Anifa is an 18-month-old girl who was born with spina bifida, a serious birth defect of the spine. Like many children with spina bifida, Anifa is paralyzed and has no bowel or bladder control. She lives with her family in a village in Nigeria where there is no primary health center to help her. As a result, Anifa could not have surgery to close the opening in her spine until she was nine months old. During this time, her spinal cord was exposed and without protection. In the U.S., the first surgery for a baby born with spina bifida usually takes place within the first 24 hours of life to avoid complications or death. But Anifa had no choice but to wait.
In the United States, children born with spina bifida often live long and productive lives, even though they face many challenges. In many other countries, however, the outlook for children like Anifa is not as positive.
The Centers for Disease Control and Prevention (CDC) first began researching folic acid’s role in preventing birth defects in the early 1980s. Early studies found the risk for having a baby with a neural tube defect (NTD), such as spina bifida, was reduced if the mother had taken folic acid before and during early pregnancy. As a result, U.S. Public Health Service released the 1992 recommendation that all women who could become pregnant should get 400 micrograms (mcg) of folic acid every day.
Women can get folic acid in three ways: diet, vitamin supplements, and flour fortification. Experts agreed that getting 400 mcg of folic acid from naturally-occurring food sources alone was impractical—women would have to eat a lot of folate-rich foods which are expensive and not readily available in many communities.
In January 1998, in response to requests from the CDC and its collaborators, including the March of Dimes, the FDA mandated fortification of cereal grain products labeled as enriched in the United States. “At that point, we had what we thought was the best possible coverage of women of child-bearing age to get folic acid for the prevention of neural tube defects,” says former CDC scientist Joe Mulinare. With a 36 percent reduction in the rates of neural tube defects by the end of 2006, folic acid fortification was recently named one of the Ten Great Public Health Achievements in the United States.
Folic Acid Awareness Week is January 6-12th, 2013. We are honored to have this guest post from the CDC. Author: Christina Kilgo, MA, Health Communication Specialist and SciMetrika contractor for CDC’s National Center on Birth Defects and Developmental Disabilities.