“Cleft lip with or without cleft palate is among the most common of birth defects. The Centers for Disease Control and Prevention (CDC) estimates that in the United States:

• About 1 in every 1,600 babies is born with cleft lip with cleft palate.
• About 1 in every 2,800 babies is born with cleft lip without cleft palate.
• About 1 in every 1,700 babies is born with cleft palate.”

National Institute of Dental and Craniofacial Research (https://www.nidcr.nih.gov/health-info/cleft-lip-palate)

Health care providers are encouraged to provide women to plan for pregnancy; avoid harmful substances, like tobacco (2) and alcohol (3); and choose a healthy lifestyle, like eating a healthy diet (4), to increase their chances of a healthy pregnancy. Health care providers also discuss with women any medications they might be taking, both prescription and over-the-counter, to ensure they are taking only what is necessary. If yours is not maybe you need a new one. Prevention is the key to giving highier odds the baby will be healthier when born. Re-enforcement is a great tool and that’s where the medical profession comes into play with pregnant women who is their clientele.

Know that not all birth defects can be prevented. But, we also know that women can increase their chances of having a healthy baby by managing health conditions and adopting healthy behaviors before becoming pregnant. Make a commitment to yourself, to get healthy before and during pregnancy by actively trying to plan ahead, avoid harmful substances, choose a healthy lifestyle, and talk with your healthcare provider.   There are some that can be prevented.

1.Plan ahead.

Get 400 micrograms (mcg) of folic acid every day. Folic acid is a B vitamin. If a woman has enough folic acid in her body at least one month before and during pregnancy, it can help prevent major birth defects of the developing brain and spine defects like anencephaly or spina bifida. Anencephaly is a serious birth defect in which a baby is born without parts of the brain and skull. It is a type of neural tube defect (NTD). As the neural tube forms and closes, it helps form the baby’s brain and skull (upper part of the neural tube), spinal cord, and back bones (lower part of the neural tube). Spina bifida is a condition that affects the spine and is usually apparent at birth. It is a type of neural tube defect (NTD). Spina bifida can happen anywhere along the spine if the neural tube does not close all the way. The backbone that protects the spinal cord does not form and close as it should. This often results in damage to the spinal cord and nerves. Spina bifida might cause physical and intellectual disabilities that range from mild to severe. The severity depends on:

• The size and location of the opening in the spine.
• Whether part of the spinal cord and nerves are affected.
• There are 3 types and they are: 1-Myelomeningocele, 2-Meningocele, and 3-Spina Bifida Occulta.
• 1-Myelomeningocele is the most serious type of spina bifida. With this condition, a sac of fluid comes through an opening in the baby’s back. Part of the spinal cord and nerves are in this sac and are damaged. This type of spina bifida causes moderate to severe disabilities, such as problems affecting how the person goes to the bathroom, loss of feeling in the person’s legs or feet, and not being able to move the legs.
• 2-Meninocele is a sac of fluid comes through an opening in the baby’s back. But, the spinal cord is not in this sac. There is usually little or no nerve damage. This type of spina bifida can cause minor disabilities.
• 3-Spina bifida occulta is the mildest type of spina bifida. It is sometimes called “hidden” spina bifida. With it, there is a small gap in the spine, but no opening or sac on the back. The spinal cord and the nerves usually are normal. Many times, spina bifida occulta is not discovered until late childhood or adulthood. This type of spina bifida usually does not cause any disabilities.

1. • Women can get folic acid from fortified foods or supplements, or a combination of the two, in addition to a varied diet rich in folate.
   • See a healthcare professional regularly. A woman should be sure to see her doctor when planning a pregnancy and start prenatal care as soon as she thinks that she is pregnant. It is important to see the doctor regularly throughout pregnancy, so a woman should keep all her prenatal care appointments. If you are trying to have a baby or are just thinking about it, it is not too early to start getting ready for pregnancy. Use these checklists to help you write down your goals and have them in a place that you reinforce yourself to maintain them as best as possible for your child’s sake and your own sake as well.

2.Avoid harmful substances.

1. • Avoid alcohol at any time during pregnancy.                                    
   • Alcohol in a woman’s bloodstream passes to the developing baby through the umbilical cord. There is no known safe amount of alcohol use during pregnancy or while trying to get pregnant. There is also no safe time during pregnancy to drink. All types of alcohol are equally harmful, including wine and beer. Drinking alcohol during pregnancy can cause miscarriage, stillbirth, and a range of lifelong physical, behavioral, and These disabilities in the child, which occur because the mother drank alcohol during the pregnancy, are known as fetal alcohol spectrum disorders (FASDs). The best advice for women is to stop drinking alcohol when trying to get pregnant.
   • Avoid smoking cigarettes.
   • The dangers of smoking during pregnancy include preterm birth, certain birth defects from cleft lip or cleft palate to even infant death and more diseases inherited by mom through smoking. Even being around tobacco smoke puts a woman and her pregnancy at risk for problems. Quitting smoking before getting pregnant is best. 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 birth weight. It’s never too late to quit smoking.
   • Avoid marijuana and other “street drugs”.
   • A woman who uses marijuana or other “street” drugs during pregnancy can have a baby who is born preterm, of low birth weight, or has other health problems, such as birth defects. Marijuana is the illicit drug most commonly used during pregnancy. Since we know of no safe level of marijuana use during pregnancy, women who are pregnant, or considering becoming pregnant, should not use marijuana, even in states where marijuana is legal. Women using marijuana for medical reasons should speak with their doctor about an alternative therapy with pregnancy-specific safety data.
   • Prevent infections.
   • Some infections that a woman can get during pregnancy can be harmful to the developing baby and can even cause birth defects. Some easy steps to prevent infections include frequent hand-washing, cooking meat until its well done, and staying away from people who have an infection. 

3.Choose a healthy lifestyle.

1. • Keep diabetes under control.
   • Poor control of diabetes during pregnancy increases the chances for birth defects and other problems for the pregnancy. It can also cause serious complications for the woman. Proper healthcare before and during pregnancy can help prevent birth defects and other poor outcomes.
   • Strive to reach and maintain a healthy weight.
   • Do you know …Your body mass index (BMI)? Calculate it. Where? Just look it up on the internet anywhere for free.

A woman who is obese (a Body Mass Index of 30 or higher) before pregnancy is at a higher risk for complications during pregnancy. Obesity also increases a pregnant woman’s risk of several serious birth defects. Even if a woman is not actively planning a pregnancy, getting healthy can help boost her health and her mood. If a woman is overweight or obese, she should talk with her doctor about ways to reach a healthy weight before she gets pregnant.

4.Talk with your healthcare provider.

1. • Talk to a healthcare provider about taking any medications.
   • We know that certain medications can cause serious birth defects if they are taken during pregnancy. For many medications taken by pregnant women, the safety has been difficult to determine. Despite the limited safety data, some medications are needed to treat serious conditions. If a woman is pregnant or planning a pregnancy, she should not stop taking medications she needs or begin taking new medications without first talking with her healthcare provider. This includes prescription and over-the-counter medications and dietary or herbal products.
   • Talk to a healthcare provider about vaccinations (shots).                                                

Most vaccinations are safe during pregnancy and some vaccinations, such as the flu vaccine and the Tdap vaccine (adult tetanus, diphtheria and acellular pertussis vaccine), are specifically recommended during pregnancy. Some vaccines protect women against infections that can cause birth defects. Having the right vaccinations at the right time can help keep a woman and her baby healthy. She should talk to her doctor about which vaccines are recommended for her during pregnancy.

ACPC-American Cleft Palate – Craniofacial Association addresses July the month of awareness to this condition with stating:

“Here are five key facts about clefts and craniofacial conditions, their impact and treatments:

1. Clefts are usually repaired surgically in the first year of life, though many children require additional surgeries and treatments through adolescence to correct challenges to breathing, eating or speech development.
2. Individuals born with cleft lip or palate often need specialized dental or orthodontic care throughout their lives as well.
3. There is no single factor related to the cause of cleft. Sometimes clefts run in families and in some cases have been linked to environmental factors.
4. Despite unique health challenges, those born with cleft and craniofacial conditions lead fulfilling, successful and accomplished lives.
5. Coordinated care is the best approach for successful surgical repair. Multidisciplinary teams approved by the ACPA are located across the nation and are comprised of qualified professionals from medical, surgical, dental, speech and allied health disciplines.”

“The causes of orofacial clefts among most infants are unknown. Cleft lip and cleft palate are thought to be caused by a combination of genes and other factors.

CDC research has found some factors that increase the risk of having a baby with an orofacial cleft:

• Smoking during pregnancy
• Having diabetes before pregnancy (type 1 or 2)
• Use of certain epilepsy medications during pregnancy”

CDC Birth Defects (https://www.cdc.gov/birth-defects/about/cleft-lip-cleft-palate.html)

What is cleft lip and palate?

National Cleft and Craniofacial Awareness and Prevention Month is observed in July. This is an opportunity to raise awareness and improve understanding of orofacial clefts, clefts of the lip and palate, and other conditions of the head and face. In the United States, approximately 2,600 babies are born with a cleft palate and 4,400 babies are born with a cleft lip, with or without a cleft palate each year. There are other craniofacial birth defects including craniosynostosis (skull sutures fusing prematurely), anotia/microtia (ear is missing or underdeveloped), and anophthalmia/microphthalmia (missing or abnormally small eye).

• Unilateral incomplete
• Unilateral complete
• Bilateral complete

What causes cleft lip and cleft palate?

We’re not sure what causes cleft lip and cleft palate. They may be caused by a combination of factors, like genes and things in your everyday life, like certain medicines you take. Risk factors include:

• Having a family history of cleft lip and cleft palate
• Smoking or drinking alcohol during pregnancy
• Having diabetes before pregnancy
• Taking certain anti-seizure medicines during the first trimester of pregnancy, like topiramate or valproic acid
• Being obese during pregnancy.
• Having certain infections during pregnancy, like rubella (also called German measles)

How are Cleft lip and palate treated?

July is National Cleft and Craniofacial Awareness and Prevention Month.

Cleft lip and cleft palate happen when a baby’s lip or mouth doesn’t form completely during pregnancy. Cleft lip is an opening in a baby’s upper lip. Cleft palate is an opening in the roof of a baby’s mouth. Cleft lip and cleft palate are birth defects. These conditions affect thousands of babies, children, teens and adults in the United States each year.

Cleft lip and palate happen very early in pregnancy. Your baby’s lips form between 4 and 7 weeks of pregnancy, and the palate forms between 6 and 9 weeks of pregnancy. Cleft lip and palate don’t have to happen together — a baby can have one without the other.

Prevention:

To help reduce the chances of having a baby with an orofacial cleft or other craniofacial condition health care providers must encourage patients who are thinking about becoming pregnant to commit to a healthy lifestyle. Among certain healthy habits, we have: control diabetes, quit smoking, exercise regularly, practice yoga, etc. before becoming pregnant. Moreover, health care providers should also work with prospective parents to make informed decisions about medical treatment during pregnancy. This condition can occur in the first three months of pregnancy. Therefore, steps before becoming pregnant are essential for the health of the baby.

“Group B streptococcus (also called Group B strep or GBS) is a common type of bacteria (tiny organisms that live in and around your body) that can cause infection. Usually GBS is not serious for adults, but it can hurt newborns.

Many people carry Group B strep bacteria and don’t know it. It may never make you sick. GBS in adults usually doesn’t have any symptoms, but it can cause some minor infections, like a bladder or urinary tract infection (UTI).

While GBS may not be harmful to you, it can be very harmful to your baby. If you’re pregnant, you can pass it to your baby during labor and childbirth.

About 10 to 30 percent of pregnant women carry GBS bacteria. The best way to know if you have GBS is to get tested.”

March of Dimes (https://www.marchofdimes.org/find-support/topics/planning-baby/group-b-strep-infection)

Group B Streptococcus (GBS), or Streptococcus agalactiae, is a type of bacteria that is naturally found in the digestive and lower reproductive tracts of both men and women.  About 1 in 4 pregnant women “carry” or are “colonized” with GBS.

Carrying GBS does not mean that you are unclean.  Anyone can carry GBS. GBS is not considered to be a sexually transmitted disease or infection as it can occur on its own even in someone with no prior sexual experience. However, bacteria can be passed between sexual partners, including through oral contact.

The awareness month for group B strep is July. This is a common bacterium that affects adults and it does not present with any symptoms or signs. The pregnant women can pass these bacteria to their unborn children during the first few months after delivery or during child birth and this can be fatal. Most people who suffer from this bacterial infection are not aware of it and pregnant women get to know about it because of the screening that is done during prenatal visits. The screening tests is usually done during the third trimester and this test was started in the mid 1990s. Research indicates that since that time, the number of children who are affected by this infection has dropped from 1.7 to 0.28 in every 1000 births.

This month helps in raising awareness to women who are pregnant and those who are in the child rearing period to prevent Group B Strep infection. This helps women to keep their unborn babies healthy and safe as the infection can be fatal.

The National Charity that is associated with group B strep advices all pregnant women to be aware of this infection caused by streptococcus group B. This is the most common type of infection in new born babies as it causes meningitis, pneumonia and sepsis which can be fatal in the first few weeks of life. The bacterium is carried by women who do not present with any symptoms and therefore it can be easily passed to the baby during child birth.

The main message that is shared on this month awareness is that Group B Strep is fatal and that the infection can be prevented. People are taught on the need to go for testing as the bacterial colonization can be carried by people in the vagina or the lower intestines. Most people are carriers of this infection but they are not aware because they have never been tested for the same. This is because the infection does not present with any signs or symptoms. However, in some cases, the infection can get access into the blood stream and this can trigger fatal infections. When a pregnant woman gets this infection it can be spread to the unborn baby in the following ways:

While the baby is still in the womb, during a normal or a cesarean section birth, through the urinary tract or amniotic fluid, or through direct contact with the bacteria that is present in the birth canal.

The infants who are infected by this bacterium during birth are prone to infections and this includes meningitis, pneumonia and sepsis. The children who survive this infection are at risk of getting long term complications especially in cases where they suffered from meningitis. The common complications that can occur include cerebral palsy, hearing loss, mental and physical disabilities.

Pregnant women should be aware of the need for testing for each pregnancy and it does not matter whether they were tested for the previous pregnancies. This is because all pregnancies are different and it is vital to ensure that the baby is safe in all pregnancies.

“Health care providers can treat hemochromatosis safely and effectively by removing blood from the body on a regular basis. This is similar to donating blood. The process is known as phlebotomy.

The goal of phlebotomy is to lower your iron levels. The amount of blood removed and how often it’s removed depend on your age, your overall health and the severity of iron overload.”

MAYO CLINIC (https://www.mayoclinic.org/diseases-conditions/hemochromatosis/diagnosis-treatment/drc-20351448)

Diagnosis

It can be tricky for your doctor to diagnose hemochromatosis, because other conditions have the same symptoms. He might want you to get tested if:

• You’re having symptoms.
• You have one of the problems listed above.
• A family member has the disorder.

There are some other ways your doctor can figure out if you have it:

Checking your history. He’ll ask about your family and if anyone has hemochromatosis or signs of it. He might also ask about things like arthritis and liver disease, which might mean you or someone in your family has hemochromatosis but doesn’t know it.

Physical exam. Your doctor will examine your body. This involves using a stethoscope to listen to what’s going on inside. He might also tap on different parts of your body.

Blood tests. Two tests can give your doctor a clue about hemochromatosis:

• Transferrin saturation. This shows how much iron is stuck to transferrin, a protein that carries iron in your blood.
• Serum ferritin. This test measures the amount of ferritin, a protein that stores iron, in your blood. – If either of these show you have more iron than you should, your doctor might order a third test to see if you have a gene that causes hemochromatosis.
• Liver biopsy. Your doctor will take a small piece of your liver. He’ll look at it under a microscope to see if there’s any liver damage.
• MRI. This is a scan that uses magnets and radio waves to take a picture of your organs.
  

  Treatment

  If you have primary hemochromatosis, doctors treat it by removing blood from your body on a regular basis. It’s alot like donating blood. Your doctor will insert a needle into a vein in your arm or leg. The blood flows through the needle and into a tube that’s attached to a bag.

  • Initial treatment schedule. In the beginning, you may have a pint (about 470 milliliters) of blood taken once or twice a week — usually in a hospital or your provider’s office. While you lean back in a chair, a needle is inserted into a vein in your arm. The blood flows from the needle into a tube that’s attached to a blood bag. The process of removing blood is referred to as therapeutic blood removal.  In the Initial treatment. You’ll visit your doctor’s office or a hospital once or twice a week to have your blood drawn. You may have up to a pint taken at a time.
  • Maintenance treatment schedule. Once your iron levels go down, blood can be removed less often, typically every 2 to 3 months. Some people may maintain typical iron levels without having any blood taken. Some may need to have blood removed monthly. The schedule depends on how quickly iron builds up in your body.  So Maintenance treatment starts when once your blood iron levels have gone back to normal, you’ll still have to have to have blood taken, but not as often. It’ll be based on how fast iron builds back up in your body.

  The goal is to remove some of your blood so that your iron levels return to normal. This could take up to a year or more. Blood removal is divided into two parts: initial treatment and maintenance treatment.

   

   

“Hemochromatosis is a metabolic disorder in which your organs accumulate excess iron, leading to organ damage. Hereditary hemochromatosis affects one in 300 people in the United States.”

John Hopkins Medicine (https://www.hopkinsmedicine.org/health/conditions-and-diseases/hemochromatosis)

This is a problem with the Liver and in a nutshell it is IRON OVERLOAD!

Hemochromatosis (Hemo meaning blood, Chroma meaning change in color and Osis meaning swelling)  is a condition where there is abnormal accumulation of iron in the organs resulting in organ toxicity. It is the most common autosomal recessive genetic condition along with being the most common cause of severe iron overload. 75 percent of patients who have hereditary hemochromatosis are asymptomatic. The diagnosis can be made based on the clinical symptoms of the disease. Since most patients are asymptomatic, they are diagnosed when their serum iron levels are noted to be elevated during a routine chemistry screening panel. Some of the tests performed on an individual suspected with hemochromatosis include genetic testing to test for HFE mutations, transferrin saturation levels, hepatic iron concentration, and serum ferritin studies. Imaging studies such as a chest radiography and echocardiography might be beneficial to help evaluate cardiac disease in patients with hemochromatosis.

Early diagnosis is important in hemochromatosis, like in most every other diagnosis.

The aim of therapy is to remove iron before it causes irreversible parenchymal damage. Once the diagnosis is confirmed, it is treated by phlebotomy to maintain normal iron stores and rid the body of excess iron. Chelation therapy uses agents such as deferoxamine, deferiprone, or deferasirox. Surgery may be required if there is end stage liver disease or severe arthropathy. In the United States, hereditary hemochromatosis is found in 1 of 200 to 500 individuals. Most of these cases are seen in individuals of northern European origin. It has the same prevalence in Australia, Europe, and other western countries. The highest prevalence is among individuals of Celtic origin and less among those of African descent.

Symptoms would be:

1.) Fatigue and 2 types of fatigue, that would be:

Physical fatigue occurs when there is transient inability to achieve peak physical performance.

Mental fatigue is the temporary inability to maintain optimal cognitive performance. It is a common and non-specific symptom that can be seen in stress, overwork, depression, boredom, anemia, inadequate sleep, malnutrition, pregnancy, infections, and more. It can manifest as somnolence in patients.

2.) Impotence in patients with hemochromatosis is due to a result of hypogonadism. Hypogonadism can occur in hemochromatosis patients due to pituitary or testicular iron deposition.

3.) Arthropathy that’s a disease of a joint. In arthropathy, there can be joint pain, stiffness, swelling, and decreased range of motion. Patients can see this occuring because of the accumulation of iron in the joint tissues. The most commonly affected joints are the knees, feet, wrists, neck, back, metacarpophalangeal joints, and proximal interphalangeal joints.

4.) It has been observed that 62 percent of patients with hemochromatosis experience partial loss of body hair. The most commonly affected area is the pubic area. Approximately 12 percent of patients experience total body hair loss. In some patients, the thinning and loss of hair may be reversed through therapy.

5.) Koilonychia refers to spoon nails where the nails are abnormally thin and have lost their convexity resulting in flat or concave nails. Causes of koilonychia include iron deficiency anemia and it can be seen in 25 to 50 percent of these patients.

6.) Skin Hyperpigmentation or Bronzing of the skin refers to darkening of the skin. It is due to the combination of melanin and iron deposition which is characteristic. It is one of the classic triad symptoms with the other two being cirrhosis and diabetes in the late stages of the disease. This usually occurs only when the total iron content in the body is more than 5 times the normal levels.

7.) Amenorrhea refers to the absence of menstruation in females who are in their reproductive age.

8.) In the heart it can cause the following: Atrial flutter is a problem with the way your heart beats. Such problems, whether in the rhythm or speed of the heartbeat, are known as arrhythmias. Heart Failure is the other.

In addition to these symptoms it can also cause problems with the spleen, adrenal glands, pituitary gland, gallbladder or thyroid.

For helping in possible PREVENTION of this diagnosis and most others stay as healthy as possible and get yearly check ups to pick up this or any other diagnosis EARLY!! In so many cases of diseases the early picked up or diagnosed the better the results turn out in most cases.  When a disease just start in your body is being treated compared to late in the disease higher the odds will resolve or you will last longer with a better quality of life, just like with so many other diseases!