WRNMMC, Bethesda, Md.  –   July is National Cleft and Craniofacial Awareness and Prevention Month, observed to improve understanding of orofacial clefts and other conditions of the head and face.

Cleft lip and cleft palate happen when a baby’s lip or mouth does not form properly during pregnancy. “Together, [they] commonly are called ‘orofacial clefts,’” according to the Centers for Disease Control and Prevention. A cleft lip is an opening in a baby’s upper lip. Cleft palate is an opening in the roof of a baby’s mouth.

Numbers from the CDC show:
• about one in every 1,600 babies is born with a cleft lip with a cleft palate in the United States
• about one in every 2,800 babies is born with a cleft lip without a cleft palate in the United States
• about one in every 1,700 babies is born with a cleft palate in the United States

Health care providers aren’t sure what causes cleft lip and cleft palate. Still, the conditions may be due to a combination of genes and other factors, “such as things the mother comes in contact within her environment, or what the mother eats or drinks, or certain medications she uses during pregnancy,” according to the CDC.

Risk factors include:
• Having a family history of cleft lip or cleft palate
• Smoking or drinking alcohol during pregnancy
• Having diabetes before pregnancy
• Use of certain anti-seizure medicines during the first trimester of pregnancy, like topiramate or valproic acid
• Obesity during pregnancy
• Having certain infections during pregnancy, like rubella (German measles)

Walter Reed’s Plastic Surgery offers hope for parents, and their children with orofacial clefts. Surgery can improve the look and appearance of a child’s face who has an orofacial cleft, and with treatment, most children do well and lead a healthy life. Surgery might also improve breathing, hearing, and speech and language development, often impacted by an orofacial cleft. “Some children with orofacial clefts may have issues with self-esteem if they are concerned with visible differences between themselves and other children,” the CDC adds.

To reduce your baby’s risk for an orofacial cleft:
• Take folic acid (found in a prenatal vitamin)
• Don’t smoke or drink alcohol.
• Get a preconception checkup.
• Maintain a healthy weight before pregnancy and talk to your provider about gaining the right weight during pregnancy.
• Get early and regular prenatal care.
• Protect yourself from infections by ensuring all of your vaccinations are up to date and washing your hands often.

In addition to the care of Military Health System (MHS) beneficiaries with orofacial clefts, plastic surgeons and their teams from Walter Reed for many years have participated in humanitarian missions to abroad as part of medical readiness training exercises (MEDRETE) and surgical readiness training exercises (SURGRETE). The exercises allow U.S. military health care personnel to hone their skills, gain experience, and train in a deployed environment while providing care to those in various countries who might otherwise not receive such safe, quality care.

Last August, surgeons and providers from Walter Reed joined other health care personnel on the USNS Mercy (T-AH 19) for the Palawan Smiles portion of the Pacific Partnership 2022 (PP22).

“When USNS Mercy (T-AH 19) left Puerto Princesa, Philippines, 35 young children were all smiles, thanks in part to the Pacific Partnership 2022’s plastic surgery team,” according to U.S. Navy Petty Officer 2nd Class Brandie Nuzzi, assigned to the hospital ship at the time. Pacific Partnership is the largest annual multinational humanitarian assistance and disaster relief preparedness mission conducted in the Indo-Pacific, which last year marked its 17th year.

During PP22, doctors on Mercy partnered with counterparts in the Philippines to conduct the cleft palate repair surgeries, explained Air Force Col. (Dr.) Kerry Latham, who served as one of the lead surgeons on the mission. Latham is a plastic surgery consultant to the Air Force Surgeon General and vice chair for the Department of Surgery at the Uniformed Services University of the Health Sciences (USU). She formerly served as a craniofacial team leader at Walter Reed and said the hospital has supported a craniofacial team for nearly four decades.

“I really enjoy taking care of kids with congenital facial differences, and adults who have issues that pertain to their facial differences,” she said. “I was fortunate enough to be assigned to Walter Reed and to direct the team here. I think people who are drawn to the team feel a passion for taking care of kids and adults with facial differences.”