Pregnancy has been called “a window of opportunity” for health promotion because it is thought to be the time when women are most willing to give up unhealthy habits. However, we should bear in mind that the focus for health promotion in pregnancy is the health of the developing child. In the linked study (doi:10.1136/bmj.b481), Inskip and colleagues assess the degree to which 12 445 women aged 20-34 years recruited to the Southampton women’s survey followed nutritional and lifestyle recommendations when planning a pregnancy.1

Sadly, the window often opens too late to provide sufficient care for pregnant women and offspring with special needs, or to start preconception supplementation to decrease the risks of adverse pregnancy outcomes that originate early in gestation. Daily folic acid supplements of 400 µg taken before conception and during organogenesis reduce …