Signs of Spina Bifida in Baby
Medically reviewed by Dr. Sarah Chen, MD, FAAP · Board-Certified Pediatrician
Content reviewed against published CDC, AAP, NIH guidelines
Last reviewed:
Your baby's physical development is unique, and concerns about signs of spina bifida in baby, here is what you need to know.
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.
Key takeaways
- 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.
- Usually normal when: A shallow sacral dimple near the tailbone (very common, affecting 2-4% of babies)
- Call your doctor if: You notice a visible bulge, opening, or sac on your baby's back at birth
- Varies by age — see the age-by-age breakdown below
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What Parents Should Know
According to CDC, AAP, NIH guidelines, 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. At Newborn, 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. It is generally considered normal when a shallow sacral dimple near the tailbone (very common, affecting 2-4% of babies). However, you should contact your pediatrician promptly if you notice a visible bulge, opening, or sac on your baby's back at birth.
Normal vs. Concerning
By Age
What to expect by age
Newborn
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.
0-12 months
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.
1-3 years
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 to Tell Your Pediatrician
- Describe when you first noticed signs of spina bifida in baby and how it has changed over time.
- Note your baby's current age and which age-specific patterns you are seeing.
- Mention if a dimple on the lower back that seems deep or you cannot see the bottom of.
- Mention if a tuft of hair, birthmark, or fatty lump on the lower spine.
- Let your doctor know if you have noticed any related concerns, such as changes in feeding, sleep, or movement patterns.
- Bring a list of any questions or observations you want to discuss at the appointment.
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
What You Can Do at Home
- Keep track of when you notice signs of spina bifida in baby — noting the time of day, duration, and any triggers can help your pediatrician.
- Remember that a shallow sacral dimple near the tailbone (very common, affecting 2-4% of babies) — this is generally within the range of normal.
- At Newborn, focus on observation rather than intervention unless your pediatrician advises otherwise.
- Provide plenty of supervised floor time and tummy time to support your baby's physical development.
- While monitoring at home, seek immediate care if you notice a visible bulge, opening, or sac on your baby's back at birth.
Related Conditions
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.
Related Resources
Milestone Checklists by Age
Track your baby's developmental milestones from birth to 5 years with age-specific checklists.
Month-by-Month Development
Detailed monthly development guides from birth through 24 months.
When to Call the Doctor
General guide on when to call the pediatrician, visit urgent care, or go to the ER.
Frequently asked questions
Is signs of spina bifida in baby normal?
When should I call the doctor about signs of spina bifida in baby?
When is signs of spina bifida in baby normal?
What causes signs of spina bifida in baby?
What should I mention to my pediatrician about signs of spina bifida in baby?
Is signs of spina bifida in baby normal at Newborn?
Is signs of spina bifida in baby normal at 0-12 months?
Should I go to the ER for signs of spina bifida in baby?
Does signs of spina bifida in baby go away on its own?
References
Doctor Visit Checklist
Bring this checklist to your next pediatrician visit to discuss Signs of Spina Bifida in Baby.
Things to mention
- Describe when you first noticed signs of spina bifida in baby and how it has changed over time.
- Note your baby's current age and which age-specific patterns you are seeing.
- Mention if a dimple on the lower back that seems deep or you cannot see the bottom of.
- Mention if a tuft of hair, birthmark, or fatty lump on the lower spine.
- Let your doctor know if you have noticed any related concerns, such as changes in feeding, sleep, or movement patterns.
- Bring a list of any questions or observations you want to discuss at the appointment.
Observations to share
- 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)
Urgent signs to report immediately
- 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
My notes
From ismybabyalright.com — free, evidence-based baby health guides
All content follows our editorial policy and is reviewed against published clinical guidelines.
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Related Resources
Bottom line
Most cases of signs of spina bifida in baby are normal. Talk to your pediatrician if you notice a visible bulge, opening, or sac on your baby's back at birth.
Trust your instincts. If something feels wrong, reach out to your pediatrician. Worrying about your baby means you care — that is a good thing.
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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.
Should I Use Adjusted Age for My Preemie's Milestones?
Yes — for premature babies, developmental milestones should be assessed using adjusted (corrected) age, not chronological age, until at least 2 years of age. Adjusted age is calculated by subtracting the number of weeks your baby was born early from their actual age. For example, a 6-month-old born 2 months early would have an adjusted age of 4 months, and should be assessed against 4-month milestones. Most pediatricians use adjusted age for developmental assessment through age 2-3, and for growth charts through age 2.
Baby-Proofing a Small Apartment
Baby-proofing a small apartment is absolutely possible and focuses on the same key safety principles as any home: securing furniture to walls, covering outlets, locking cabinets with hazardous materials, and ensuring safe sleep spaces. Small spaces actually have an advantage - there is less area to monitor. Focus on eliminating the most dangerous hazards first: falls, poisoning, choking, and burns.