Health

The Importance of Folic Acid: Anifa's Story

Photo: Two babiesWorldwide, more than 300,000 babies are born with serious birth defects of the brain and spine each year. Read Anifa's story and find out what CDC is doing to help.

Neural tube defects, like spina bifida, affect babies all over the world. They are a significant cause of death and disability, and many, but not all, are preventable.

Anifa's Story

Anifa is an 18 month old boy who lives in Nigeria. Anifa was born with spina bifida. Like most children with spina bifida, Anifa has no movement of his legs (he is paralyzed) and he has no bowel and bladder control. He works very hard just trying to crawl on his chest.

Anifa lives with his family in a village where there is no primary health center. His mother does not own a stroller and cannot buy diapers. She has to use leaves and paper to keep him clean. She and her husband are doing everything they can for their child, but without proper care, the reality is that Anifa's future is uncertain.

Anifa had to wait until he was nine months old before he had his first back surgery to close the opening in his spine. Imagine that for nine months his spinal cord was exposed, without protection. In the United States, the first surgery for a baby born with spina bifida usually takes place within the first 24 hours of life to avoid infection, other complications, or death. But Anifa had no choice but to wait.

Anifa will likely face lifelong medical challenges associated with his spina bifida, and the financial and emotional impacts that his family will endure are overwhelming. In the United States, children born with spina bifida often live long and productive lives, even though they face many challenges. But, in many other countries, the outlook for children like Anifa is not as positive.

Folic Acid Can Prevent Neural Tube Defects

The most common neural tube defects are anencephaly and spina bifida. Anencephaly is a serious birth defect that happens when the brain and skull do not form correctly. Babies born with anencephaly do not survive. Spina bifida is a serious birth defect that happens when the spine does not close correctly. Babies born with spina bifida can survive, but face lifelong medical challenges even when they have access to the best medical care.

Many of these neural tube defects could be prevented if women consumed 400 micrograms (mcg) of folic acid daily, before and during pregnancy. Folic acid is a B vitamin. Our bodies use folic acid to make new cells. Everyone needs folic acid, but it is particularly important for women who can become pregnant!

Neural tube defects happen in the first few weeks of pregnancy; usually before a woman knows she is pregnant. By the time she realizes she's pregnant, it's often too late to prevent these birth defects. In addition, half of all pregnancies in the United States are unplanned.

That is why CDC urges every woman who could become pregnant to consume 400 mcg of folic acid every day. Find out how to get 400 mcg of folic acid every day »

Advancing Neural Tube Defect Prevention Globally

Building on the success of preventing neural tube defects through folic acid fortification in the United States, CDC's National Center on Birth Defects and Developmental Disabilities has developed a global initiative to significantly reduce infant death and childhood disability worldwide.

The initiative builds on CDC's expertise and experience in neural tube defect prevention and aims to expand the number of low- and middle-income countries with mandatory folic acid fortification. The initiative will focus on increasing folic acid intake among women of reproductive age through fortification of staple foods consumed by a large part of the population (such as wheat flour and maize flour). Key components of the initiative are to provide needed technical expertise for surveillance of neural tube defects, monitor fortification efforts, and improve laboratory capacity. The initiative's strategic objectives are centered on science, policy, and partnerships to reach countries with the most need and where the health impact would be greatest.