WHAT IS CLEFT?

A cleft lip and/or palate is a facial birth defect involving the upper lip and the roof of the mouth. The upper lip and palate fail to come together during the 4th to the 12th week of the fetus’ embryonic life. These deformities have severe repercussions throughout the life of the individual.

Incidence

According to the World Health Organization, out of 1,000 live births, one to two babies are afflicted with cleft lip and/or palate. In the Philippines, the incidence may be greater than one in every 500 live births. This means as many as 200,000 Filipinos may have a cleft lip and/or palate, with around 4,000 new babies born every year with this condition. This makes this particular deformity, arguably the most common congenital defect. It certainly is one of the most easily correctible deformity. Unfortunately, facial clefts most commonly occur among the lower social income group, which often makes proper cleft care inaccessible to them.

Problems encountered by a cleft patient

At birth, feeding immediately becomes a problem because the child is unable to suck properly. This leads to malnutrition and lower body weight. Frequent ear infections, plus recurring coughs and colds result from the palatal muscle abnormalities, leading to weak hearing and a child that is often sick. Of course, speech development will be retarded and permanently hypernasal until the palate is repaired. The gap in the gums lead to deformed and easily decaying teeth, and at a later age, unbalanced facial profile because of lacking upper jaw bone.

Cause of Clefting

Many factors have been pointed out in causing clefts. These include genetic predisposition, maternal malnutrition, abortifacients and other drug intake, alcohol and tobacco abuse, viral illness and exposure to radiation. Attempts at prevention have focused mainly on folic acid supplements for predisposed pregnant mothers, and in some other countries, legalized abortion of cleft fetuses.

Emotionally tormented

An unrepaired cleft lip and palate patient is a tormented individual. Unwanted at birth, cleft lip, and palate babies have repeatedly been abandoned by their parents, especially in the poorest communities. Parents who choose to keep their babies are subjected to both guilt and grief, wondering what they have done wrong and pondering the future of their disadvantaged child. As the child grows up.he becomes a victim of the cruelty of his playmates and peers, teased to the point of flight or fight. He gets into trouble at school, and so prefers to hide in a solitary corner of the house. Even as he forces himself to pronounce the words correctly, he is unsuccessful and constantly frustrated. And because of this incorrect speech, his teachers never get to recognize how intelligent he actually is. As he grows to adulthood, years of social rejection will have bred an individual unable to believe that he is deserving of normal social relationships. Even decent job opportunities will prove to be difficult.