October 2007

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400 Micrograms of Prevention:
Folic Acid for All Women

My mom always said she was an "evil step-mother." When things were out of my reach she would say that if I couldn't get it myself I didn't deserve to have it. So, I learned to climb on chairs and counters to get things that were out of my reach. And I have to say that the fact that I had an evil step-mother was the best thing that could have ever happened to me. You see, I was born with spina bifida.

Spina bifida is the most common disabling birth defect in the United States. It is a type of neural tube defect (NTD), which is a problem with the spinal cord or its coverings. It happens if the fetal spinal column doesn't close completely during the first month of pregnancy. There is usually nerve damage that causes at least some paralysis of the legs. Many people with spina bifida need assistive devices such as braces, crutches or wheelchairs.

Current statistics show that spina bifida occurs in seven out of every ten-thousand births. There are three different types of spina bifida:

1. Occulta: the spina bifida is hidden. You usually don't find out that you have it unless you get an x-ray done.
2. Meningocele: a mild form of spina bifida. People with this type usually have mild disabilities.
3. Myelomeningocele: the most severe form of spina bifida. It can cause severe disabilities.

In the United States, there are 65 million women of childbearing age and each one is potentially at risk of having a pregnancy affected by spina bifida. Birth defects can happen in any family. In fact, 95 percent of NTDs occur in women with no personal or family history of such defects.

Studies have shown that if all women who can become pregnant were to take a multivitamin with the B-vitamin folic acid, the risk of NTDs could be reduced by up to 70 percent. Folic acid helps the body make healthy new cells. When a woman has enough folic acid before and during early pregnancy, it can help prevent major birth defects of her baby's brain or spine. Since spina bifida occurs early in pregnancy—often before a woman knows she is pregnant—it is important for all women who could possibly become pregnant to take folic acid every day. Even if you are not trying to get pregnant, it is important to take your folic acid. Current recommendations are 400 micrograms of folic acid a day. The Spina Bifida Association of America recommends getting this amount of folic acid by taking a daily multivitamin.

The following foods are also good sources of folic acid:

• Broccoli
• Asparagus
• Bananas
• Oranges
• Peas
• Nuts
• Whole Grains

Helping your child become independent

Once you become a parent—whether he or she is disabled or not—your job is to prepare your child to be as independent and self-sufficient as possible. Of course, if your child is born with a disability like spina bifida, independence will be determined by the severity of the disability. But teaching children the difference between "I want" and "I need," makes them more autonomous—even when the disability is severe. Instead of being told when to eat, they can tell someone, "I'm hungry, I need to eat."

Many parents over-protect their kids because they are scared of what might happen. Many feel like they weren't able to protect their kids from getting the disability in the first place so it's their job to protect them now. The fact is that they must protect them, but they must also be able to teach them how to survive in a world that isn't always the safest place to be.

All parents worry about what will happen when they are not able to take care of their ill or disabled children any more. It makes sense to teach kids to be as independent as possible so that, when their parents are no longer able to take care of them, responsibility does not fall to the state or other family members if it does not have to. Many disabled children can grow to be successful adults, if they are given the chance. Teaching your child to communicate needs and wants will help him or her be more autonomous and have more control of life.

Many of my disabled friends have gone to state institutions or hospitals when it might not have been the most appropriate for them. Sometimes an institution is the best place for a person with a disability, but far too often we are sending perfectly capable adults to institutions because they weren't taught to be self-sufficient.

Parents of children with disabilities will often ask me, "What happens if my child gets hurt?" Well, isn't this how everyone—disabled or not—learns? Yes, my mom let me be independent and self-sufficient and yes, there have been times when I have gotten hurt. But I have learned what my limits are, and that helps me take care of myself. I have learned what to do when I do get hurt.

Anyone, at any age, has the potential to have a child with spina bifida. This risk can be lessened when the proper amounts of folic acid are consumed. And, if you do have a child with spina bifida, teach him or her to be as independent as he or she can be. Don't let your fear stop them from learning important life lessons such as being independent.

Source:
Spina Bifida Association

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Content last updated October 1, 2007.