Posts Tagged ‘oral cleft’

Cleft and craniofacial awareness and prevention month

Monday, July 21st, 2014

July is cleft and craniofacial awareness and prevention month. Craniofacial abnormalities are  defects of the head (cranio) and face (facial) that are present when a baby is born. Cleft lip and/or cleft palate are a couple of the most common abnormalities.

Craniofacial abnormalities can range from mild to severe. These defects can present a variety of problems including eating and speech difficulties, ear infections and misaligned teeth, physical learning, developmental, or social challenges, or a mix of these issues. However, there are steps you can take to help prevent cleft and craniofacial defects before your baby is born.

What increases the risk of having a baby with craniofacial abnormalities?

We’re not sure what causes these defects. 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.

• Diabetes. Women who have diabetes before they get pregnant have a higher risk of having a baby with a cleft or craniofacial birth defect.

• Maternal thyroid disease. Women who have maternal thyroid disease or are treated for the disease while they are pregnant have been shown to have a higher risk of having a baby with an abnormality.

• 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.

• Drinking alcohol during pregnancy.

• Having certain infections during pregnancy.

How can you prevent cleft and craniofacial defects?

There are steps you can take to decrease the chance of having a baby with cleft and craniofacial defects.

• Before pregnancy, get a preconception checkup. This is a medical checkup to help make sure you are healthy before you get pregnant.

• Take a multivitamin that contains folic acid. Take one with 400 micrograms of folic acid before pregnancy, but increase to one with 600 micrograms of folic acid during pregnancy. Your provider may want you to take more – be sure to discuss this with him.

• 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 safer during pregnancy.

• Don’t smoke.

• Don’t drink alcohol.

• Get early and regular prenatal care.

If you have any question about cleft or craniofacial defects, causes or prevention, read more here or email us at AskUs@marchofdimes.org.

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.

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.