Posts Tagged ‘cleft lip’

Congratulations CVS Caremark

Thursday, February 20th, 2014

stop smokingThe March of Dimes congratulates CVS Caremark for its historic decision to stop selling cigarettes and other tobacco products in its pharmacies and stores nationwide. By becoming the first U.S. pharmacy chain to stop selling tobacco, CVS Caremark has become a pioneer in improving the health of American women and children today and in the future. Tobacco is poisonous to women who smoke and to their unborn babies. Smoking during pregnancy contributes to miscarriage and premature birth, and we learned just last month from the U.S. Surgeon General that smoking is a proven cause of disfiguring oral clefts. We’re grateful to CVS Caremark for working to improve the health and the lives of mothers and babies.

Smoking causes birth defects

Tuesday, January 21st, 2014

stop-smokingTo dispel any uncertainty about the serious harm caused to babies and pregnant women by smoking, the first-ever comprehensive systematic review of all studies over the past 50 years has established clearly that maternal smoking causes a range of serious birth defects including heart defects, missing/deformed limbs, clubfoot, gastrointestinal disorders, and facial disorders (for example, of the eyes and cleft lip/palate).

Smoking during pregnancy is also a risk factor for premature birth, says Dr. Michael Katz, senior Vice President for Research and Global Programs of the March of Dimes. He says the March of Dimes urges all women planning a pregnancy or who are pregnant to quit smoking now to reduce their chance of having a baby born prematurely or with a serious birth defect. Babies who survive being born prematurely and at low birthweight are at risk of other serious health problems, Dr. Katz notes, including lifelong disabilities such as cerebral palsy, intellectual disabilities and learning problems. Smoking also can make it harder to get pregnant, and increases the risk of stillbirth.

About 20 percent of women in the United States reported smoking in 2009. Around the world, about 250 million women use tobacco every day and this number is increasing rapidly, according to data presented at the 2009 14th World Conference on Tobacco or Health in Mumbai.

The new study, “Maternal smoking in pregnancy and birth defects: a systematic review based on 173,687 malformed cases and 11.7 million controls,” by a team led by Allan Hackshaw, Cancer Research UK & UCL Cancer Trials Centre, University College London, was published online January 17th in Human Reproduction Update from the European Society of Human Reproduction and Embryology.

When women smoke during pregnancy, the unborn baby is exposed to dangerous chemicals like nicotine, carbon monoxide and tar, Dr. Katz says. These chemicals can deprive the baby of oxygen needed for healthy growth and development.

During pregnancy, smoking can cause problems for a woman’s own health, including:

• Ectopic pregnancy

• Vaginal bleeding

• Placental abruption, in which the placenta peels away, partially or almost completely, from the uterine wall before delivery

• Placenta previa, a low-lying placenta that covers part or all of the opening of the uterus

Smoking is also known to cause cancer, heart disease, stroke, gum disease and eye diseases that can lead to blindness. If you are pregnant or thinking about becoming pregnant, there has never been a better time to quit.

You can read the Surgeon General’s report: The Health Consequences of Smoking – 50 Years of Progress at this link.

Birth defects

Friday, January 17th, 2014

In recognition of National Birth Defects Prevention Month, here are 10 things you need to know about birth defects from the Centers for Disease Control and Prevention, CDC.

1. Birth defects are common.
Birth defects affect 1 in 33 babies in the United States every year. For many babies born with a birth defect, there is no family history of the condition.

2. Birth defects are costly and can greatly affect the finances not only of the families involved, but of everyone.
In the United States, birth defects have accounted for over 139,000 hospital stays during a single year, resulting in $2.6 billion in hospital costs. Families and the government share the burden of these costs. Additional costs due to lost wages or occupational limitations can affect families as well.

3. Birth defects are critical conditions.
Birth defects can be very serious, even life-threatening.  About 1 in every 5 deaths of babies before their first birthday is caused by birth defects in the United States. Babies with birth defects who survive their first year of life can have lifelong challenges, such as problems with infections, physical movement, learning, and speech.

4. Women should take folic acid during their teens and throughout their lives to help prevent birth defects.
Because half of all pregnancies in the United States are not planned, all women who can become pregnant should get 400 micrograms of folic acid every day, either by taking a vitamin each day or eating a healthy diet. Folic acid helps a baby’s brain and spine develop very early in the first month of pregnancy when a woman might not know she is pregnant.

5. Many birth defects are diagnosed after a baby leaves the hospital.
Many birth defects are not found immediately at birth, but most are found within the first year of life. A birth defect can affect how the body looks, how it works, or both. Some birth defects like cleft lip or spina bifida are easy to see. Others, like heart defects, are found using special tests, such as x-rays or echocardiography.

6. Birth defects can be diagnosed before birth.
Tests like an ultrasound and amniocentesis can detect some birth defects such as spina bifida, heart defects, or Down syndrome before a baby is born. Prenatal care and screening are important because early diagnosis allows families to make decisions and plan for the future.

7. Birth defects can be caused by many different things, not just genetics.
Most birth defects are thought to be caused by a complex mix of factors. These factors include our genes, our behaviors, and things in the environment. For some birth defects, we know the cause. But for most, we don’t. Use of cigarettes, alcohol, and other drugs; taking certain medicines; and exposure to chemicals and infectious diseases during pregnancy have been linked to birth defects. Researchers are studying the role of these factors, as well as genetics, as causes of birth defects.

8. Some birth defects can be prevented.
A woman can take some important steps before and during pregnancy to help prevent birth defects. She can take folic acid; have regular medical checkups; make sure medical conditions, such as diabetes, are under control; have tests for infectious diseases and get necessary vaccinations; and not use cigarettes, alcohol, or other drugs.

9. There is no guaranteed safe amount of alcohol or safe time to drink during pregnancy.
Fetal alcohol spectrum disorders (FASDs) are a group of conditions that can occur in a person whose mother drank alcohol during pregnancy. These effects can include physical problems and problems with behavior and learning which can last a lifetime. There is no known safe amount, no safe time, and no safe type of alcohol to drink during pregnancy. FASDs are 100% preventable if a woman does not drink alcohol while pregnant.

10. An unborn child is not always protected from the outside world.
The placenta, which attaches a baby to the mother, is not a strong barrier. When a mother uses cigarettes, alcohol, or other drugs, or is exposed to infectious diseases, her baby is exposed also. Healthy habits like taking folic acid daily and eating nutritious foods can help ensure that a child has the best chance to be born healthy.
For more information: www.cdc.gov/birthdefects.

Written By: Cynthia A. Moore, M.D., Ph.D. Director
Division of Birth Defects and Developmental Disabilities
National Center on Birth Defects and Developmental Disabilities
Centers for Disease Control and Prevention

Craniofacial birth defects

Monday, July 22nd, 2013

About 7,000 babies in the U.S. are born each year with a cleft lip, cleft palate or both. These conditions, along with other birth defects of the head and face, are called craniofacial birth defects. July is National Cleft and Craniofacial Awareness and Prevention Month, so we think it’s a great opportunity for people to learn more about these conditions.

A cleft lip is a birth defect in which a baby’s upper lip doesn’t form completely and has an opening in it. A cleft palate is a similar birth defect in which a baby’s palate (roof of the mouth) doesn’t form completely and has an opening in it. These birth defects are called oral clefts and happen in the first 5-7 weeks of pregnancy.
• Cleft lip and cleft palate affects about 4,200 babies each year. It is more common in Asians and certain Native Americans.
• Nearly 2,600 babies are born with isolated cleft palate each year. Isolated cleft palate affects babies of all races about the same.

Can other birth defects happen along with oral clefts? Yes. There are about 400 health conditions (called syndromes) that are related to oral clefts. If your baby has an oral cleft, his provider checks him thoroughly for other birth defects soon after birth.

How does clefting happen? Well for the most part, we don’t really know. Most likely a number of genes and environmental factors play a role. Some studies have shown that folic acid may help prevent oral clefts—yet another good reason to make sure you take that 400mcg of folic acid before and during your early pregnancy!

Babies born with clefts may have trouble feeding, speech problems, dental issues, and more frequent ear infections. That is why most children born with clefts are seen by a team of specialists that includes a pediatrician, a dentist, an ENT (ear, nose, and throat specialist), and a speech-language specialist, an audiologist (hearing specialist) and a genetic counselor. That team can help with any issue that may arise.

You can read lots more about oral clefts on our website (click on In Depth, and select Cleft Lip and Palate) , or visit the CDC’s website.

What is amniotic band syndrome?

Thursday, January 17th, 2013

Amniotic band syndrome is a well-know condition that can include a variety of different birth defects, usually affecting an arm or leg, fingers or toes. No two cases are alike – some are just a single malformation while others can include many disfiguring complications.

The upper body is involved more often than the legs or toes. (If you’re watching the current season of “The Bachelor” on TV, one of the women on the show is missing the lower part of an arm due to amniotic band syndrome.) Sometimes fingers or the lower portion of an arm are smaller than normal, sometimes they are missing all together, or occasionally some fingers may be webbed together. Sometimes a limb may have a deep groove around it showing where a tight band constricted growth.

In other cases, aside from defects of the arms or legs, a baby may also have facial defects (cleft lip or palate), a neural tube defect of the brain or spine, or have portions of internal organs protruding through a hole in the abdominal or chest wall.

The causes of amniotic band syndrome are yet unknown, but there are two main theories. One is that strands of tissue from the inside of the amniotic sac surrounding the developing baby separate from the lining and form bands that float free and entangle parts of the baby. If they wrap too tightly, they can restrict movement, blood flow and proper development, possibly even amputation. This may be due to random chance or trauma to the abdominal area and placenta during pregnancy.

Another theory holds that the cause stems from within the baby itself and involves insufficient blood flow to specific parts of the body. If an area of the body does not receive enough blood, tissues in that area die which can lead to physical defects. Some researchers believe that genetic factors may be involved in these cases. But whether this is caused from within the developing baby or from outside influences, occurrence is random and the chance of having another child with amniotic band syndrome is extremely low.

Treatment really depends on the severity of the defects. Surgery may be recommended to repair defects such as cleft lip or palate, clubfoot, or abdominal wall defects, etc. Sometimes physical or occupational therapies are needed to ensure the child has the best range of motion and use of the affected limb as possible.

Topiramate may increase clefts in babies

Tuesday, August 14th, 2012

Topiramate is a medication used to treat epilepsy. But it’s also considered for treatment of sleep and eating disorders, other psychiatric conditions, and weight loss. Topiramate is also a component of Qsymia, a medicine which was approved by the Food and Drug Administration (FDA) on 7/17/2012 for chronic weight management.

Topiramate is currently considered a Category D medication by the FDA.  This means that potential risks of using the medicine during pregnancy have been recognized, but benefits of the medicine (example: controlling epilepsy) may warrant use despite the risks.

A new study looked at the risk of oral clefts (cleft lip and cleft palate) in infants whose mothers took topiramate during the first trimester of pregnancy.  It used data from two large birth defects case-control studies. Both studies showed an increased risk of oral clefts in infants exposed to topiramate during the first trimester compared to infants not exposed to antiepileptic medicines.

Previous studies have shown a potential association between oral clefts and the use of topiramate during pregnancy. However, this association has been hard to evaluate because both the use of topiramate during pregnancy and the occurrence of oral clefts are rare.

This new study supports previous findings showing an increased risk of oral clefts among infants exposed to topiramate. Assuming this study is correct, this means that for any pregnancy exposed to topiramate, the risk of oral clefts in the offspring would be increased 5-fold. This shouldn’t make anyone panic, however, because oral clefts are a rare occurrence. It is important to keep the absolute risks in mind. Approximately 1 in 1,000 infants is born with cleft lip/palate in the US each year, and for any topiramate-exposed pregnancy, the risk would increase to approximately 5 in 1,000 infants.

If you have questions about the safety of any medications during pregnancy, speak with your health care provider, check out this CDC website or contact the Organization of Teratology Information Specialists.

What causes clefts and facial birth defects?

Tuesday, July 24th, 2012

July is National Cleft and Craniofacial Awareness and Prevention Month. A cleft lip is a birth defect in which a baby’s upper lip doesn’t form completely and has an opening in it. A cleft palate is a similar birth defect in which a baby’s palate (roof of the mouth) doesn’t form completely and has an opening in it. These birth defects are called oral clefts.

Babies and children with oral clefts may have feeding problems, ear infections and hearing loss, speech problems and dental problems.

We’re not sure what causes oral clefts. Some possible causes are:
• Changes in your baby’s genes. Genes are part of your baby’s cells that store instructions for the way the body grows and works. They provide the basic plan for how your baby develops. Genes are passed from parents to children.
• Not getting enough folic acid before pregnancy. Folic acid is a vitamin that can help protect your baby from birth defects of the brain and spine called neural tube defects. It also may reduce the risk of oral clefts by about 25 percent.
• Taking certain medicines, like anti-seizure medicine, during pregnancy
• Smoking during pregnancy. Smoking causes 1 in 5 (20 percent) oral clefts.
• Drinking alcohol during pregnancy
• Having certain infections during pregnancy

Not all clefts can be prevented. But there are things you can do to help reduce your chances of having a baby with an oral cleft:
• Before pregnancy, get a preconception checkup. This is a medical checkup to help make sure you are healthy before you get pregnant.
• Before pregnancy, take a multivitamin with 400 micrograms of folic acid in it every day.
• During pregnancy, take a prenatal vitamin with 600 micrograms of folic acid in it every day.
• Talk to your provider to make sure any medicine you take is safe during pregnancy.
• Your provider may want to switch you to a different medicine that is safe during pregnancy.
• Don’t smoke.
• Don’t drink alcohol.
• Get early and regular prenatal care.

Smoking and heart defects

Monday, April 25th, 2011

cigarette-buttsWe all know that smoking isn’t good for us, but it’s hard to quit. There is growing evidence linking mom’s cigarette smoking during the first trimester with the occurrence of some birth defects. In the past we learned that smoking during pregnancy may increase the risk of a developing baby having a cleft lip or palate. A new study finds it might also increase the risk of the baby having a heart defect.

When you smoke during pregnancy, your baby is exposed to dangerous chemicals like nicotine, carbon monoxide and tar. These chemicals can lessen the amount of oxygen that your baby gets. Oxygen is very important for helping your baby grow healthy. Smoking can also damage your baby’s lungs.

The findings from a new study out of Baltimore are in line with findings from previous studies, including those from the National Birth Defects Prevention Study, suggesting that maternal cigarette smoking during the first trimester of pregnancy might be a modest risk factor for certain heart defects.

Congenital heart defects are conditions present at birth that decrease the ability of the heart to work well, which can result in an increased likelihood of death or long-term disabilities. They affect nearly 40,000 infants in the United States every year.

We know quitting smoking can be hard, really hard, but it is one of the best ways a woman can protect herself and her baby’s health. Quitting smoking before getting pregnant is best. But for a woman who is already pregnant, quitting as early as possible can still help protect against some health problems for the baby, such as low birthweight. Whatever you can do to limit the amount of smoke you and you’re your baby are exposed to is fabulous.  Need help? Call this free number: 1-800-QUIT-NOW (1-800-784-8669).

Cleft lip and cleft palate: what it is and what can be done

Friday, June 25th, 2010

What do King Tutankhamun, Peyton Manning, Tom Brokaw, Jesse Jackson, and Stacy Keach all have in common?  It is an interesting group, isn’t it?  The one thing they all share is that they were all born with a cleft lip, a cleft palate, or even both.  About 4,200 babies are born each year in the United States with cleft lip/palate.  A cleft occurs when either the lip or the palate (or both) does not close completely.  These birth defects occur very early in gestation—the lip usually closes by about 5-6 weeks after conception and the palate is formed by 7 weeks.

How does this happen?  Well for the most part, we are not quite sure.  Most likely a number of genes and environmental factors play a role.  Some studies have shown that folic acid may help prevent oral-facial clefts—yet another good reason to make sure you take that 400mcg of folic acid before and during your early pregnancy!  We also know that some ethnic groups have a higher rate of clefts.  Cleft lip and palate occurs more frequently in certain Native American groups and Asians than it does in Caucasians.  It is least common in African Americans.  Isolated cleft palate, however, occurs less often (2,600 babies each year) and among all ethnic groups equally.

Babies born with clefts share a few common problems.  The first is feeding.  Although isolated cleft lip usually doesn’t disrupt feeding, a cleft palate definitely can.  An opening in the roof of the mouth is going to make it difficult for a baby to really be able to suck milk through a small opening efficiently.  Some may have problems with gagging, choking, or milk coming out of their nose.  There are specially made bottles that can help with these issues.  Breastfeeding is still strongly encouraged.  Although nursing can be very difficult, a mom can pump and use the special bottle to feed the baby.

Babies with clefts can also have speech problems, dental issues, and more frequent ear infections.  That is why most children born with clefts are seen by a team of specialists that includes a pediatrician, a dentist, an ENT (ear, nose, and throat specialist), and a speech-language specialist, an audiologist (hearing specialist) and a genetic counselor.  That team can help with any issues that may arise.

Surgery is used to repair cleft lip and cleft palate but the timing depends on the type of repair needed.  Cleft lip is frequently repaired by about 3 months of age and cleft palate between 6-18 months of age.  Sometimes children will need additional surgeries as they grow.  The March of Dimes has spent $6.9 million  in the past ten years trying to figure out why clefts happen and how to prevent them.  For more information you can check out the Cleft Palate Association.  If you have any specific questions feel free to email us at AskUs@marchofdimes.org.

Managing weight for baby’s sake

Tuesday, February 17th, 2009

scaleYou might remember me writing about my best friend and her new baby, Milana. I can’t get over how cute Milana is!!! Now that she’s 4 months old and doing fine, my best friend is ready to hit the gym and lose the weight she gained during pregnancy. I’m hitting the gym, too – not to lose any baby weight, but rather to stay at a healthy weight for the baby I’ll have someday.

I know all about the benefits of being at a healthy weight, such as reduced risk of diabetes, heart disease and more. But I was fascinated to learn that being at a healthy weight has a major impact on the health of your baby, even before pregnancy.

USA Today recently featured an article about a study in the Journal of the American Medical Association. The study reviewed research that showed babies born to overweight, obese moms were more likely to face special health risks. Some of these risks include birth defects (spina bifida, cleft palate, heart defects), being born prematurely or being born too large (macrosomia).

Since you can’t diet once you’re pregnant (because you risk limiting nutrients your baby needs to grow), it’s very important to eat healthy and manage weight before getting pregnant. Not only will I have a better chance of having a healthy pregnancy someday, my future baby will also have a better chance of being born healthy.