Facts About Spina Bifida

What are Neural Tube Defects?

Neural tube defects (NTDs) are serious birth defects that involve incomplete development of the brain, Spinal cord and/or protective coverings for these organs. There are 3 types of NTDs: anencephaly, encephalocele, and Spina Bifida. Babies born with anencephaly have underdeveloped brains and incomplete skulls. Most infants born with anencephaly do not survive more than a few hours after birth. Encephalocele results in a hole in the skull through which brain tissue protrudes. Although most babies with encephalocele do not live or are severely retarded, early surgery has been able to save a few children.

What is Spina Bifida?

Spina Bifida is the most frequently occurring permanently disabling birth defect and the most common Neural Tube Defect. It affects approximately one out of every 1,000 newborns in the United States.

Spina Bifida results from the failure of the spine to close properly during the first month of pregnancy. In severe cases, the Spinal cord protrudes through the back and may be covered by skin or a thin membrane. Surgery to close a newborn's back is generally performed within 24 hours after birth to minimize the risk of infection and to preserve existing function in the Spinal cord.

Because of the paralysis resulting from the damage to the Spinal cord, people born with Spina Bifida may need surgeries and other extensive medical care. The condition can also cause bowel and bladder complications. A large percentage of children born with Spina Bifida also have hydrocephalus, the accumulation of fluid in the brain. Hydrocephalus is controlled by a surgical procedure called "shunting" which relieves the fluid build up in the brain by redirecting it into the abdominal area. Most children born with Spina Bifida live well into adulthood as a result of today's sophisticated medical techniques.

Who is at higher risk?

Women who:

• Have a child with Spina Bifida
• Have Spina Bifida themselves
• Have already had a pregnancy affected by any neural defect

are at greater risk of having a child affected by Spina Bifida or another neural tube defect. These women may need to get a prescription for folic acid before trying to become pregnant, so it's important to plan any future pregnancy. Please speak with your health care provider about folic acid.

Do children with Spina Bifida have learning problems?

Some children with Spina Bifida do experience learning problems. They may have difficulty with paying attention, expressing or understanding language, organizing, sequencing and grasping reading and math.

How can we help with those learning problem?

Early intervention can help considerably to prepare these children for school. Students should be in the least restrictive environment and their day to day activities should be as "normal" as possible. It often helps to have a psychological evaluation, which tests the child's intelligence, academic levels (reading, spelling, math etc.), and basic learning abilities (visual perception, receptive and expressive language skills).

What about the physical limitations?

Children with Spina Bifida need to learn mobility skills, and often with the use of crutches, braces, or wheelchairs can achieve more independence. Also, with new techniques children can become independent in managing their bowel and bladder problems. Physical disabilities like Spina Bifida can have profound effects on the child's emotional and social development. It is important that health care professionals, teachers, and parents understand the child's physical capabilities and limitations. To promote personal growth, they should encourage children (within the limits of safety and health) to be independent, to participate in activities with their non-disabled peers and to assume responsibility for their own care.

What are secondary conditions associated with SB?

Special attention is needed to identify and treat secondary disabilities. Due to the wide range of neurological damage and mobility impairment it can be difficult to identify some secondary disabilities. Attention should be focused on the psychological and social development of children and young adults with Spina Bifida. Many recent studies, including the SBAA's Adult Network Survey, clearly indicate the presence of emotional problems that result from factors such as low self-esteem and lack of social skills training. Examples of secondary conditions associated with Spina Bifida are latex allergy, tendinitis, obesity, skin breakdown, gastrointestinal disorders, learning disabilities, attaining and retaining mobility, depression, and social and sexual issues.

Can anything be done to prevent Spina Bifida?

Birth defects can happen in any family. Many things can affect a pregnancy, including family genes and things women may come in contact with during pregnancy. Recent studies have shown that folic acid is one factor that may reduce the risk of having an NTD baby.

Taking folic acid cannot guarantee having a healthy baby, but it can help. Taking folic acid before and during early pregnancy reduces the risk of Spina Bifida and other neural tube defects. Here's what you can do:

• Take a vitamin with 400 micrograms (mcg) folic acid every day.This amount is also written as 0.4 milligrams (mg). All women should take this amount every day while not planning to become pregnant.
• If you have a child with Spina Bifida, have Spina Bifida yourself, or have had a history of pregnancy affected by a neural tube defect, and you are thinking about becoming pregnant, you need a higher dose of folic acid. You should take 4000 micrograms (mcg) of folic acid by prescription for 1 to 3 months before becoming pregnant.This amount is also written as 4.0 milligrams (mg). Taking this amount of folic acid by prescription may reduce the chance of a neural tube defect like Spina Bifida in future pregnancies. Please see your doctor. Do not take this extra folic acid by taking more multivitamins because too much of some of the other vitamins could harm you and your future baby.
• Plan your next pregnancy.Speak with your health care provider about your personal risk of having a baby with a neural tube defect. You may need to get a prescription for folic acid before you try to become pregnant.

What is Folic Acid?

Folic acid, a common water-soluble B vitamin, is essential for the functioning of the human body. During periods of rapid growth, such as pregnancy and fetal development, the body's requirement for this vitamin increases. Folic acid can be found in multivitamins, fortified breakfast cereals, dark green leafy vegetables such as broccoli and Spinach, egg yolks, and some fruits and fruit juices. However, the average American diet does not supply the recommended level of folic acid.