Cleft Surgery’s Role in Nutrition

Three-month-old Alham (left) shortly before her Smile Train surgery and five-month-old Alham two months after. Alham's story highlights the need for cleft surgery in order to obtain proper nutrition.

Three-month-old Alham (left) shortly before her Smile Train surgery and five-month-old Alham two months after. Alham’s story highlights the need for cleft surgery in order to obtain proper nutrition.

Tanga, TanzaniaIn honor of National Nutrition Month, Smile Train shares a story from Tanzania highlighting the role that timely cleft surgery plays in preventing malnutrition.

When Ahlam was born in rural Tanzania with a cleft lip and palate, her mother Salha, like so many mothers of Smile Train patients, did not know about the common birth defect. Salha’s first two children had been born without incident and perfectly healthy.

Salha and her five-month-old daughter Ahlam pose three months after Ahlam's cleft surgery. Ahlam's health and appearance have vastly improved thanks to her cleft surgery that has allowed her to eat properly.

Salha and her five-month-old daughter Ahlam pose three months after Ahlam’s cleft surgery. Ahlam’s health and appearance have vastly improved thanks to her cleft surgery that has allowed her to eat properly.

Luckily, shortly after Ahlam’s birth, the family was told about Smile Train and that the organization provided free care for thousands of children like Ahlam. The newborn girl would have to wait until she was three months old for surgery though.

During that time life for Salha was difficult. She had no problem feeding her other children, but Ahlam was different because of her cleft. Milk came out of Ahlam’s mouth and nose because she could not suck like a normal infant. With a large gap in her lip and at the roof of her mouth, feeding Ahlam was almost impossible.

Although surgery was a short time away, Salha worried her daughter would not make it. She was not steadily gaining weight and was becoming sick. Despite this, Ahlam’s surgery day came and weighed just enough to go through with surgery.Now at five months old, only two months after her cleft lip surgery, Ahlam’s appearance and health bear no resemblance to the baby girl who entered the hospital for cleft surgery. Not only does she have a new smile, but she has the chubby cheeks of other children her age. The difference is remarkable.

In four months Ahlam will undergo another surgery to correct her cleft palate, which should help her nutrition further as food can still escape through the roof of her mouth. Salha is also looking forward to her daughter’s next surgery and feels this will improve her health even more.

Salha is very grateful for the Smile Train surgery and is happy that her child will have a normal and healthy life.

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To help mothers like Salha, Smile Train developed the following resource video demonstrating the best feeding methods for a child with cleft.

“Sugar,” Change and Hope for Homeless Youth

Sugar Film Movie Poster

Sadly, many children born with cleft are often abandoned by one or both parents. Children like Mili, left on a train in India are unfortunately not an anomaly.

While this story is true for a number of Smile Train patients in the developing world, the issue of abandonment and homeless can also affect children in the United States as well.

The upcoming film Sugar offers a snapshot of youth homelessness. The film follows Sugar, a young woman living on the streets of Venice Beach after her family is killed in a car accident.

She encounters an unfamiliar world that threatens the bright future of just a short time ago. Sugar’s plight is sudden and dramatic, which shows how vulnerable youth can be to homelessness.

Throughout the film, Sugar refuses social services she does not understand or trust. Her decisions are heavily influenced by her homeless peers, who have a deep distrust of support systems. The young adults face common challenges together, despite their different paths to homeless life.

As a new phenomenon, homeless youth pose several opportunities and challenges to outreach efforts. Homeless youth are the fastest growing segment of America’s street population, according to Homelessness Resource Center.  Generic views of homelessness may overlook this aspect.

Early intervention helps prevent long term dependence on social services. Before street life becomes a lifestyle, homeless youth can see they have the capacity to be self-sufficient.

Youth subjects present a chance for providers to adapt services to changing demographics. An integrated approach that identifies and treats high risk factors should be adopted. High risk factors include: youth released from juvenile corrections, mentally ill youth, and foster children who age out of the system.

Such experiences create distrust for social services that negatively affects outreach. Social providers who collaborate can offset limited budgets to prevent youth homelessness before it occurs.

With a short history, there is little data to judge the success of social programs, but much like making cleft surgery available to children in need, a sustainable approach to social services is needed.

Homeless youth face increased physical and mental risks. These range from mental illness, drug abuse, STDs and violence. Street youth are far more likely to be in the juvenile justice system. Being cited for loitering or trespassing may limit employment or school prospects, which affects self-sufficiency.

Shenae Grimes (90210), Marshall Allman and a young cast bring star power that younger audiences can relate to. Many viewers come to realize they are not altogether different from the young characters.

Cast and crew were invited to a film screening before Congress in June, 2013. The screening was a step towards giving homeless youth a voice in public policy. Sugar also earned the Film Heals Award at The Manhattan Film Festival in July 2013.

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Producer, Sugar: Rotimi Rainwater 
Executive Producer, Sugar: Elliott Broidy