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Cleft lip and palate among most common birth defects in U.S.

Published On: Jul 03 2013 11:52:55 AM CDT   Updated On: Jul 17 2013 11:50:43 AM CDT
Baby playing with toys


(COLUMBUS, Ohio) – We’ve all seen the TV commercials and ads in magazines featuring babies in developing countries who are in need of corrective surgery for cleft lip or palate.  But it might surprise you to know that cleft lip and palate is one of the most common birth defects here in the U.S.  Every hour and 15 minutes, of every single day, on average, another baby is born in this country with cleft lip and palate.

“It’s a very common belief that cleft lip and cleft palate is a third world problem, but in reality, it’s the most common birth defect in the United States, behind only congenital heart disease.  In fact, cleft lip and cleft palate is twice as common in the United States as it is in the developing continent of Africa,” said Dr. Richard Kirschner, chief of Plastic and Reconstructive Surgery and director of the Cleft Lip and Palate-Craniofacial Center at Nationwide Children’s Hospital

While there is no way to prevent babies from forming in the womb with cleft lip or palate -- or both -- there has been a shift over the years in the approach to treating them.  Today, it’s more than just surgery, it is a team approach, designed to not only repair the babies physical defects, but any issues they may have as they grow.

“No longer are we simply taking care of children as surgeons alone, but as surgeons as part of a multi-disciplinary health care team” said Kirschner, who is also affiliated with Ohio State University.  “In our program, that includes our surgeons, nurses, otolaryngologists, geneticists, speech pathologists and speech physiologists, dentists, psychologists and social workers.  And they may treat these kids until they are 20, 21 years old.”

And a new study shows that where a baby is treated matters.  A study published in March 2011 in Plastic and Reconstructive Surgery (the journal of the American Society of Plastic Surgeons) shows that complications from surgery to repair clefts in teaching hospitals dropped by as much as 27 percent since 2000, compared to non-teaching hospitals.

“We have a critical mass of absolute world-class leaders in their field, in surgery, in speech therapy and in orthodontics” said Kirschner of the program through Nationwide Children’s Hospital and Ohio State University, “so not only are we striving to provide the best care that we can today, but we’re training the cleft-care providers of tomorrow.”

That made a difference to Matthew and Chelsee Osborne of Coshocton, Ohio, who had never even thought of cleft issues until the day their son Carter was born.  “It was kind of heartbreaking, you know, the first time.  The shock of it all” said Carter’s father, Matthew.
But after Carter underwent surgery to correct his lip, within a matter of months, the Osbornes would have to face it all again.

Pregnant with her third child, Chelsee Osborne specifically asked her doctor to look for problems in the womb with their son Mason.  An ultrasound confirmed their worst fear.  “The look on the nurses face, I could kind of tell something was wrong.  Neither my husband nor I, in a million years, would have thought it happened again.”

But it did, and this time their son Mason had both a cleft lip and palate, and needed more extensive treatment than his older brother.  The Osbornes didn’t hesitate choosing a program at a teaching hospital.  “We’ve had more time to learn about it.  And the more we’ve learned the easier it’s gotten for us,” said Matthew.

Babies born with cleft lip and palate can’t suckle properly and have problems feeding.  But the physical scars are only the beginning.  They might also deal with everything from dental issues to depression.  Which makes the resources of a teaching hospital, like the one at Nationwide Children’s Hospital all the more important.

“We understand that we’re not simply treating a cleft lip and cleft palate, but we’re treating a child with a cleft lip and cleft palate.” said Dr. Kirschner.  “It’s certainly very important to achieve outstanding surgical outcomes, but our goal really, is to restore normal quality of life.”