Spina bifida, a type of birth defect in which the infant’s spinal cord sticks out of a gap in their spine, is rare: It occurs in about three of every 10,000 births.
It is so rare thanks in part to the discovery that a multivitamin taken daily can provide all the folic acid babies need to help them get off to a healthy start.
Still, scientists do not know what causes spina bifida, so taking these precautions cannot prevent the condition with certainty. Moreover, there is no cure.
Considering the wide-ranging impacts spina bifida can have on a child’s life — including paralysis, bowel problems and many other potential complications — a pregnant mother’s best tools are prevention and preparedness.
Florida Hospital experts counsel mothers to take what steps they can to prevent spina bifida in the early stages of pregnancy. And for those instances where spina bifida is not preventable, our spine experts are here to help with leading-edge treatments and a whole-hearted approach.
They’ll work with you to create a treatment plan focused on doing everything possible to help your child thrive.
What is it?
Named after the Latin for “split spine,” spina bifida is a birth defect that occurs about a month into a pregnancy. That’s when the baby’s brain and spinal cord are just beginning to take shape.
The spinal cord typically runs through the spine’s vertebrae, like a belt passing through the loops of a pair of jeans.
It the spine doesn’t form correctly around the spinal cord, the cord can escape its barrier and jut out of the body, usually at the lower back. There are typically three ways in which spina bifida is diagnosed before birth:
- Routine blood tests can screen for unusual levels of certain chemicals, which may lead to other tests.
- An amniocentesis, in which a needle is used to pull some amniotic fluid surrounding the baby, can answer questions a blood test can’t.
- An ultrasound can take images of the baby and spot spina bifida.
In other cases, the condition is not diagnosed until birth.
Though spina bifida is sometimes described only in its most severe form — in which the spinal cord protrudes outside of the back — there are two other types. Though they are not nearly as severe, knowing them will help you understand spina bifida.
The most common type is called spina bifida occulta, and about 15 percent of babies are born with it. But most never know it.
“Occulta” is Latin for hidden, and it gets this name because the spinal cord remains hidden under the skin. While gaps are still formed in the backbone, they are not large enough for the spinal cord to fit through. The skin at the site of this small gap may be marked in some way, such as with hair or a dimple, or it may be normal.
This form of the condition is typically harmless, and is sometimes found by accident during an X-ray for another reason.
The third and least common form of the condition is called “meningocele.” In this case, there is also a gap in the spine and a visible protrusion from the baby’s back. However, only the protective tissue around the spinal cord leaves the spinal column; the cord itself stays safely tucked within.
Because the spinal cord is typically undamaged, this condition usually only causes minor long-term problems.
It’s easy to see why an exposed spinal cord, as happens in the most severe form of spina bifida, can affect the entire body. The spinal cord is the brain’s main route of communication with the rest of the body, so any interruption can lead to paralysis or a host of other symptoms.
Spina bifida occurs early in pregnancy, about a month after conception, a time when many women do not know they are pregnant. For that reason, folic acid is not just recommended for pregnant women — it’s recommended for those who might become pregnant.
That’s in line with other guidance to prevent birth defects. Roughly half of pregnancies in the United States are not planned, so women who may become pregnant should take these precautionary steps.
How much is the right amount?
If folic acid can protect against spina bifida, you’ll want to know how much you should eat and where you can get it.
The recommended daily amount for pregnant mothers is 400 mcg. To ensure you’re getting enough, check the nutrition labels on your food and vitamins — you’re looking to get 100 percent of your daily value (or “DV”) each day.
You can often get enough folic acid from foods such as cereal that have vitamins added to them.
The Centers for Disease Control and Prevention recommends women who are pregnant or may become pregnant should take a multivitamin that contains 100 percent of your daily value of folic acid. The CDC says taking a daily vitamin is a hassle-free way to ensure you get all the folic acid you need, instead of relying on diet alone.
Prenatal vitamins do not require a prescription. Most over-the-counter prenatal vitamins contain enough folic acid, but it’s best to check the label to make sure.
Beyond taking folic acid, the CDC has the following recommendations to prevent spina bifida:
- Talk to your doctor or pharmacist about any vitamins, supplements or over-the-counter or prescription drugs you’re taking.
- If you have a long-term medical condition such as diabetes or obesity, be sure to work with your physician to ensure it is under control before you become pregnant.
- Avoid overheating your body, including using a hot tub or sauna.
- Treat any fever you develop with acetaminophen.
It’s important to note that a lack of folic acid does not, by itself, cause spina bifida. A complex interaction between genes and the environment is behind the condition, and they mesh together in ways scientists don’t fully understand.
How is it treated?
Most infants with the most severe form of spina bifida receive an operation shortly after birth to put the spinal cord back in the spine to spare it further damage.
Though there is no cure, research continues into experimental methods to repair the spinal cord in the womb, before the baby continues to develop. This therapy is only in initial stages, though it is providing hope for a cure.
Because spina bifida ranges widely in severity, later treatment decisions are often made on a case-by-case basis. If the gap in the spine occurs further up, for example, more of the spinal cord is typically damaged, and there may be more paralysis.
Most kids with this form of the illness will benefit from a team of specialists, including:
- An expert in bones and muscles to treat curvature of the back, contracted muscles, weak bones and other issues.
- Physical therapists and other specialists in movement to promote activity and age-appropriate development.
- Urologists to repair the bowel and bladder.
- Neurologist to treat brain complications.
At Florida Hospital for Children, we are experienced in assembling teams that see to every aspect of your child’s physical, emotional and spiritual health. We also see further, to the family as a whole, to help parents by coordinating that care under one health system.
Even though spina bifida is rare, we hope that knowing such a team is available will give you a little peace of mind.
For more information, call us at (407) 303-KIDS or schedule an appointment on our website.