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The Importance of Folic Acid: Anifa's Story

Two babies with globe

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

Anifa lives with her family in a village where there is no primary health center. Her mother does not own a stroller and cannot buy diapers. She has to use leaves and paper to keep Anifa 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’s nurse in Nigeria holding another patient with a birth defect.

Anifa had to wait until she was nine months old before she had her first back surgery to close the opening in her spine. Imagine that for nine months her 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 her spina bifida, and the financial and emotional impacts that her 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 Help 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.

Did You Know?

  • In the U.S., 3,000 pregnancies are affected by neural tube defects every year.
  • An estimated 1,000 more babies are born without a neural tube defect in the U.S. annually since fortification.
  • Worldwide, there are more than 300,000 babies born with neural tube defects each year.
  • Expanding the reach of global folic acid fortification in developed and developing countries can prevent the majority of these serious birth defects annually.

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 Defects 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 developed Birth Defects COUNT, a global initiative to significantly reduce death and lifelong disability resulting from neural tube defects. The initiative aims to increase folic acid intake among women of reproductive age to prevent neural tube defects. These efforts can help prevent approximately 150,000-210,000 neural tube defects globally each year. Birth Defects COUNT is a critical step toward reducing the challenges faced by children like Anifa.