Mr. Lucky: What’s the name of the two lines between your nose and upper lip?
The Internet is great. You go online trying to find out the name of the two lines under your nose and a half hour later you’re looking at a picture that will likely require years of therapy to help you come to terms with.
“Cyclops Kitty” with holoprosencephaly.
(AP Photo/Traci Allen)
The two lines under your nose are part of the philtrum. Inexplicably, the name comes from the Greek word “phil,” or love.
In embryonic development, if all goes well two folds of flesh grow around and meet in the front of the embryo’s head, forming the face. The philtrum is the last little bit of the “seam” where the halves of the face fused together.
According to The March of Dimes, cleft lip and cleft palate are relatively common – about 1 in 1000 babies are affected. Nowadays a cleft lip or cleft palate is usually surgically corrected with excellent results.
Holoprosencephaly is another birth defect – the philtrum is often missing altogether, and that’s just the beginning of the problem. Though they look like an extreme case of cleft palate, the facial anomalies in holoprosencephaly are the result of an underlying brain malformation. According to the National Institutes of Health (NIH), holoprosencephaly results when the budding brain fails to grow properly, 
to differentiate into right and left frontal lobes. Facial anomalies usually go along with it, since the face forms as part of the same process that causes the frontal lobes of the brain to form. Serious cases of holoprosencephaly cause significant defects including missing facial features, or facial features that fail to move around to their usual position on the head, and mental retardation. In the worst cases, the baby usually doesn’t make it to a year old. Mercifully, the kitten in the picture only lasted a day despite his owner’s best efforts to feed him and keep him warm. His littermates were all normal.
Interesting tidbit: pregnant women who experience morning sickness are less likely to miscarry and less likely to have babies with birth defects. It seems that the mother’s body can detect toxins in amounts that wouldn’t have any effect on a adult, but that interfere with embryonic organ development. Her body can also detect proteins released into the amniotic fluid in some birth defects such as anencephaly or spinal bifida and have a miscarriage.
There are so many things that can go wrong. The absolute worst of them are rejected by the mother’s body before she is even aware that she is pregnant. I believe the number is only 1 in 10 pregnancies “take.”
Many medications, including psych meds, are teratogenic, that is, they cause defects. Lithium causes a very specific heart defect. Valproate causes neural tube defects. The damage to the embryo can occur before the mother even knows she’s pregnant. This makes a very strong case for being on the minimum amount of meds necessary to control the illness, or perhaps to take a med holiday before becoming pregnant.
I leave it to the reader to google “holoprosencephaly.”
Photo credit – Source: Flickr, Author: cloud_nine
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