Spina bifida and all: Why do you need folic acid before and during pregnancy?

Mar 6, 2018,

Found this story and thought to share with you guys. Eli’s story was written by his mom, Jodie (culled from https://www.cdc.gov/ncbddd/birthdefects/stories/spinabifida.html)

Jodie shares the story of her son Eli, who was born with Spina Bifida.  Upon Eli’s birth, Jodie and her husband learned that he had further health problems, causing him to be on life support. Although Eli was only alive for a short time, he has given his family a lifetime of peace.  Read his special story below.

"After four years of marriage, we thought we had it all figured out. We had finished college, bought a new home, and began to start our family. But due to reasons unknown, that served to be quite the challenge for us. Our first pregnancy resulted in painful miscarriage. Then we experienced fertility problems. We assumed adoption would be our fate. With our last fertility treatment, we achieved success! Several weeks later, our doctor found two healthy beating hearts on the ultrasound screen. However, complications arose very quickly. About midway through, we were given another devastating news.

"We were told that we were having twin boys, but that Twin A had been diagnosed with spina bifida, a neural tube defect. We left our doctor’s office in shock. But after few days, we began to prepare a place for a special needs twin and his healthy brother. On August 3rd we delivered: Elijah “Eli” Cole 6lbs 3oz & Walker Daniel 5lb 7oz.

"As planned, Eli (Twin A) was rushed to the local children’s hospital upon birth for observation by their Spina Bifida Team and Walker remained with me. Eli’s MRI results were worse than we thought, and he had multiple problems associated with his spina bifida. We learned that if he survived, our baby would never know how to eat, how to speak, or how to breathe on his own for the rest of his life. He would never know us, his parents. We immediately felt a rush of strength that God was preparing us for what was to come. We met with an organ donation organization so Eli might be able to give the gift of life. A representative informed us that Eli’s heart valves could save possibly two other babies. We planned the removal of his ventilator and prepared our entire family to say their goodbyes.

"On August 6th, we watched as his ventilator & monitor wires were removed. We were told to only expect minutes with him. But against all odds, Eli kept breathing for fourteen hours. Our doctors encouraged us to transport Eli from the local children’s hospital to the hospital where his twin brother was so that they could be together. Once Eli’s hand was placed onto Walker’s little body, Eli’s color began to return and a slight smirk came across his face. We saw proof of the power of twins. And for the first time, we were finally able to enjoy our Eli, celebrate his life, and mourn peacefully, as a family.

Eli passed away in our arms later that evening, after an amazing 31 hours after his ventilator was removed. Those 31 hours gave us a lifetime of peace. Throughout this journey, we witnessed unbelievable strength, compassion, and the good deeds of friends, family, and medical personnel. We cherish each day we have with Walker and remain in constant awe of God’s plan for our lives.
On August 8th of this year, as we were mourning the 1-year anniversary of Eli’s death, we found out we are expecting again. We found out that this miracle baby is a baby girl, whom we have named Ellie.” 

So you are wondering what is Spina Bifida?

Spina bifida is caused by an abnormal development of the spine and spinal cord which leaves a gap in the spine. Spina bifida can vary from causing no problems to causing severe physical disability.

Why do you need folic acid?

If you are pregnant right now or would likely get pregnant in future, folic acid should be your best friend. Deficiency of folic acid during pregnancy has been linked with Neural Tube Defects - NTDs - such as spina bifida and anencephaly. These NTDs can be diagnosed in pregnancy when you do your anomaly scan - usually done during the second trimester or during a routine ultrasound scan.
Other possible risks associated with deficiency of folic acid are cleft lip, cleft palate and other forms of heart defect.

Anencephaly is a term that refers to the incomplete development of the brain, skull, and scalp. These two (spina bifida and anencephaly) accounts for 95% of all NTDs.

When is the right time to start taking folic acid?

Ideally, folic acid should be taken even before you get pregnant. There are formulations compounded as pre-natal vitamins with folic acid. Women who take folic acid about a year before getting pregnant reduced their chances of having a child with NTDs by 50%. Also, there are meals fortified with folic acid and food which are rich in folic acid. This can also be consumed routinely as they are wonderful in preventing NTDs.

How much folic acid should you take?

1.    It is recommended that all women between 15 and 45 years of age should consume folic acid daily, birth defects such as NTDs occur very early in pregnancy (3-4 weeks after conception), before most women know they are pregnant.
2.    Prophylactic folic acid (400 micrograms daily) is recommended for all women planning a pregnancy.
3.    During pregnancy and breastfeeding. For the first three months of pregnancy: 400 mcg, for months four to nine of pregnancy: 600 mcg, while breastfeeding: 500 mcg
4.    Women who have had a child with an NTD should take 5 mg folic acid daily before and during a subsequent pregnancy.

What are the natural sources of folic acid?

Some of the natural sources of folic acid (folate) include:
a.    Lentils
b.    Dried beans, peas, and nuts
c.    Avocado
d.    Dark green vegetables such as broccoli, spinach, collard or turnip greens and okro.
e.    Citrus fruit and juice

Signs of a folic acid deficiency

The signs of folic acid deficiency can be subtle. You may have diarrhea, anemia, loss of appetite, and weight loss, as well as weakness, a sore tongue, headaches, heart palpitations, and irritability.

If you are experiencing any of the symptoms listed above talk to our doctors right now on the Talktomedoc app. Go to the app store on your android phone to download immediately.

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