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Light shed on birth defects

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One in 700 births occur with cleft lip and palate.
One in 700 births occur with cleft lip and palate.

Cleft lip and palate are among the five most common birth defects reported in South Africa. One in 700 births occur with cleft lip and palate.

These defects are in the spotlight in July, declared as National Cleft and Craniofacial Awareness and Prevention Month.

The focus is also on educating parents and giving medical solutions.

“Cleft lip and palate are birth abnormalities which develop when the lips or mouth do not form correctly during pregnancy. These congenital deformities are orofacial clefts,” says Murray Hewlett, chief executive officer of Affinity Health.

“Children with clefts may have delayed feeding and language development. They may also be at a higher risk for ear infections, hearing impairments and tooth problems.”

Cleft lip and palate occurs during the first few weeks of pregnancy.

The palate forms between six and nine weeks of pregnancy.

Cells increase and move when a baby grows during gestation. Specialised cells from either side of the head move forward and fuse in the centre to form the face. This tissue fusion creates face characteristics, such as the lips and mouth.

A cleft lip occurs when the tissues that comprise the lip do not unite before birth. That results in the upper lip opening. The aperture in the lip may be a little slit or a large hole extending from the lip to the nose.

A cleft lip can develop on one or both sides of the lip. Although rarely, it may also form in the centre of the lip.

There is no one cause of cleft lip and cleft palate. In most cases, the reasons for orofacial clefts are unknown.

Some children are born with a cleft lip or cleft palate due to alterations in their DNA.

Other circumstances, like food and drinks consumed during pregnancy and specific drugs women take during pregnancy, may also contribute to cleft formations.

The following can increase the risks:

  • Smoking during pregnancy enhances the likelihood of orofacial cleft development.
  • Diabetic mothers may be more susceptible to having babies with a cleft lip or palate.
  • Epilepsy treatment could have an effect, and medication such as Topiramate and Valproic acid may be unsafe during the first trimester. Taking these medications may increase the dangers of cleft lip or palate in babies.
  • Relating to genetics, parents with a family history of cleft lip or palate have a higher likelihood of having a child with a cleft.
  • Obesity during pregnancy may lead to an increased risk of cleft lip and palate in infants.
  • Boys are more likely than girls to have a cleft lip, with or without a cleft palate.

Surgery is often the best course of treatment to improve facial appearance. Services and treatment for children with orofacial clefts might range according to severity.

Surgery to correct a cleft lip occurs within the first few months of life. Doctors might also prefer to resolve it within the first year.

Cleft palates may need surgical repair within the first 18 months of life.

As children age, they will often need more surgical treatments. It can also enhance breathing, hearing and language development.

Children born with orofacial clefts may need speech therapy or orthodontic care.

Organisations that assist with interventions to help children born with orofacial clefts include Cleft Friends and the Smile Foundation.

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