Spina Bifida

Home Treatment

Prevention of spina bifida

Having enough folic acid (a B vitamin) in your diet is an important part of preventing spina bifida and other neural tube defects. To be effective, it needs to be consumed before a baby is conceived. To reduce the risk of spina bifida, most women need 400 mcg (micrograms) of folic acid a day. Women who are at risk (such as those who have already had a child with spina bifida) should take 4,000 mcg of folic acid a day.⁴ Folic acid may be obtained from vitamin supplements and by eating foods that are rich in folic acid. Since 1998, the United States government has required that foods made from grains and sold in the United States be supplemented with folic acid to help reduce the risk for spina bifida.

Before you become pregnant, talk with your health professional about the risk for having a baby with spina bifida. This is especially important if you are taking medicines for epilepsy, such as valproic acid (Depakene or Depakote) or medicines for acne, such as isotretinoin (such as Accutane, Amnesteem, Claravis, or Sotret). These medicines are associated with a higher rate of neural tube defects and should not be taken just before and during the first 3 months of pregnancy.

Because no amount of alcohol is considered safe during pregnancy, do not drink while you are pregnant. Women who drink large amounts of alcohol during their pregnancy have an increased risk of having a child with physical and mental effects caused by alcohol exposure.

High body temperature (hyperthermia) can cause spina bifida to develop in your fetus. So avoid exposure to excessive heat, such as saunas or soaking in a very hot bath, during the first weeks of your pregnancy. A high fever during the first weeks of pregnancy can also cause hyperthermia.

Home treatment for the child with spina bifida

Exercise promotes strength, physical development, and enhanced mobility in children with spina bifida. Even children who use a wheelchair full time benefit from exercise, because it helps prevent brittle bones, strengthens muscles, and reduces the risk of joint injury. Your health care team will provide you with exercises to do with your baby. To promote activity, you can also:

• Place your child on his or her stomach and place toys within reach to encourage the use of arms.
• Move your child's joints through their full range of motion to help increase flexibility and prevent injury to the joints.
• Encourage your child to take responsibility for household chores as he or she grows older.

Preventing skin infections and injuries requires daily inspection of your child's skin. Children with spina bifida who have little or no feeling in their legs and feet are not able to sense pain and may injure themselves without knowing it. Some injuries may result in infections. Look for cuts that your child has not noticed, blisters and pressure sores that result from staying in one position too long, raw places where braces rub on the skin, and other signs of injury. Early care of any blisters, sores, or cuts helps prevent infection.

Treatment for bladder control problems is important to prevent bladder infections and kidney damage. A common treatment is a technique called clean intermittent catheterization (CIC). In CIC, at least 4 times a day a catheter is inserted into the bladder through the urethra to allow urine to drain.³

Help your child prevent constipation by paying close attention to his or her diet. If your child has nerve damage that contributes to constipation, encourage him or her to drink plenty of fluids and eat foods that are high in fiber, such as whole grains and fruits. Some children need enemas to help them pass stool.

Children with spina bifida often have an allergy to latex. Help your child to avoid contact with latex products, such as certain toys, balloons, and gloves. The Spina Bifida Association of America (www.sbaa.org) maintains a list of items that contain latex.

Educational needs of the child with spina bifida

When your child reaches school age, you may need to help teachers understand your child's special needs. Children with severe spina bifida often have decreased intelligence. They may also have problems with coordination that make writing difficult. You can work with teachers and other school officials to develop a plan to accommodate your child's mental and physical disabilities. Sometimes this is as simple as giving the child extra time to complete school work.

In the United States, laws guarantee free early treatment programs and equal access to public education for all disabled children. These laws protect a parent's right to be fully informed about educational decisions concerning their child. In addition, the laws protect the parents' rights when they disagree with any decision. Contact your state and local education departments for information about your rights to educational accommodations.

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Author:	Shannon Erstad, MBA/MPH	Last Updated: May 10, 2007
Medical Review:	Michael J. Sexton, MD - Pediatrics Colin Chalk, MD, CM, FRCPC - Neurology
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