MEDICAL SURFARI: HEALTHY BABIES FOR 1998

As I sat in the kitchen of our home preparing this column, my daughter Elizabeth who is almost four months to the day looked at me with her sparkling big blue eyes and, after plucking her pacifier from her lips, she smiled at me only to remind me how fortunate and blessed we are to have a healthy and happy baby.

Unfortunately, 8,000 infants die annually in the U.S. as a result of birth defects and 150,000 more are born with severe birth defects. These numbers are humbling and they remind me to be thankful. Not only is this a tragedy for the families involved, but it has a strong impact upon a variety of resources, healthcare, special education, social security, and welfare. In the past, it was said that nothing could be done about this -- this is no longer the case. Modern science and medicine have now established the causes and prevention strategies for many severe and fatal birth defects.

Although there is a wide variety of birth defects that may occur, some of the most common and important are fetal alcohol syndrome, spina bifida, and cleft lip and palate.

Women who are moderate to heavy drinkers of alcohol may bear children with fetal alcohol syndrome (FAS) which can cause a variety of health problems. Alcohol use during pregnancy causes one third of all cases of mental retardation. The central nervous system can be affected causing tremors, irritability, feeding difficulties, and speech problems. Babies with FAS may have facial and major organ malformations. FAS children tend to be small and emaciated. At puberty, FAS girls are often short, stocky, and overweight. These disabilities will last a lifetime and are 100 percent preventable by not using alcohol during pregnancy or breast feeding. No safe level of alcohol consumption has been established.

Spina bifida is a defect in the closure of the spinal column. Its severity varies from a type with no external signs to a completely open spine with severe neurological disability and death. It is most common in the lumbar and low thoracic or sacral region of the spine and usually extends for three to six vertebral segments. It is more common in Caucasians than African Americans and in many cases it can be prevented with good prenatal nutrition.

One in 700 children is born with a cleft lip/palate and this is the most common facial birth defect. The cleft may vary from involvement of the soft palate only, to a complete cleft of the soft and hard palates, and the lip may be involved in either case. Unrepaired, these are often cosmetically distressing and may interfere with feeding and speech development. For couples who have had an affected child, genetic counseling may help to determine the risk of having other affected children.

World Wide Web Resources

These sites are good resources for more information on birth defects.

The National Organization on Fetal Alcohol Syndrome

http:\\www.nofas.org\what.htm

This site provides up-to-date statistics and information on how to prevent fetal alcohol syndrome. It provides strategies for parents and caregivers of children affected by alcohol during their early development.

Genetic Syndrome Support Groups On-Line and Other Health-Related WWW Sites

http:\\members.aol.com\dnacutter\sgroup.htm

This site provides a variety of links to other web sites for specific birth defects. In addition, it contains links to national support group and information sites.

Wide Smiles: Cleft Lip and Palate Resource

http:\\www.widesmiles.org\

Here you may learn just about everything that relates to cleft lip and palate. The history of clefting, cleft surgery, parent's feelings about their children born with clefts, a gallery full of pictures, support groups, and even insurance issues related to this condition.

Dr. Scott Gibbs is a neurosurgeon and editor-in-chief of Mosby's Medical Surfari. You may e-mail questions to him at drgibbs@semissourian.co or write in care of the Southeast Missourian, P.O. Box 699, Cape Girardeau, Mo., 63701.