Myelomeningocele (Spina bifida)

Description

Myelomeningocele is caused by failure of the neural tube to close completely during fetal development, resulting in a lesion along the spinal cord. The level of muscle weakness and paralysis depends on the level of the lesion (high or low along the spinal cord). Children with myelomeningocele may or may not be ambulatory.

Possible effects on nutrient needs

Inadequate intakes may be a problem in infancy and early childhood:

• problems with feeding, including abnormal gag reflexes and problems with sucking and swallowing, interfere with an adequate intake (more common among children with Arnold Chiari malformation)
• difficulties with positioning and posture, interfering with an adequate intake

Increased needs of some nutrients may be present because of problems associated with the disorder:

• bowel and bladder problems, often making fluid and fiber intakes critical
• pressure ulcers and other problems that are more common among children with myelomeningocele, increasing nutrient (energy, protein, fluid, micronutrient) needs

Decreased energy needs may be due to factors related to the disorder:

• short stature, common among children with myelomeningocele
• smaller muscle mass
• decreased levels of physical activity

Possible medication-nutrient interactions

• anticonvulsants
• medications for neurogenic bladder