Cleft palate ranks fourth among all facial birth defects. According to the Center for Disease Control, cleft palate occurs one of 700 infants in the United States and is more frequent in Asian, Indian and Hispanic populations.
What is Cleft Palate?
When the lip and or palate do not fuse during neonatal development, an infant is born with a gaping hole from the upper lip to the nose. Due to advancement in the treatment of cleft palate, reconstructive surgery is now performed prior to the end of the first year of life.
While cleft palate is common and treatable, the appearance of a child with a cleft palate is shocking. Even in modern societies, parents who are not prepared have difficulty relating normally to the child. In less educated cultures, cleft palate can result in ostracism from society, abandonment or death.
Social Stigma of Children with Cleft Palate - Historical and Present Day
As recently as the 19th century, Charles Darwin, who wrote The Descent of Man (London, John Murray, 1871), describes children with cleft palate, as “idiots,” with tendencies of lower species such as sheep. In the United States, during the same time period, some believed that cleft palate was caused by witchcraft. When a pregnant woman encountered the devil in the shape of a rabbit, her child was born with a cleft, hence the term, “hare lip.”
Unfortunately, the societies in which cleft palate is most common often have social stigmas associated with the defect. According to Smile Train, in many parts of the world, it is considered that a child with a cleft lip or palate is a monster born in human form. Operation Smile explains, “...the poorer the country, the greater the superstition surrounding children with cleft palate, which is considered like voodoo.”
Social Stigma of Cleft Palate - Cultural Beliefs and Folklore
Some Latino cultures, and interestingly, northern areas of India as well, believe that cleft palate occurs when an expectant mother cuts with a knife during an eclipse. Some Latino cultures believe that a child born with a cleft is a punishment for a sin committed by the parents. Because of this, the child may be hidden for years and not sent to school, living as a permanent social outcast. Just as Darwin describes, in some remote areas children with cleft palate are put out to live among goats and other farm animals.
Cheb and Ajok - Names for Children with Cleft Palate
Smile Train reports that, in Cambodia, they call a child with a cleft a “Cheb.” They explain that "cheb" is a word that can mean “freak,” “loser,” “ugly,” “mistake,” or other bad things. In another country, these children are called “Ajok,” which means "cursed." The term “hare lip,” which is considered derogatory, is still commonly used in the United States to describe a child with cleft palate.
Emotional Stigma of Cleft Palate: Parental Bonding Issues
It is hard to look at a child with cleft palate. The face is unsightly and food and liquids pass through the mouth and nose. Feelings of love mix with disgust as parents struggle to suppress natural abhorrence and respond with affection for their child. This causes tremendous conflict and guilt in the parents.
A study of cleft palate and its impact on parental bonding (Perry, BD et. al., “Neuropsychologic Impact of Facial Deformities in Children,” Clinics in Plastic Surgery, 25, 1998) showed that the importance of facial features dates back to early tribal existence, when strange faces meant an enemy threat. As the brain developed over centuries, it categorizes faces as “safe,” or “threatening.” According to the study, a facial anomaly triggers a “low level alarm” in the subconscious mind.
To add to parents’ conscious feelings of aversion – without being aware of it – they may react to the child with a primitive fear signal. According to the study, mothers may have an abnormal gaze pattern and avoid eye contact with the infant, resulting in difficulty for the child to bond with parents and form normal human attachments.
Social Stigma of Cleft Palate - Cleft Palate is More than a Health Issue
Children with cleft palate begin their lives not only with serious health issues, but also with a huge disadvantage. It is called ugliness. It can result in failure of parental bonding, ostracism, denial of education, or even death.
Emotional Stigma of Cleft Palate - A Lifelong Struggle for Children
In well-educated and affluent countries, raising and treating children with cleft palate is a challenge. In isolated or underdeveloped countries, such children fight a tragic and uphill battle to thrive and even to live.
