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Cleft lip and palate: One in 700 chance

Published on: Wednesday, June 11, 2014

Kota Kinabalu: Based on statistics, one in every 700 newborn babies in Malaysia may have a cleft lip and/or palate condition.

Chairman of the Cleft Lip and Palate Association of Malaysia (Clapam), Zainal Azhar Ahmad, said the first thing he would do when he gets a call from the hospital is visit the mother and assure her that this birth defect is non-life threatening, and to get the child treated as soon as possible.

Going by the cleft management protocol guide, the ideal age for cleft lip corrective surgery is about three months after birth.

"What is more important is how do we manage a cleft baby.

One of the duties of Clapam is also to teach the parents how to feed the baby. And if the mother can breastfeed the baby without the bottle, that is the best.

"We tell them that the cleft management protocol is from birth until the child reaches adulthood. You need dental care, orthodontics and speech therapy in the case of a child with cleft palate.

"A lot of times, parents get the surgery done and then they stop.

That's not enough," he lamented.

Zainal stressed that this congenital condition affects babies, irrespective of race, religion or social background.

"What is important is the fact that cleft is not specific to any particular race or social status or due to geography. It can be a Malay, Chinese, Indian, Kadazan or Iban.

"You also see it among the Australians, Americans, Africans and Asians, among others. If you look at history, the fourth son of Abraham Lincoln was born with a cleft lip.

"One of the reasons why it happens on a global basis is that there is no root cause. What makes the difference is how one particular country manages the problem versus another country," he said.

On Clapam's 3,000 members nationwide comprising parents with children born with cleft lip and/or palate, and adults with cleft lip and/or palate, Zainal said not all of them are low-income earners.

"It's all the way from high income, average income, middle to low-income, so income or individual socio-economic status is not the reason for cleft occurrence."

From a worldwide standpoint, Zainal noted that there is some variation between certain races. "For example, it has been shown that one in 1,000 births among the Aborigines in Australia is a cleft baby."

Explaining the role of Clapam, he said its mission is to provide moral support and advice on feeding and the management of cleft cases, especially to parents of newborn cleft babies.

"We visit hospitals, clinics and homes of cleft individuals to provide counselling and guidance on the correct feeding techniques for a cleft baby.

This is important as proper feeding is essential to a baby's growth and development," he pointed out.

According to Zainal, the non-profit, non-governmental organisation (NGO) sponsored 91 surgeries last year.

"We also issued 1,000 free special feeding bottles and 1,000 teats to new members nationwide."

Asked why Clapam decided to come to Sabah for the first ever Kota Kinabalu Cleft Carnival 2014, he said: "We have always worked with medical and health professionals. So why don't we do something in Sabah to get more Sabahans into the cleft correction programme, rather than sending one or two to KL for treatment.

"We are happy to collaborate with the Sabah Women and Children's Hospital. In fact, we are open for collaboration with any group, including the Rotary Club of Likas Bay to help Malaysians born with cleft condition.

"This inaugural event marks the start of a few more programmes with the hospital on how to get early treatment for Sabahans in the years to come."

Zainal hoped that whatever knowledge and experience shared on this occasion would get expanded throughout the whole of Sabah.

Meanwhile, he concurred with Sabah Women and Children's Hospital Paediatric Dentist, Dr Leong Kei Joe, that the cause of cleft formation is actually multi-factorial in nature.

While conceding that genetics and environmental factors contribute to the formation of cleft, Zainal said there is no conclusive root cause or proof that a cleft condition is due to this or that factor.

"There is a combination of factors that can come into play.

But it is not correct to say that it is solely due to genetics or the environment. There are some elements related to genetics or the environment but not necessarily purely attributed to genetics or the environment itself," the Clapam Chairman contended.

Welcoming the presence of Clapam in the Cleft Carnival, Dr Leong Kei Joe said it is multi-purpose as the team is here until today (Wednesday) not only for cleft lip and/or palate surgery but also to educate parents and health care providers while creating critical awareness on the importance of management of cleft individuals.

He, meanwhile, acknowledged the good work done by the Rotary Club of Likas Bay as reflected in the cleft lip and/or palate surgery programme under its community service project since 2001.

In response, Club President Woo Soo Poo said before QEH 1 Consultant Plastic Surgeon, Dr Sergius Ajik, became involved in the programme, it was paediatric surgeon Dr Rajah in the early years.

Dr Ajik is an honorary member of the club.