Spina bifida is a neural tube defect that occurs during the first month of pregnancy. The embryo develops a structure called the neural tube, which later forms the spine and central nervous system. Spina bifida happens when this tube doesn’t form or close properly, leading to issues in the spine or spinal cord.

The spinal column is made up of stacked vertebrae (bones) and discs that cushion them. This structure protects the spinal canal, which contains the spinal cord — the vital nerve bundle connecting the brain to the rest of the body. When part of this structure doesn’t form correctly, it can result in a split or opening in the spine.

Types of Spina Bifida

Spina bifida presents in three main types, categorised by severity:

Spina Bifida Occulta

This is the mildest and most common form. The gap in the spine is so small that it may go unnoticed, and many people with this condition are unaware they have it. Some children may have a patch of hair, dimple, or birthmark on their lower back. Occasionally, mild symptoms such as reduced sensation or minor bladder issues may be present, but most lead normal lives without intervention. Diagnosis is usually via X-ray or other imaging.

Spina Bifida Meningocele

This rare type occurs when the protective membrane around the spinal cord (the meninges) pushes out through the gap, forming a fluid-filled sac. While the spinal cord remains intact, surgery is typically performed shortly after birth to reposition the membrane and close the gap. Recovery is usually good, though some children may experience minor nerve-related issues or bladder and bowel challenges.

Spina Bifida Myelomeningocele

The most severe form, this occurs when both the meninges and part of the spinal cord protrude through the opening in the spine. This exposes the spinal cord and nerves, making the baby vulnerable to infections and serious complications. A baby with myelomeningocele usually requires surgery within the first 48 hours of life to prevent further damage. Long-term effects can include paralysis, hydrocephalus (fluid buildup in the brain), seizures, and orthopaedic issues such as hip problems or foot deformities.

Causes and Prevention

Folic acid deficiency during early pregnancy is one of the leading risk factors for spina bifida. While supplementation can greatly reduce the risk, it doesn’t eliminate it entirely. Genetics, maternal diabetes, and obesity are also potential contributors. Women planning to conceive are advised to take 0.4mg of folic acid daily, starting before pregnancy and continuing through the first trimester. Folic acid is found in leafy greens, eggs, citrus fruits, legumes, and supplements.

Care and Support

Children with more severe forms of spina bifida — particularly myelomeningocele — require ongoing medical care. This may include specialists such as neurologists, urologists, orthopaedists, orthotists, and physiotherapists. Emotional, psychological, and social support are equally important to ensure overall well-being.

Orthopaedic challenges, especially involving the legs and feet, are common. Many children may experience partial or complete leg paralysis and require orthotic support, braces, or mobility aids like walkers, crutches, or wheelchairs. Proper footwear plays a critical role in daily function and comfort.

Specialist children’s shoes — such as those designed by First Walkers — provide the extra support, stability, and structure needed for kids with mobility challenges. Our orthopaedic footwear helps support proper posture, reduce pressure points, and accommodate orthotic devices when needed.

Although raising a child with spina bifida can be challenging, many children go on to lead active, independent lives with the right care and tools.

At First Walkers, we offer a wide selection of supportive orthopaedic shoes for children aged 6 months to early teens. Designed in collaboration with paediatric experts and crafted in Europe, our shoes never compromise on quality, comfort, or style. Browse our supportive high-top range here.