Is your baby's spine weird? Let's talk about Spina Bifida in detail!

When a new baby comes into this world, the biggest wish of every mother and father is to have a healthy child. But sometimes, babies can be born with minor health problems that we don't even think about. Today, we are going to talk about a special condition that occurs in the spine, that is, the back, of some babies at birth. Doctors call this Spina Bifida . Although the name is a bit strange, it is very important to be aware of this.

What exactly is Spina Bifida?

Simply put, Spina Bifida is a neural tube defect . Now you may be wondering what a neural tube is. Think about it, during the first few weeks of a baby's conception, the baby's brain and spinal cord begin to develop from a small tube that runs down the spine. This is called the neural tube . If this tube does not close properly, a small gap, or opening, forms in the spine. That's what we call spina bifida. This gap can affect the vertebrae, spinal cord, and nerves that connect to them. In some severe cases, a fluid-filled sac can protrude from this gap.

Are there types of Spina Bifida?

Yes, there are three main types of this condition. Each one is different from the other.

1. Meningocele: This is a sac filled with fluid that protrudes from the opening in the spinal cord. However, this sac does not contain the spinal cord. This is the least common type of spina bifida.

2. Myelomeningocele: This is the most severe and common type of spina bifida. In this case, the fluid-filled sac that protrudes from the opening contains part of the spinal cord and part of the nerves. This increases the risk of the baby developing various complications.

3. Spina Bifida Occulta: This is the mildest and most common type of this condition. Here, although there is a small gap in the spinal cord, no sac is visible. Most of the time, these people do not have any symptoms. Sometimes it is discovered accidentally when a spine X-ray is taken for another reason.

What are the symptoms of this condition?

Symptoms can vary from person to person. They depend on how big the gap in the spine is, where it is located, and what type of spina bifida it is. Some common symptoms include:

• Back pain.
• Weakness, numbness, or loss of feeling in the legs.
• Problems with bowel and bladder function (e.g., incontinence).
• Some babies may notice a strange patch of skin, a tuft of hair, or a small bump where the gap is (especially in cases of Spina Bifida Occulta).

Someone with a very mild case may be able to live without showing any symptoms.

Why does this happen? What are the risk factors?

The exact cause of spina bifida is not yet known , but doctors believe it is caused by a combination of genetics and environmental factors. This means that the neural tube may not develop properly during the early stages of development in the mother's womb.

Some risk factors have been identified. If you are expecting a baby, it is good to be aware of these:

• Folic Acid Deficiency: Not getting enough folic acid, a vitamin that is essential for healthy pregnancy, is a major risk factor.
• Certain medications: Things like some antiseizure medications taken for conditions like epilepsy.
• Mother's health conditions: The mother has conditions such as diabetes or obesity .
• High fever or overheating of the body during early pregnancy: This can be caused by things like frequent use of hot tubs.
• Family history: If someone in the family has this condition, or if a previous child had a neural tube defect, the risk is slightly higher.

You can talk to your doctor about these risk factors and get the advice you need to have a healthy pregnancy.

What other complications can this cause?

Various complications can occur, especially in severe cases such as myelomeningocele. These include:

• Walking difficulties: Some children may have difficulty walking, or may not be able to walk at all.
• Hydrocephalus: This is a condition in which the head becomes enlarged due to the accumulation of cerebrospinal fluid inside the brain. This may require surgery to remove the excess fluid and place a shunt.
• Learning difficulties: Things like motor skills , memory, and problem-solving may be affected.
• Paralysis: The legs may become completely paralyzed.
• Scoliosis: The spine may curve to one side.
• Tethered spinal cord: This is when the spinal cord is attached to the inside of the spine. Normally, it should be free. This also requires surgery.

Living with physical problems like these can also cause some mental stress as the child grows up. Therefore, it is very important to seek help from a mental health counselor or join a support group for parents with similar children.

How does Spina Bifida affect adults?

Adults with spina bifida face different problems than children. For example:

• Accelerated aging process (decreased muscle strength, decreased flexibility, decreased physical strength, decreased sensory abilities).
• Possibility of a tethered spinal cord occurring again.
• Constipation or abdominal pain.
• Bone problems (e.g. osteoporosis , early onset of arthritis , increased back pain).
• Loss of skin sensation, poor blood circulation, inability to sweat, easy bruising, and delayed wound healing.
• Latex allergy: An allergy to latex.
• High blood pressure.
• Sleep apnea ( obstructive sleep apnea and central sleep apnea ).
• Obesity.

Although women with spina bifida can get pregnant, the pregnancy can be complicated, so it's important to follow your doctor's advice.

How do doctors diagnose this condition?

In most cases, this condition can be diagnosed during pregnancy (prenatal diagnosis) . The tests used for this are:

• Alpha-fetoprotein (AFP) blood test: This is a test done on the mother's blood.
• Amniocentesis: A test that takes a sample of the amniotic fluid surrounding the baby.
• Ultrasound scan: This can check for any abnormalities in the baby's spine.

If your baby is diagnosed with a condition like myelomeningocele, doctors may recommend a C-section to prevent further damage to the damaged area of ​​your baby's spine.

Even after the baby is born, the condition can be diagnosed based on symptoms. Imaging tests such as a CT scan , MRI , or ultrasound can also be done to examine the spine and spinal cord.

Sometimes, mild conditions like spina bifida occulta may not show symptoms and may go undiagnosed until adulthood. It is often discovered incidentally during a spinal examination for another reason.

What are the treatments?

Spina Bifida cannot be completely cured.However, there are many treatments that can help control symptoms and help the child live a normal life.

• Surgery: Surgery is performed to close the hole in the spinal cord. In severe cases, such as myelomeningocele, this surgery is performed during pregnancy in some countries. However, it is most often done within a few days of the baby's birth. The protruding sac is removed, the hole is closed, and the wound is stitched up. Surgery is also performed for a condition called a tethered spinal cord .
• Medications: Medications are given for urinary and bowel problems, pain, and other symptoms.
• Physical therapy and occupational therapy: These help improve a child's mobility, strength, and ability to perform daily tasks independently.

The medical team will develop a treatment plan tailored to the child's needs.

Can a child with Spina Bifida walk?

The way this condition affects walking varies depending on where the spinal stenosis is located (higher or lower) and the severity of the condition. The higher the stenosis is, such as near the neck, the less likely you are to walk on your own. However, if the stenosis is lower, such as near the hips, you may be able to walk with some support (e.g., braces, walker ). In mild cases, walking may not be affected at all.

Mobility devices, such as wheelchairs and walkers, can help them perform daily activities more comfortably and independently. The medical team can help you choose these devices and teach you how to use them safely.

What should I expect as a parent?

Every child is different. This is especially true for a child with Spina Bifida. Keep these things in mind as your child grows:

• Injuries: A minor scrape or bruise may not be felt on the affected parts of the child's body. Therefore, it is important to regularly check the child's body for injuries.
• Mobility: Your child may need some help getting around safely. Things like a wheelchair or walker can help them become more independent.
• Toilet training: Your child may not feel the need to urinate or defecate. This can make toilet training challenging. You can seek advice from doctors to prevent unnecessary wetting of clothes and to improve your child's self-confidence.

If your child has spina bifida, talk to their medical team about all of this. They can answer your questions and connect you with the resources you need.

Can Spina Bifida be prevented?

Although it cannot be completely prevented, there are several ways to reduce the risk of a child developing spina bifida:

• Getting enough folic acid: This is the most important thing. If you are planning to get pregnant, you should start taking a folic acid pill every day for at least a month before you conceive. It is also very important to continue taking it for the first three months of pregnancy. Ask your doctor how much you need.
• Avoiding hot tubs or saunas: Avoid overheating your body during early pregnancy.
• Controlling conditions like diabetes: If you have diabetes, control it well before you get pregnant.
• Talking to your doctor about your medications: If you are taking any medications, talk to your doctor before you get pregnant. They may be able to prescribe a safer alternative.

Where can I find out more about this?

As with many other conditions, being well-informed about Spina Bifida and connecting with local support groups is the best way to manage the condition and prevent further complications. You can ask your doctor about these places.

Finally, remember these things (Take-Home Message)

When you find out that your newborn baby has Spina Bifida, that happy moment can suddenly become one filled with anxiety and uncertainty. You may have a million questions running through your mind, and you may not know where to start.

But don't worry. You're not alone. Your medical team understands how difficult this news can be. They'll be by your side and your baby's side every step of the way, providing you with the care you need.

Remember, early detection and prompt treatment go a long way in helping your child live a better life. Educate others about the importance of folic acid. Above all, give your child lots of love and support.

` Spina bifida, spinal cord defects, neural tube defects, folic acid, birth defects, myelomeningocele, child health