departments of the NHS trusts who helped us to recruit our sample; and the nurses who collected the data.

Aim To document peri‐conceptual folic acid supplementation in women with type 1 diabetes mellitus (DM) attending the diabetic ante‐natal clinic of a university teaching hospital. Methods Women with pre‐existing type 1 DM who booked at the diabetes antenatal clinic at University Hospital, Nottingham over 3 years (1996–98) took part in a telephone survey about folic acid supplements. Results Data was available on 50 women, 65 pregnancies. Folic acid supplements were used before 50.7% (33) pregnancies, all planned, and started on confirmation of pregnancy in 34% (22), at a mean gestation of 5.8 weeks. No folic acid was used before or during 10 (15.4%) pregnancies. 75.4% (49) pregnancies were planned. 24 planned pregnancies were in women who had never had pre‐pregnancy counselling. 70.8%(17) of these were in multiparous women, and folic acid was taken before 41.1% (seven) of such pregnancies. Lack of awareness was the predominant reason for failure to take folic acid supplements in all groups. Conclusions Folic acid was taken before conception in only half of the pregnancies in the survey, due to lack of awareness of its importance. Three‐quarters of pregnancies were planned but a disappointing number of women had pre‐pregnancy counselling, probably due to poor advertising and the assumption that women who had been pregnant before did not need such a session. Women with DM should be informed about folic acid and offered pre‐pregnancy counselling. It should not be assumed that women who have had a pregnancy know about folic acid. Copyright © 2001 John Wiley & Sons, Ltd. Key Points Folic acid supplementation prior to conception and in the first trimester helps to prevent neural tube defects. Almost half of the women in this survey failed to take folic acid prior to conception. Women who did not take folic acid were unaware of its importance. We need to ensure that women with diabetes understand the importance of folic acid.

No abstract