Signs of Spina Bifida in Baby
The short answer
Spina bifida is a birth defect where the spine does not close completely during development. It ranges from very mild (spina bifida occulta, which often causes no symptoms) to more serious forms that are usually detected before or at birth. Signs that might suggest mild spina bifida include a deep dimple, tuft of hair, birthmark, or fatty lump on the lower back over the spine. Many of these skin findings are completely harmless, but your pediatrician can determine if further evaluation is needed.
By Age
What to expect by age
More obvious forms of spina bifida (meningocele and myelomeningocele) are typically detected on prenatal ultrasound or are visible at birth as an opening or sac on the back. These require immediate surgical management. Spina bifida occulta (the mildest form) may show subtle skin signs: a deep sacral dimple, a tuft of hair on the lower back, a small fatty lump, or a red birthmark over the spine. Your pediatrician will examine the lower back during newborn exams.
Most sacral dimples are simple, shallow dimples near the tailbone that are completely harmless and need no further testing. Your pediatrician may recommend an ultrasound of the lower spine if the dimple is deep, located higher on the back (above the gluteal crease), or accompanied by other skin markings. The ultrasound checks for tethered spinal cord, which can be present even with mild spina bifida.
Signs of a tethered cord (which can be associated with spina bifida occulta) may become apparent as your child grows. These include asymmetric foot size, one foot turning in or out, difficulty with potty training, recurring urinary tract infections, or new-onset leg weakness. If your child was identified as having a sacral dimple or other spinal skin finding, your pediatrician will monitor motor development and bladder function.
What Should You Do?
When to take action
- A shallow sacral dimple near the tailbone (very common, affecting 2-4% of babies)
- A dimple that is visible and has a clear bottom
- A dimple located within the gluteal crease (buttock fold)
- No other skin markings or neurological symptoms
- A dimple on the lower back that seems deep or you cannot see the bottom of
- A tuft of hair, birthmark, or fatty lump on the lower spine
- The dimple is located above the gluteal crease (higher on the back)
- You notice any asymmetry in your baby's leg movement or foot position
- You notice a visible bulge, opening, or sac on your baby's back at birth
- Your child has new onset of leg weakness, foot dragging, or bladder control issues
- Your child develops back pain with progressive leg weakness or numbness
Sources
Related Resources
Related Physical Concerns
My Baby Has a Dimple at the Base of Their Spine
A sacral dimple is a small indentation at the base of the spine, just above the buttocks. Most are simple, shallow dimples that are completely normal and never cause problems. Your pediatrician will check the dimple at well visits. Occasionally, if it's deep, large, or has unusual features, an ultrasound may be ordered to ensure the spine is developing normally.
My Baby Isn't Walking
The normal range for first independent steps is huge - anywhere from 9 to 18 months, and all of it is considered typical development. Many parents feel pressure when they see other babies walking early, but a baby who walks at 15 months is just as healthy as one who walks at 10 months.
Baby Hip Dysplasia (Hip Click)
Developmental dysplasia of the hip (DDH) is a condition where the hip joint does not form properly, ranging from mild looseness to complete dislocation. It occurs in about 1 in 1,000 births and is more common in firstborns, girls, breech babies, and those with a family history. When caught early, treatment with a soft brace (Pavlik harness) is highly effective.
Signs of a UTI in Babies
UTIs (urinary tract infections) in babies can be tricky to spot because symptoms are often vague - fever without other cold symptoms, fussiness, poor feeding, or foul-smelling urine. If your baby has unexplained fever, especially if under 3 months, your pediatrician may test for a UTI. UTIs need antibiotic treatment to prevent kidney damage.
My Baby Seems to Use One Side More Than the Other
Babies should use both sides of their body fairly equally during the first 18 months of life. While slight preferences can be normal, a consistent pattern of favoring one side - using one arm much more than the other, crawling with one leg dragging, or turning the head predominantly one way - should always be discussed with your pediatrician. Early identification of asymmetry leads to the best outcomes.
Baby or Toddler Body Odor - When Is It Normal?
Babies and toddlers can develop body odor from several benign causes: sour milk caught in skin folds, sweating, diaper area odor, strong-smelling foods in the diet, and certain medications or vitamins. True body odor (like adult BO from apocrine glands) should not occur before puberty. If your baby or young toddler has a persistent unusual body odor that is not explained by skin folds, diaper, or diet, it could indicate a metabolic condition, infection, or foreign body (especially in the nose or vaginal area). Unusual persistent odor warrants a doctor visit.