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Jan 19, 2012

Healthy Living examines birth defects

Earlier this month we reported on the heart-wrenching story of a baby born with an imperforate anus. The International Hospital for Children has committed to assist the parents with the necessary surgery for baby Ronelia. Tonight Healthy living tonight looks at birth defects in Belize by examining the known causes and treatment options.

Tanisha Fortnard, Mother of Ronelia Ferguson [File: Jan 9, 2012]

Tanisha Fortnard

“I am asking the public to please assist me with my child.”

Marleni Cuellar, Reporting

Tanisha’s plea is one that we hear several times in our newscasts. We broadcast the heart wrenching stories about children born with birth defects and in need of urgent medical care to survive.  Thankfully, for babies like Ronelia, generous donors and hard working organizations are able to offer the much needed assistance. But how often are babies born with birth defects and are there any known causes? We sat down with pediatrician, Dr Victor Rosado, to find out more.

Dr. Victor Rosado, Pediatrician

“There are about four thousand different birth defects and they range from very serious to relatively mild and also some defects are far more common than others. In Belize and throughout the world, one of the most common birth defects are heart defects: They are probably one in every one hundred and fifty or one in every two hundred live births. We have other things like cleft lip or cleft palette which are one in every seven hundred and fifty live births.  Things to do with the gastrointestinal tract, like your esophagus or your gut or your anal region are far less common, far less common, they are like one in every ten thousand live births. So that paints the picture that some birth defects are less common than others. Certain birth defects are far more serious than others so we need to take care of each one individually.”

For most parents, any anomaly in their child development is devastating whether it be mild or life threatening. For parents, their most obvious query is why? But, the causes for the abnormalities are as wide-ranging as the types of defects. Typically, though, they are classified under two main categories.

Dr. Victor Rosado

“Most of the time, birth defects come from two causes of genetic cause and of environmental cause. Environmental causes is if the mother had an infection, if the mother was using alcohol or tobacco, if the mother is exposed to radiation like had an x-ray and she did not know she was pregnant. And so we can explain some of the birth defects but I would say that is in about twenty-five percent of the cases.  In approximately seventy-five percent of the cases we really can’t tell what cause the birth defect.”

Victor Rosado

Genetic causes can only be explained as when one or more genes don’t work properly or part of a gene is missing. Like every other health condition, early detection is crucial.  All hospitals must complete a full check of a newborn before they are discharged; however not all defects will be noticeable from that early.

Dr. Victor Rosado

“The issue is that heart defects are always not picked up at birth and sometimes its not picked up until the child is four/five years old and the child has a heart murmur at that time and maybe faints but it is not classified as a heart defect but it is more difficult to be picked up at birth.”

In the case of baby Ronelia she was born with one of the rarer birth defects: an imperforate anus a condition in which the opening to the anus is missing or blocked. Although Dr Rosado was NOT the attending physician; he shares what he suspects was the situation and how baby Ronelia’s birth defect could have gone undetected for 6 weeks.

Dr. Victor Rosado

“In that case, there was the opening at the anus area, the child obviously had most of the intestine and colon formed and there was a joining from the colon to the vaginal area, the child can pass stool; albeit through a narrow opening not from the anal area, so the child does pass meconium, does pass stool, but through an orifice that leads to the vagina. So what you do in these cases is that you perform a colostomy and then the child can use a colostomy for the first year of life and then the correct surgical repair later on in life.”

Ronelia

Through the assistance of the International Hospital for Children, Ronelia underwent a procedure for a colostomy at the KHMH on Monday. The colostomy now allows for her stool to be drained through a bag attached to the abdomen. This is a short term fixture until the corrective surgery can be performed later this year. It is with the assistance of organizations like IHC and others that many children born with birth defects have been able to survive. Unfortunately not all parents are aware of these options.

Dr. Victor Rosado

“A lot of these parents may not be aware of these options, so many times a child with cleft pallet for example can survive that 6months until you get the medical brigade in Belize to fix it; other things like children with genito- urinary defects, can sometimes have a temporary procedure done that will buy them enough time till the specialist comes and does the definitive surgical repair of the cosmetic repair in terms of cleft pallet & cleft lip. With the proper information, most parents understand and are accepting once you’ve cleared the air that they are not at fault and where they can get the proper care; like is aid most of the time care is available if not in Belize then in regional centers. Care is available.”

While, it is difficult to definitively advise expecting parents on how to prevent birth defects. There is one piece of advice that can significantly reduce the risks.

Dr. Victor Rosado

“If you want to minimize birth defects it needs to start there. Plan your pregnancy. Decide that you want to get pregnant, visit your physician, make sure you don’t have any infections; get a pap smear, start taking multivitamins that have folic acid in it, stop smoking, stop consuming alcohol and then you get pregnant. That is important we must understand that most birth defects occur in the first trimester of pregnancy and even more important in the first part of the first trimester, in the first eight weeks probably. Ninety-five percent of the birth defects will occur in that period. You can’t get pregnant and then decide at the fourth month of pregnancy that you will start to do things correct. It’s a little bit too late then.”

Dr. Rosado encourages parents to communicate with their doctors and never hold back from asking questions about their baby’s health & development.

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Viewers please note: This Internet newscast is a verbatim transcript of our evening television newscast. Where speakers use Kriol, we attempt to faithfully reproduce the quotes using a standard spelling system.

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