Mental Distress among Mothers of Infants with Orofacial Clefts
Abstract
Background: Orofacial clefts (OFCs) impose severe biomedical and psychosocial burdens on families. In Nigeria, cultural stigma and limited infrastructure compound this strain. This study evaluated the prevalence of mental distress, mother-infant bonding, and maternal attitudes among mothers of children with OFCs.
Methods: This cross-sectional study evaluated 41 mothers of children with OFCs at the University of Benin Teaching Hospital, Nigeria. Validated instruments included the General Health Questionnaire-12 (GHQ-12; distress threshold ≥ 3), Mother-to-Infant Bonding Scale (MIBS), and Maternal Attitude Scale (MAS). Data were analysed using Chi-square, Kruskal-Wallis, and Spearman correlation tests.
Results: The children's median age was 12.0 months (IQR: 7.0–26.0). Isolated cleft lip was the most common phenotype (80.5%). The prevalence of significant maternal mental distress was 85.4% (n=35). Item-level analysis revealed profound functional impairments in decision-making (92.7%) and mood (58.5%), though self-worth and confidence remained relatively intact, indicating functional but distressed coping. While bonding was overwhelmingly healthy (100% reported loving feelings), 29.3% experienced resentment, and 75.6% wished the child were different.
No statistically significant variations in distress or bonding scores were found across socio-demographic factors or cleft phenotypes (p>0.05). Spearman correlations showed that higher maternal distress was significantly and paradoxically associated with poorer mother-infant bonding (rs= -0.346, p = 0.027) and more positive maternal attitudes (rs = 0.481, p = 0.001), suggesting cultural protective buffering or social desirability bias.
Conclusion: Mothers of children with OFCs in Nigeria experience exceptionally high rates of mental distress that directly threaten early bonding, regardless of the cleft's physical visibility or severity. Comprehensive cleft management must pivot from a purely surgical focus to family-centred care, incorporating mandatory psychosocial screening and culturally tailored support frameworks to safeguard caregiver resilience and infant development.
