Today was a sad day for me and my patient … her baby has a cleft lip.
This is sometimes called a hare lip or bingot.
How is it detected?
Very often your doctor will request for an ultrasound or more specifically a Congenital Anomaly Scan when your tummy is 22-28 weeks old as a routine check-up.
This is the best time … how should I say it gently… to check for any possible “unusualness”.
In this day and age of equal rights and non-discrimination for people with disabilities, the words deformity, defect and abnormality should be used with the greatest of care. But that’s another issue…
Going back … the ultrasound is done NOT so that we can do surgery for your baby while inside the uterus (These have not been mastered here in our country yet. In more advanced centers abroad, yes, such surgeries can be done to correct problems of the fetus while inside the mother’s uterus.) but the main purpose for early detection is for early intervention after the baby is born.
Cleft lip is the most common congenital anomaly in newborn babies. It occurs at an incidence of 1 in 500 pregnancies. It happens sometime during the 4th week of life even before the mother gets a positive pregnancy test result. The upper lip fails to fuse leaving a gap in the upper lip and sometimes all the way to the palate or the roof of the mouth.
There is little evidence linking cleft lip to any single cause like a viral infection or exposure to chemicals. There is, however, an increased incidence in women taking Phenytoin (an anti-epilepsy drug) and smoking. Most cases of cleft lip are due to an irregularity in Chromosome #22 which causes the migration of the upper lip cells to stop before they meet each other and close.
Cleft lip and palate are surgically correctible. We refer the baby to a pediatric surgeon or a maxillofacial surgeon and the procedure is carried out at 2-3 months of age. Do not delay it. The earlier it is corrected the better, so as not to affect your baby’s speech and feeding habits. Usually the Rule of 10 applies before surgery is scheduled: the baby should weigh at least 10 lbs, his/her hemoglobin is at least 10 g/dl, and the baby should be at least 10 weeks old ( 2 1/2 months).
Since it is a genetic problem, parents should be aware of a 4% chance of having another baby with the same problem. But this should not stop us from trying to have kids.
Imagine all the famous people who had cleft lips and see how successful they turned out to be: Annie Lennox, Mark Hamill, Jesse Jackson, Stacy Keach, Cheech Marin, King Tut the Pharoah and our very own Azkal’s team captain, Aly Borromeo!
Every child is a blessing… and no matter what shape, size or color, they were given to us as a gift.