Written by Lauren Murphy, SIU School of Medicine

It’s the most common birth defect in the country, and it often requires several different types of services. According to the Cleft Palate Foundation, approximately one out of every 594 newborns in the U.S. is born with a cleft lip and/or cleft palate each year. SIU School of Medicine physicians work closely with an entire team of specialists, including surgeons, geneticists, audiologists, speech therapists and pediatric dental and orthodontic professionals, to help these babies.

Learning your child has a cleft lip or palate can be scary for parents. It’s important for parents to know that cleft lips and palates are temporary and correctable.

What is a cleft palate and a cleft lip?

A cleft palate is an opening in the roof of the mouth, and a cleft lip is an opening in the lip. Both result from incomplete development of the lip or palate while the baby is still in the womb. During the first three months of pregnancy, the baby’s lips and palates develop separately, and in most cases, the left and right parts of the lips and palates will eventually come together to create a normal upper lip and palate.

About half of children with clefts have clefts that involve the lip and palate. Another 25% have clefts that involve only the lip, and the remaining 25% have clefts that only affect the palate.

Why didn’t our baby’s mouth fully develop?

While we don’t know the complete answer to this question, it’s important for parents to know that it did not occur because of something you did wrong. Clefts can sometimes run in families, and other times, clefts occur in combination with other health problems.

What can health professionals do to help our baby? What can we do as parents to help our child?

The great news is that our team of specialists can usually repair a cleft lip in the first few months of life. Often, we can repair a cleft palate between 9-18 months, but the exact timing of these repairs will depend on the baby’s health and how it will affect the baby’s future development.

In addition to a pediatric plastic surgeon, your baby may need a speech pathologist and a dental professional. Your surgeons will work closely with geneticists, audiologists and orthodontists.

As parents, it’s important that you treat your child as you would any other: Talk to your baby and expose him or her to good language.

Will a cleft lip/cleft palate affect our baby’s ability to eat?

It depends – some babies have few or no problems feeding, while others may have more difficulty. Babies with cleft palates may need a modified feeding technique, such as a different type of bottle or nipple or different positioning. Breastfeeding a baby with a cleft palate can also be much more challenging as babies have a hard time creating enough suction to effectively breastfeed.

Will our child have added difficulty learning to speak?

If the cleft affects only the lip, it’s unlikely your baby will experience any speech problems. However, many children with a cleft palate may the need the help of a speech pathologist or additional surgeries. Our goal is to help your baby develop normal speech as soon as possible.

Copyright © SIU School of Medicine, Springfield, Illinois

Written by Rebecca Budde, SIU School of Medicine

Ever try to convince a child that if she eats her carrots or spinach she’ll never have to wear glasses? Truth be told, these veggies are high in Vitamin A, which is essential for healthy vision, but only a small amount is necessary for good vision.

Here are some other myths about vision:

Copyright © SIU School of Medicine, Springfield, Illinois

Written by Rebecca Budde, SIU School of Medicine

It’s Illinois State Fair time again! What’s your favorite fair food?

Consider a meal of a few of the most popular choices on the fair’s menu: a jumbo corn dog, funnel cake and a chocolate shake. At more than 1100 calories and more than 30 grams of fat, it might be a better option to walk around fairgrounds rather than take the skyride.

SIU registered dietitian, Sara Lopinski has some tips for curbing come of the extra sugar, fat and calories that come with these favorites.

• Eat a healthy, high-fiber snack before you go to take the edge off your appetite
• Choose one high calorie food and balance it with healthier options
• Share with fellow fair-goers so that you don’t feel you have to eat the entire portion
• Do some sight-seeing after eating to work off the extra calories and get some exercise

If you’re trying your best to eat healthily at the fair, Lopinski suggests looking for these options:

• Grilled chicken sandwich
• Corn on the cob
• Portabella mushroom sandwich with veggies
• Shrimp on a stick
• Fruit smoothies

Copyright © SIU School of Medicine, Springfield, Illinois

Written by Laura Bottom, SIU Center for Family Medicine

Breastfeeding has many benefits for mom and baby, but it’s also a commitment to maintain a substantial milk supply. One way to continue a positive milk supply is by pumping.

Pumping can help decrease the chance of engorgement or decreased milk supply, especially for mothers who may be away from their babies for more than a few hours a day. Breast engorgement happens when more milk is being supplied than used, and feeding or pumping usually relieves engorgement. Pumping is also important because a mother’s milk supply will also dwindle as feedings or pumping sessions decrease.

If you’re pumping or considering pumping, here are some tips for success:

1. If you return to work, tell your employer of your need to pump. Federal laws require workplaces to give breastfeeding mothers a reasonable break time and provide a private place other than a bathroom to pump for one year. Being on the same page as your employer from the start will make the transition smoother.
2. Relax. Stress can hinder your body’s natural ability to release breast milk. It may be helpful to look at a picture and think about your baby or listen to relaxing music. Choose a time of day that’s not as hectic.
3. Invest in a good pump and pump often. The more you pump, the more milk you produce. If you can, pump both breasts simultaneously. A double breast pump helps stimulate milk production while reducing pumping time by half. SIU Center for Family Medicine physician Dr. Careyana Brenham encourages woman to check with their health insurance providers since many cover certain types of breast pumps.
4. Avoid or limit formula feedings. Formula feedings will reduce your baby’s demand for breast milk, which will lower your milk production.
5. Drink plenty of fluids. Water, juice and milk can help keep you hydrated. Make sure to limit soda and other caffeinated drinks as it could lead to irritability or interfere with your baby’s sleep.
6. Take good care of yourself. Make sure to continue eating a healthy diet, which includes fruits, vegetables and whole grains. Continue to exercise and sleep when you’re able. Don’t be afraid to ask for help when you need it.
7. Don’t smoke. Smoking can reduce your milk supply, change the taste of your milk and interfere with your baby’s sleep. Smoke and secondhand smoke also increases the risk of sudden infant death syndrome (SIDS) and other respiratory illnesses.

Not sure if breastfeeding is right for you? Talk to your doctor or lactation consultant. If you’re having trouble with breastfeeding or pumping, these professionals can also help.

Copyright © SIU School of Medicine, Springfield, Illinois

Written by Rebecca Budde, SIU School of Medicine 

Psoriasis is a common skin disorder that affects about seven million people in the United States, according to the National Institutes of Health. The itchy, red scales caused by this genetic condition can be a source of mental and physical discomfort for those who suffer from it.

“The most common symptom of psoriasis is itching,” says SIU dermatologist Dr. Stephen Stone.  “In some patients, they sting and burn, but the main feature of the disease is this visible rash on the skin.”

Some important facts:

• Psoriasis is not an infection
• Psoriasis is not contagious
• Environmental factors such as stress, trauma and sunburn can cause psoriasis flare-ups

The condition has no cure but fortunately, dermatologists can prescribe treatments to help. Those with moderate to severe psoriasis may also benefit from ultraviolet light treatments or injectable medications known as biologics. Thanks in part to a clinical trial that took place at SIU School of Medicine and other sites, a new oral medication, Otezla® (Apremilast), is also available for certain individuals who are diagnosed with moderate to severe psoriasis.

If you think you have psoriasis or another skin condition, contact your primary care provider or dermatologist. If you are in need a dermatologist, contact SIU’s Division of Dermatology at 217-545-8000.

Copyright SIU School of Medicine, Springfield, Illinois

Written by Karen Carlson

To better address all aspects of patients’ health, SIU School of Medicine is thinking differently.

“Think beyond the individual patient office visit,” said Dr. Janet Albers, and SIU Family Medicine Physician. “Health workers must take a population health approach to caring for patients. That means understanding how patients’ lifestyles and home environments can affect their health.” For example, families living in areas with high crime rates may not feel safe to exercise outdoors, leading to obesity, diabetes and other conditions. Tenants living in a dilapidated housing complex may suffer from severe asthma.

A five-year, $2 million grant from the U.S. Department of Health and Human Services Administration will support training to help health workers think differently by addressing these types of population health issues. The program, called “Population Health and Systems Thinking,” will include a variety of SIU School of Medicine learners: physician assistant students, medical students and physicians in the family and community medicine residency program.

The population-health methods will include training in preventive screening measures, critical thinking and team skills that will help learners better care for the communities they serve. “For many years, doctors weren’t aware of what resources were available to help patients with issues such as housing, legal or crime problems,” Dr. Albers said. “Now with a larger, inter-professional team within the medical home, we are more likely to screen for and recognize such issues and then connect patients with appropriate resources.” This training may eventually include community partnerships with local law enforcement, public health and ambulance companies.

This project builds on initiatives undertaken in recent months by SIU Department of Family & Community Medicine, including the “hotspotting” model that addresses high-risk patients and the community health worker program that cares for residents of the Enos Park neighborhood. It targets the 16 county Delta region, which includes Illinois’ southernmost counties. In the Delta region, 15 of 16 counties rank in the lower 50th percentile of Illinois counties for health outcomes.

“This is our dream, and patients will ultimately benefit with a better health care team,” Dr. Albers said.

Written by Gayle Jennings, MS, RD, LDN, CDE

Have you heard the buzz about the DASH diet? No, it’s not a diet coined by the Kardashian clan. However, U.S. News & World Report routinely names it one of the best diets overall, including diabetic and heart healthy diets.

DASH stands for Dietary Approaches to Stop Hypertension.

What’s the big deal about hypertension?

More than 70 million American adults have hypertension (high blood pressure), and more than half of adults over age 60 have hypertension. It is estimated that 90% of Americans over age 55 will develop hypertension. That means all these folks are at an increased risk for heart disease, kidney disease, stroke, dementia and blindness, according to the National Center for Health Statistics. High blood pressure costs the U.S. $46 billion each year.

So, how can the DASH diet help?

DASH is a simple, straightforward approach to eating foods that are full of vitamins, minerals, antioxidants and low in sodium, fat and simple sugars. This diet doesn’t require special foods or complicated recipes.  By consuming foods that are high in calcium, potassium and magnesium, you can lower blood pressure. These minerals counteract the action of sodium in the blood, which is responsible for high blood pressure.

What types of foods does DASH promote?

Fruits and vegetables in a quantity that most individuals would find overwhelming at first are at the heart of DASH. A total of 8-10 combined servings of fruits and vegetables total each day is the overall goal for someone who consumes about 2000 calories. To meet this goal, eat a variety of fruits and vegetables for every meal and snack. Fruit can be fresh, canned in its own juice, or light syrup, frozen, 100% fruit juice or dried. Vegetables can be fresh, frozen, “no salt added” canned, or vegetable juice. The options are tremendous.

These fruits and vegetables are nutrient rich foods, leaving little room for empty calories, high sugar or fatty foods that we should avoid.

Besides the addition of a variety of fruits and vegetables, here are some other tips for incorporating the DASH eating plan into your diet:

1.)    Choose low-fat or fat-free dairy foods, such as skim or 1% milk and yogurt.

2.)    Go for reduced-fat or low-fat condiments and dressings and low fat, trans-fat free soft tub margarine.

3.)    Choose smaller portions of cooked fresh meats, poultry without skin, and fish. Avoid canned, cured, smoked or processed meats, which are high in sodium. A suggested portion size is 3 ounces cooked, or about the size of a deck of cards.

4.)    For dessert, choose fresh, frozen, dried or canned fruits with low-fat frozen yogurt, ice cream or sorbet.

5.)    Instead of salt and seasoning salts, use herbs and spices. Limit salty condiments such as ketchup, mustard, pickles and barbeque sauce.

It is exciting to think that what you eat can make such a big difference on not only blood pressure, but also weight, blood sugar and heart health. Learn more about the DASH diet here.

Gayle Jennings is a certified diabetes educator and registered dietitian with SIU Center for Family and Community Medicine.
Copyright © SIU School of Medicine, Springfield, Illinois

Written by Laura Bottom, SIU Center for Family Medicine

Expectant mothers often spend months stocking up on diapers and wipes, preparing the nursery to be just right and reading up on what’s best for their baby. The experts overwhelmingly agree that when it comes to feeding, the breast is best.

Breastfeeding benefits extend well beyond basic nutrition for both mother and baby. Breast milk not only contains all of the vitamins and nutrients baby needs, but it’s also packed with disease-fighting substances that offer protection from illness. Breast milk contains nutrients that cannot be reproduced in formula.

In the first few days before the milk comes in, a thicker substance called colostrum will give the newborn important nutrition. As the baby develops, the breast milk changes to meet the demands of the growing baby. The American Academy of Pediatrics recommends breastfeeding exclusively for the first 6 months, and experts strongly suggest continuing for at least the first year.

While some mothers may find difficulties getting the baby to latch properly, lactation consultants can help make breastfeeding easier. They can teach proper positioning and techniques that make breastfeeding an enjoyable experience for mother and baby. Nursing builds trust and security between mother and child.

Benefits for the

baby:

• Lower risk of SIDS (Sudden Infant Death Syndrome)
• Reduced chances of diarrhea, ear infections, breathing infections, etc.
• Protection against asthma and juvenile diabetes
• Lower risk for obesity and high blood pressure when they are older
• Fewer cavities in adolescence and adulthood
• Higher IQ

Benef

Quicker post-partum recoveryits for mom:

• Quicker return pre-pregnancy weight
• Lower risk of anemia after childbirth
• Cost savings by not buying formula
• Less likely to miss work to care for sick children
• Less likely to develop ovarian cancer, some breast cancers and osteoporosis later in life

Don’t forget that fathers like to be a part of the special bond. Dads can stay involved by

• offering to bathe, change or read to etc. the baby between feedings.
• providing mom with a high protein snack and water while she nurses. Nursing moms need more calories and water to keep up their milk supply.
• helping make the nursing space comfortable for mom and baby. Ask if she needs a blanket, fan or pillow or wants the lights dimmed or music on.
• offering to feed the baby breast milk in a bottle on occasion after breastfeeding has been established.

Copyright © SIU School of Medicine, Springfield, Illinois