On this page:
       Spina Bifida - occults, meningocele, myelomeningocele  
       Arnold-Chiari Malformation
          Folic acid  (folate) 
          Hydrocephalus (Congenital) 

Spina Bifida 
is a birth defect. Most children who have spina bifida do not have problems from it. It occurs when the bones of the spine (vertebrae) do not form properly around part of the baby’s spinal cord. It can affect how the skin on the back looks. And in severe cases, it can make walking or daily activities hard to do without help.

The disease can be mild to severe.
Occulta - The mild form is the more common form. It usually does not cause problems or need treatment. You can’t see the defect. So most people don’t know they have it until they get a back X-ray for another reason.

Meningocele(muh-NIN-juh-seel) - Fluid leaks out of the spine and pushes against the skin. You may see a bulge in the skin. In many cases, there are no other symptoms.

Myelomeningocele (my-uh-loh-muh-NIN-juh-seel).    Although this is the most rare and severe form of spina bifida, it is the form most people mean when they say “spina bifida.” Part of the spinal nerves push out of the spinal canal, and you may see a bulge in the skin. The nerves are often damaged, which can cause problems with walking, bladder or bowel control, and coordination. In some babies, the skin is open and the nerves are exposed. 

What are the symptoms?
          Your child’s symptoms will depend on how severe the defect is. With a mild defect, your child may have no symptoms or problems. Or your child might have a dimple, a birthmark,or a hairy patch on his or her back.
           In severe cases, you may see nerves coming out of your child’s back or swelling on the spine. A child with a severe defect may have nerve damage that affects daily living. The child may have little or no feeling in the legs, feet, or arms. And he or she may not be able to move those parts of the body.  Children with a severe defect are sometimes born with fluid buildup in the brain (hydrocephalus).  They may also have this problem after birth. It can cause seizures, mental retardation, or sight problems. Some children also get a curve in the spine, such as scolisis.
          Many children who have severe spina bifida develop an  allergy to latex (a type of rubber). 

How is spina bifida diagnosed?
          A pregnant woman can have a blood test (AFP-maternal serum triple or quadruple screen) and a  fetal ultrasound to check for spina bifida and other problems with the  fetus.  If test results suggest a birth defect, she can choose to have an  amniocentesis.  This test helps confirm if spina bifida exists. But the test also has risks, such as a chance of miscarriage. 
          After birth, doctors can tell if a baby has spina bifida by how the baby’s back looks. The doctor may do an X-ray, an MRI, or a CT scan to see if the defect is mild or severe.

 How is it treated?
          Treatment depends on how severe the defect is. Most children with spina bifida have only a mild defect and may not need treatment. But a child with a severe defect may need surgery. If your child has problems from nerve damage, he or she may need a brace or a wheelchair, physical therapy, or other aids.   

There are things you can do to support your child:
Help your child be active and eat healthy foods. 
Go to all scheduled doctor and clinic visits. 
Keep your child away from latex products if he or she has a latex allergy. 
If your child has bladder control problems, help him or her use a catheter each day. It can help
prevent infection and kidney damage in your child. 
If your child has little or no feeling in the limbs and can’t sense pain, he or she may get injured
and not know it. You may need to check your child’s skin each day for cuts, bruses, or 
other sores.

          Your child may qualify for Early Intervention Programs due to spina bifida.  Check with your
County for available services.
          When your child is ready to go to school, talk with teachers and other school workers. Public   
schools have programs for people ages 3 through 21 with special needs. 
Take good care of yourself so you have the energy to enjoy your child and attend to his or her
          Ask for help from support groups, family, and friends when you need it. 

What causes spina bifida?
          The exact cause of this birth defect is not known. Experts think that genes and the environment are part of the cause. For example, women who have had one child with spina bifida are more likely to have another child with the disease. Women who are obese or who have diabetes are also more likely to have a child with spina bifida.

How can you prevent spina bifida?
Before and during pregnancy, a woman can help prevent spina bifida in her child.  
          Get 400 mcg (micrograms) of folic acid (a B vitamin) each day. Eat foods rich in folic acid, such as
                avocados, black beans, and asparagus. And since most women do not get enough in their diet,
                take a daily vitamin with folic acid.

           If you take medicine for seizures or acne, talk with your doctor before you get pregnant. Some of
                these medicines can cause birth defects. 

          Don’t drink alcohol while you are pregnant. Any amount of alcohol may affect your baby’s health. 
          Don’t let your body get too hot in the first weeks of pregnancy. For example, don’t use a sauna or   
                take a very hot bath. And treat high fevers right away. The heat could raise your baby’s risk for
                spina bifida

          All foods made from grains and sold in the United States have folic acid added. It helps prevent children from being born with spina bifida.

Arnold-Chiari Malformation is a rare malformation of the brain that is sometimes, but not always, apparent at birth. It is characterized by abnormalities in the area where the brain and spinal cord meet that cause part of the cerebellum to protrude through the bottom of the skull (foramen magnum) into the spinal canal. This interferes with the flow of cerebral spinal fluid to and from the brain, leading to accumulation of cerebral spinal fluid in the empty spaces of the spine and brain. The portion of the cerebellum that protrudes into the spinal canal can become elongated and is called the “cerebellar tonsils” because it resembles the tonsils.
             There are four types of Chiari malformation. Depending on the type, the impact on the affected individual may range from mild to severe.

Folic acid (folates)
           Folic acid, one of the B vitamins, is important for the normal development of an unborn child (fetus). Folic acid and its closely related compounds, folates, are needed for the production of red and white blood cells and platelets, the formation of genetic material (DNA) in cells, and growth. 
           Only a small amount of folic acid is stored in the body. Therefore, to avoid a deficiency, a person must get folic acid regularly from the foods in the diet. Folic acid is found in foods such as liver, kidney, yeast, fruits (bananas, oranges), leafy vegetables (spinach), eggs, whole wheat bread, lima beans, and milk.
          Taking supplements of folic acid before and during pregnancy can reduce the chance of having a baby with birth defects, such as spina bifida.

Hydrocephalus (Congenital) 
            Congential hydrocephalus is a buildup of excess Cerebrospinal fluid (CSF) in the brain at birth. The extra fluid can increase pressure in the baby's brain, causing brain damage and mental and physical problems. Finding the condition early and treating it quickly can help limit any long-term problems. But long-term effects mostly depend on what caused the fluid buildup, how bad it gets, and how the baby responds to treatment.

           This condition is rare. About 1 out of every 1,000 babies is born with it.

 What causes congenital hydrocephalus?
          This condition is caused by an imbalance between how much CSF the brain makes and how well the body is able to process it.  Normally, CSF flows through and out of chambers of the brain called ventricles, and then around the brain and spinal cord. The fluid is then absorbed by the thin tissue around the brain and spinal cord. But with hydrocephalus, the fluid can't move where it needs to or is not absorbed as it should be. And in rare cases, the brain makes too much fluid.

Congenital hydrocephalus may happen because of:
          Bleeding in the fetus before birth. 
          Certain infections in the mother, such as toxoplasmosis or syphilis
          Birth defects, like spina bifida.

What are the symptoms?
          The clearest symptom of hydrocephalus is a head that is larger than normal. You and your doctor may notice it at birth or within the first several months after your baby is born. But keep in mind that babies' heads grow a lot during the first year. It is only when the head size grows faster than the normal rate for a baby's height and weight that your doctor may think that there is a problem. 
The condition may cause the soft spot (fontanelle) on your baby’s head to feel firm or bulge out. If pressure builds in the brain, your baby may:
          Be irritable. 
          Sleep too much. 
          Eat very little. 
How is congenital hydrocephalus diagnosed?
          Your doctor may suspect that your baby has congenital hydrocephalus if your baby’s head is larger than normal. Your doctor can check for the problem during a physical exam soon after birth. 
          Your baby may need imaging tests, such as a CT scan, an MRI, or an ultrasound, that can give a picture of the brain with more detail. A fetal ultrasound can sometimes show the problem before birth while the baby is in the uterus.

How is it treated?
          Early treatment during the baby’s first 3 or 4 months of life is important to help limit or prevent brain damage. Treatment aims to reduce the amount of CSF in the brain to relieve pressure.
          In most cases, the doctor places a flexible tube called a shunt in the brain to drain the fluid. The shunt may stay in the brain forever. But it may have to be fixed or replaced later if there is a problem.
After treatment, watch your child closely to make sure that the fluid is draining. You will need to watch for signs of infection or brain injury such as:
          Poor appetite. 
          Sleeping too much. 
          Vomiting often. 
          Fever and redness along the shunt tract or valve. 

          A child with congenital hydrocephalus is at risk for development problems and may need physical or speech therapy.
          Taking care of a child with hydrocephalus can be a challenge. Take good care of yourself. And ask your doctor about support groups and organizations that can help you manage your child’s special needs.



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