The world is filled with small people. Not small in stature or
importance, they are small in spirit, temper, mind and manner. You
know them as being oafish to such an extent that they do not shy away
from staring at your little angel when you wheel her around in her
chair; they are the ones not shy to ask detailed medical questions in
the checkout line at the grocery store; and they are the ones who will
loudly tell their healthy offspring that they need to be especially
kind to poor little children like yours. In extreme cases they might
go so far as to question who is to blame for the child’s birth defect
and will recommend a good lawyer.

In short, there is not scarcity of people who will try your patience
and as your child grows older and begins to understand more about her
or his birth defect and the effects it has, your child will also need
to learn to deal with such people. When a child with a birth defect
needs to be the bigger person, it is helpful to equip her or him with
a healthy sense of humor and a positive outlook on life. You may do so
early on, considering that the first people your little one will deal
with are other children.

To this end, it is wise to being teaching tolerance, acceptance of
diversity, and also forgiveness even when no pardon was asked. While
your child’s life does not depend on it, any future success in both
education and professional life, as well as a good emotional wellbeing
most certainly do.

Alert your child to the fact that just like she or he is different
from other kids, all kids are different from one another in a myriad
of ways. By coming to terms with being different and embracing this
with a sense of uniqueness, your child will operate from a position of
strength, not defensiveness.
Teach your child that she or he is not a victim. A victim mentality
is the worst possible outcome a child with a birth defect faces, and
the sooner the child understands that with effort, skill, and the use
of adaptive technologies and aides she or he will be able to perform
to the fullest potential possible, the easier small people are to spot
and deal with.
In the same vein, make sure the child understands acceptable behavior
from unacceptable behavior and knows that being the bigger person does
not mean enabling someone else to be smaller. Instead, it means
accepting the small minded individual for who they are while dealing
with the inappropriate behavior.
While it is tempting for a child with a birth defect to be open about
the condition and explain it to anyone who asks, it is important to
lay a foundation of boundaries, so the child knows that while she or
he is welcome to talk about the condition, there is no obligation to
answer a question posed unless it is within the context of a medical
evaluation. Absent this setting, curiosity may be indulged or
rebuffed, at your child’s discretion. While it may sound petty, this
little tidbit of information puts your child in a very powerful
position from which it is easier to be big.

Every pregnant woman has a heightened sense of awareness with respect
to the substances she permits to enter her body. Suddenly prescription
drugs are scrutinized, certain foods are off limits, and off course
the consumption of over the counter medications is heavily curtailed.
Yet there are times when warnings seem to come out of left field and
may actually showcase that something which was being done to benefit
the growing fetus turns out to have potentially harmful and far
reaching consequences that were not anticipated by the mother to be or
her physician.

Such an event occurred more than 10 years ago when women who sought to
give their unborn children a good start in life by supplementing
vitamin intake with over the counter prenatal formulas and also
vitamin rich foods were warned about the potential for risking birth
defects. Vitamin A was indicted as being linked to birth defects and
the resulting frustration and in some cases downright panic called for
a quick clarification of the statements made by officials and the
media alike. Since then, the events that happened that long ago are
largely forgotten, but the reality of an over-supplementation of
Vitamin A still exists.

To ensure that you and your unborn child’s health are guarded, here
are the facts about Vitamin A and its relationship to birth defects
you must have:
Birth defects caused by an overdose of vitamin A are described as
primarily affecting the head and brain, such as mental retardation,
microcephaly and hydrocephaly, and the external appearance of the
child facial features, such as deformities of the ears, eyes, and
palate. Other birth defects linked to vitamin A over-supplementation
are heart problems and to a lesser extent spinal cord malformations.
Not all vitamin A is dangerous, but only the kind that is termed as
being “pre-formed” or synthetic. This kind of vitamin A may actually
be added to certain foods as enrichment and is almost always notated
on the list of ingredients as retinyl acetate or retinyl palmitate. It
is also naturally found in organ meat, with the highest concentration
being located in the animal’s liver.
The safe kind of vitamin A is called beta-carotene and is primarily
found in vegetables and fruits. While a high intake of even
beta-carotene is not suggested, there are no known dangers associated
with overdosing on beta-carotene.
In spite of the findings that indicate dangers of vitamin A
over-supplementation, the Federal Government has pointed out the
body’s vital need for both kinds of the vitamin to further many bodily
functions, including the overall health of the reproductive system.
It is strongly suggested that pregnant women severely limit, or
completely pause, their intake of animal organ meats. Furthermore,
when taking prenatal vitamins, look for those that do not contain and
overage of the synthetic vitamin A.  By and large, a pregnant woman in
good health should not consume more than 8,000 IUs. If at all
possible, look for supplements that offer vitamin A in the form of
beta carotene.

A nuchal scan is one of the least invasive procedures done during a
pregnancy that may have the potential of pointing out a possible birth
defect. It is part of the routine ultrasound exams that are done over
the course of almost every pregnancy to ensure that things are
progressing well. Ultrasound technology has been deemed safe for the
fetus and for the expectant mother, and since they are quick and easy
to do, physicians have the freedom to do as many as necessary to
monitor the progress of a pregnancy and also to set anxious parents at
ease. Generally speaking, a healthy, young mom-to-be can expect to
have two ultrasounds taken over the course of the pregnancy: one at
about 12 weeks to check fetal development and also to check for the
nuchal translucency and another toward the end of the pregnancy or
seven to eight months, to permit physicians to once again ensure that
all is developing well, ascertain the birth weight of the child, and
also to get a glimpse as the position the child is holding. Women who
have suffered a miscarriage, are older than 35, or possibly may not be
aware as to the date of conception can expect to undergo more frequent
ultrasound examinations.

The nuchal scan is considered a routine exam and will be performed
right around the 12th week of pregnancy. It is the first indicator of
Down syndrome in an otherwise healthy fetus. Checked is the area
referred to in clinical terms as nuchal translucency, which is located
by the neck of the developing baby. Amounts of fluid checked in that
vicinity may indicate a higher risk for birth defects which fluid
levels falling into normal ranges do not necessarily rule out the
possibility, but instead lower the potential for Down’s. It is
important to recognize that an increase of fluid levels detected when
using a nuchal scan to show potential for birth defects is not a
conclusive marker of the actual presence, and any discussions with
respect to pregnancy termination or preparations for bringing a
disabled child into the world should be reserved until further testing
is done.

The follow up tests that can give better insight into the likelihood
of the actual presence of a birth defects are an amniocentesis and
also chorionic villus sampling; yet because these two tests carry with
them the risks of harming the fetus or actually inducing a
miscarriage, expectant mothers are usually reluctant to undergo the
procedures unless medically deemed necessary. It is important to
understand that the nuchal scan is only effective between the 11th and
13th week of pregnancy, thus a proper age determination of the fetus
at the onset of pregnancy or as soon as possible thereafter is vital.
The nuchal translucency will generally cease to be a useful measuring
tool after the 14th week of gestation since the fetus will have
developed to such an extent that any excess fluid is being drained
away, causing the nuchal scan to come back negative even in cases of
confirmed Down syndrome.

Birth defects affecting the heart muscle are a challenge to expectant
parents, since the severity, the manifestation, and also prognosis
usually is not known until the child is born. Similarly, some heart
related birth defects are hereditary while others are linked to other
birth defects and may actually only be secondary in nature to the
first, and more serious, birth defects. In the majority of the cases,
however, it appears that heart defects are directly due to a
preventable event, such as the use of Accutane or alcohol consumption
of the mother.

To further understand the possible birth defects affecting the heart
muscle, here is a brief synopsis of the most commonly presented ones:
Some infants will present with heart muscles that have insufficiently
operating heart valves. In some cases these valves do not close as
indicated while in other cases they are blocked or so narrowed that a
steady blood flow is not possible to maintain. The good news is that
this kind of heart related birth defect is easily fixed by an
experienced surgeon and the prognosis for these infants is very good.

A group of malformations of the left ventricle is known as
hypoplastic left heart syndrome and is a dangerous condition. In some
cases the child may die, simply because the heart’s left ventricle is
too undersized to undertake the rigorous task of unceasing blood
pumping. There are surgical techniques that have been successfully
used to correct this situation and in severe cases a heart transplant
may be indicated.
Known as septal defect, this benign birth defect is characterized by
the presence of one or more holes in the wall that subdivides the left
and right sides of the heart. In the most benign cases, this birth
defect will self correct while in the more severe cases, or cases
where the heart is working too intensely to await a self correction, a
surgeon will be able to simply apply an artificial wall.
A birth defect which always requires surgery is the tetralogy of
Fallot which is a group of heart related birth defects that always
present together and will prevent proper oxygenation of the blood as
well as that blood’s traveling to the organs. While it is possible for
a child to survive this birth defect for a short period of time,
surgery is required to ensure long term survival.

Your doctor will carefully monitor your fetus’ heartbeat and ascertain
whether it is beating normally for its gestational age, or whether it
is beating irregularly. In many cases the fetus can be treated via the
mother with medication which will protect the heart and permit the
child to grow to term so that she or he may undergo surgery – in some
cases almost immediately following birth.

While in the past the presence of birth defects affecting the heart
muscle were almost always death sentences, the advances of medical
science has changed this and the survival rate as well as the long
term outlook for children suffering from such abnormalities are better
than ever!