What Are Neural Tube Defects?
Neural Tube Defects (NTDs) are abnormal formations of the brain and spinal cord that occur when a baby is being formed during pregnancy. These babies are born with swellings at the back — at any part of the back — or on the face.
They are collectively called Spina Bifida. The common types include myelomeningocele and meningocele — both presenting with swellings at the back — and encephalocele, which presents with a swelling either on the face or at the back of the head.
How Neural Tube Defects Present at Birth
Myelomeningocele — The most serious form. A visible sac at the back containing the spinal cord, membranes, nerves, and fluid. The spinal cord is damaged or not properly developed, resulting in varying degrees of paralysis and loss of sensation below the lesion.
Meningocele — A sac at the back containing the meninges and cerebrospinal fluid, but the nerves are usually intact. Less severe neurological deficit.
Encephalocele — A protrusion of brain tissue and membranes through an opening in the skull, appearing on the face or the back of the head.
When Do Neural Tube Defects Form?
This is the most critical thing to understand — and the fact that most people don't know about it is exactly why FFF's Go Folic! Campaign exists.
The brain and spinal cord are formed in the first 3–4 weeks of pregnancy. By the fourth week, the development of the neural tube is already complete. Any malformation — any failure of the tube to close properly — has already occurred by this point.
⚠️ Neural tube forms and closes — critical window
The brain and spinal cord develop. Any NTD has already occurred by Week 4. Folic acid must already be in the body at this point.
Most women first suspect they might be pregnant
A missed period is typically noticed at Week 4–5. Many women wait another 1–2 weeks before testing or visiting a doctor.
Pregnancy confirmed — but the critical window has closed
By the time most women visit a clinic and receive folic acid, the neural tube has already closed (or failed to close). Starting folic acid now cannot prevent an NTD that has already formed.
Most women realise they are pregnant after they notice their periods are late — which is at least 1 month, plus a few days or weeks. By this time, little or nothing can be done to prevent a neural tube defect from occurring. This is why folic acid must be taken before pregnancy begins.
"By the time most Nigerian women know they are pregnant, the window to prevent Spina Bifida has already closed. Taking folic acid before conception is not optional — it is the only way to protect against neural tube defects."
— FFF Go Folic! CampaignIf a Baby Is Born with an NTD — What Happens Next?
Babies born with Neural Tube Defects will require surgery to correct the appearance and to avoid infections such as meningitis — since in conditions like myelomeningocele, the brain and spinal cord are exposed to the environment.
However, the surgery performed after birth does not correct already-damaged nerve structures. It prevents further damage and reduces infection risk — but the neurological injuries that occurred during development cannot be reversed.
This means that many of these children will live with some degree of neurological deficit, including:
Weakness or paralysis of the legs
Club foot and other lower limb deformities
Bladder and bowel incontinence — neuropathic bladder/bowel
Loss of sensation in the legs and sacral area
Hydrocephalus — excess fluid in the brain (in ~90% of myelomeningocele cases)
In developing countries like Nigeria, these challenges are compounded by poverty, stigma, inadequate medical personnel, and poor government healthcare funding — making prevention through folic acid supplementation absolutely critical.
How Common Is Spina Bifida in Nigeria?
The exact incidence of Spina Bifida in Nigeria is unknown. However, one thing is clear: the incidence is not reducing as it should.
In developed countries, the prevalence of NTDs has fallen significantly over recent decades — driven by early diagnosis, genetic counselling, nutritional supplementation programmes, and food fortification policies. In Nigeria, the combination of a critical information gap about folic acid, high poverty rates, limited access to antenatal care, and inadequate nutrition has prevented a similar decline.
FFF's Go Folic! Campaign was created specifically to close this information gap — reaching every woman who needs to know about this cheap, accessible, and enormously powerful preventive measure.
In Nigeria, the incidence of Spina Bifida is not reducing as it should — not because prevention is impossible, but because the majority of women of childbearing age are unaware that daily folic acid before pregnancy can prevent it.
What Can Be Done to Prevent Neural Tube Defects?
The good news is that NTDs can be largely prevented by a simple, inexpensive measure — one that most Nigerian women are currently unaware of.
Research has shown conclusively that daily intake of folic acid before pregnancy and during early pregnancy can greatly reduce the chances of a baby developing a neural tube defect. Folic acid — also known as Vitamin B9 — supports the proper closure of the neural tube during the critical first weeks after conception.
Folic acid also helps prevent anaemia (low blood levels), making it doubly important for women's health in Nigeria.
"Daily intake of folic acid before pregnancy and during pregnancy can prevent up to 50–70% of neural tube defects. It is simple, cheap, and available from any pharmacy in Nigeria."
— FFF Go Folic! Campaign / World Health OrganisationThe Recommended Dosage
The recommended dose depends on your personal health history and risk factors:
Taking folic acid daily before and during early pregnancy can prevent 50–70% of neural tube defects. How or why folic acid helps to prevent Spina Bifida is not yet fully understood — but the clinical evidence is overwhelming and consistent.
Where Can You Get Folic Acid in Nigeria?
Folic acid is available at any pharmacy in Nigeria — it requires no prescription and is extremely affordable. A supply of 100 tablets costs approximately ₦700. It is also available as part of most antenatal vitamin supplements prescribed at clinics and hospitals.
For many women, daily supplementation is the safest and most reliable approach to ensure adequate intake, since dietary sources alone are rarely sufficient to meet the recommended daily requirement. However, eating folic acid-rich foods is also valuable as part of a healthy diet.
Natural Food Sources of Folic Acid
While supplementation is essential, folic acid is also found naturally in the following foods:
Tell Every Woman You Know
Information is the key. This article exists because the information gap is the single biggest barrier preventing Nigerian women from protecting their unborn children from Spina Bifida.
You can change that right now — by sharing this article and the Go Folic! message with every woman around you:
Your mother, sister, cousins, and other family members
Your friends and colleagues — especially those planning to start a family
Your neighbours and members of your community
Women in your religious community or social group
Healthcare workers you know who see women of childbearing age
Are You Aware?
• Children are born daily with deformities to apparently healthy mothers.
• The number of these children is increasing worldwide — including in Nigeria.
• One group of such deformities is Neural Tube Defects — children born with swellings at the back or on the face (Spina Bifida).
• These deformities can be prevented by taking folic acid even before pregnancy.
• Folic acid costs approximately ₦700 for 100 tablets at any pharmacy. Take 400mcg (0.4mg) every day.
