How you can prevent intellectual disability

For a long time people have wrongly regarded intellectual disability, mental disability, in a child as ‘bahati mbaya’ (bad luck).

However, do you know that a good percentage of intellectual disability can be prevented?

With advances in healthcare, we have found several ways in which this challenge can be tackled. Some of the causes are genetic, others have to do with pregnancy and other issues.

Proper nutrition

In our set-up, poor nutrition is a leading cause of mild intellectual disability. Poor nutrition begins when the baby is still inside the mother and continues after the child is born.

In particular, the first five years of a child’s development are vital. Poor nutrition here does not just refer to starvation, it also refers to eating inappropriate meals, unhealthy diets.

Folic Acid

This is a particularly important vitamin, which is crucial in the development of a healthy brain in an unborn baby. Lack of it can cause mental and spinal cord abnormalities.

Women are advised to start taking folic acid supplements when they are trying to conceive a baby and during pregnancy.

Pre-pregnancy vaccination

Before pregnancy, all women should ensure their vaccination is up to date. A recent vaccine for an infection known as ‘Rubella’ is particularly important.

In Kenya, children in the private sector are getting it as part of their immunisation – its known as MMR. However, the vaccine is still not available in the public healthcare system. Rubella in a pregnant woman can be passed on to her unborn baby leading to lots of complications including mental disability.

Treat STDs

When babies are passing through the birth canal during delivery, they are exposed to any infection the mother has. A particularly notorious one, which leads to mental disability is Herpes (HSV-2).

All couples must be treated for any sexually transmitted infections prior to conception of their baby. Men are particularly prone to carrying diseases without symptoms and passing them repeatedly to their partners.

Avoid alcohol

Alcohol is the leading toxic substance unborn babies are exposed to. In terms of harm to an unborn baby, it is most dangerous to drink in the first three months of pregnancy (especially the first month).

The first trimester is when all the vital organs, including the brain, are developing. Unfortunately, most women do the exact opposite. They drink in the first months of pregnancy and avoid it in the last months when it is obvious to everyone that they are pregnant.

Avoid cat waste

Animal waste, and in particular cat pooh, is associated with a dangerous brain damaging infection known as ‘Toxoplasmosis’ which can be passed to an unborn baby.

Pregnant women should avoid contact with such waste and should instead get someone else to clean up after their pets.

Know your blood group

If you have a different blood group from your partner, your baby risks getting a condition known as jaundice when they are born (they get yellow eyes, skin, insides of mouth etc). In severe cases of jaundice, it can affect the brain leading to intellectual disability.

This is particularly so in women who are blood group negative and their partners are blood group positive. All women in such scenarios need an antidote injection during pregnancy to prevent such complications. This is available locally.

Get screened for health conditions

All women should get full screening for diseases which can affect their unborn baby. This screen should include hypertension, diabetes, HIV, STDs, low blood levels (anemia) etc.

In addition, a few weeks prior to delivery all pregnant women need to have their birth canals checked for harmful bacteria which can lead to infection (sepsis) in their baby. Sepsis in newborns can affect the brain and lead to intellectual disability.

Control blood pressure

It is important for blood pressure to be normal throughout pregnancy. Women with poorly controlled blood pressure in pregnancy put their unborn baby at risk for brain damage.

Proper childbirth

Prolonged labour and other complications of delivery can lead to reduced oxygen to a baby’s brain causing intellectual disability in future.

All first time mothers should have their doctor assess the adequacy of their birth canal to see if they can safely deliver normally (especially if they are small statured women or have narrow hips). This prevents a lot of trauma and complications to both mother and baby.

Manage HIV

Congenital HIV infection (passed from mother to unborn baby) has been a concern for healthworkers for many years. Children for whom little intervention is done to prevent HIV complications can end up with mental disability.

However, HIV care in pregnancy has drastically improved over the years in our country. We are having HIV positive mothers getting HIV negative babies. This is as a result of good ARV and diet adherence.

Screen newborns

It should be routine to screen all new born babies for potential preventable causes of intellectual disability. This screen uses a small amount of blood from the baby.

They check for things like thyroid abnormalities, a condition known as phenylketonuria and blood sugar. Phenylketonuria is a condition in which the baby is unable to break down certain proteins.

These compounds accumulate in the body and cause brain damage. Treatment usually just demands a change in diet for the baby for life.

Childhood infections and trauma

Certain childhood infections have been linked with the development of mental disability. This include infections which affect the brain such as meningitis.

In addition, any very serious bacterial or viral infection can have some negative effects on the brain. It is therefore, crucial for all children to get all their vaccinations done.

Head injury and near-drowning incidents in young children can also lead to intellectual disability.

Genetic screening

This is relatively common practice in developed countries. Genetic screening can be done for couples who have had multiple miscarriages or who have more than one child with intellectual disability.

During screening, they check if one of the partners is a carrier of any genetic abnormality. (Carriers are people who do not have any obvious features of a health problem but since the abnormality is in their genes, they are able to pass it to their children).

Another stage at which genetic screening is done is during pregnancy.

Taking care of a child’s intellectual well-being starts before conception. Admittedly, in some cases, especially those involving genetics, there is nothing a parent or doctor can do to prevent the intellectual disability.

However, in other cases, we can prevent it. Let us (doctors and parents) take charge of our children’s brains.

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