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Brain & Nervous System Health Center

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Baby Noor's Surgery Went 'Very Well'

Iraqi Baby With Spina Bifida May Still Need More Surgery

How Spina Bifida Develops continued...

Spina bifida is the most common type of neural tube birth defect. Noor has spina bifida aperta (myelomeningocele). That type of spina bifida generally involves a fluid-filled sac visible on the back. In most cases of myelomeningocele there is no layer of skin covering the sac and a section of spinal cord is exposed. Baby Noor survived for three months because she developed a leak-proof covering over the open area.

During Noor's operation, the skin was rolled up so that her spinal cord could be put back in place and closed up, which helps prevent infection and helps protect the exposed nerves and tissue from further damage. Then muscles and skin were sewn over the spinal cord.

According to the NINDS, many individuals with spina bifida will need assistive devices such as braces, crutches, or wheelchairs.

U.S. babies with the condition normally get such surgery within a few days of birth.

Hudgins says he and his colleagues will be watching to see if fluid starts to build up in Noor's brain. Noor has another complication called Chiari malformation, in which the rear portion of the brain places downward pressure on the spinal canal and blocks fluid flow around the brain and spinal cord. This condition can lead to problems breathing, feeding, and swallowing. If so, Noor will likely undergo another operation to put a shunt in place to relieve that fluid buildup.

Preventing Spina Bifida

About one in 2,000 U.S. babies are born with spina bifida. Getting enough folic acid before and during pregnancy helps reduce the risk of neural tube defects.

For that reason, health experts advise all women of childbearing age to get 400 micrograms per day of folic acid, which is also called folate.

The recommendation isn't just for women who are trying to become pregnant, since many pregnancies are unplanned.

Folic acid is found in supplements, leafy green vegetables (such as spinach), and fortified foods, such as breakfast cereals. Since 1996, the U.S. has required folic acid to be added to enriched grain products including breads and flours.

Researchers recommend that any woman who could become pregnant get a daily intake of 400 micrograms of synthetic folic acid per day from fortified foods and/or dietary supplements. That advice comes from the web site of the NIH's Office of Dietary Supplements.

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