By Nicole Lapin
CNN.com Live anchor

I’m nervous. Adnan’s parents clearly are, too. “Habibi, habibi,” his mother laughs trying to hide her nerves and keep her son entertained for what’s going to be a long night.

Adnan on the surgical table in Alexandria.

Usually the state-run hospital in Alexandria, Egypt, is closed on Friday night. But, tonight is an exception. Select staff members show up to admit kids like Adnan Saleh who will get cleft lip and/or palate surgery in the morning.

“No eating, no drinking starting now,” a nurse says in Arabic as she shuffles six moms and their kids into rooms with as many beds. The mothers sleep in a twin bed with their child, some in full veil and hijab. They’re in cramped, undesirable conditions, but they never complain.

“I would do anything for my son,” Adnan’s father, Mohammed, tells me as he is separated from his wife for the night. I know it’s going to be a sleepless night for everyone involved.

I was right- Saleh is back at the hospital at 7 a.m. the next morning with bloodshot eyes that match those of his wife and baby son. They are in the second group of surgeries the Operation Smile volunteers will perform that morning.

“You will be in the operating room? Right?” Saleh asks me. I nod, unsure how saying yes will put his mind at ease, just that it will.

I put on scrubs for the first time since I was 3 years old and my surgeon father took me into O.R. with him. I only look like a doctor, but there is a team of skilled specialists attending to Adnan. Because a cleft lip and/or palate can cause other health problems ranging from ear disease to dental problems, the team includes a pediatrician, a plastic surgeon, a dentist, an otolaryngologist, a speech-language pathologist and audiologist, and a geneticist.

The O.R. is busy but runs smoothly – seven operating tables side-by-side with a different child on each small gurney, surrounded by machines bigger than them. Saleh paces in the waiting room as the nurses clean up from the first round.

“Saleh, Adnan,” the lead nurse calls out. Before I know it, Adnan’s cubby legs are being tapped over and over again by anesthesiologists trying to find a vein. I can hear his mother yelling through the glass, “habibi, habibi,” which means “my love” in Arabic. A day later it has a different tenor.

Visit CNNhealth.com in the coming days to learn how Adnan's surgery turned out.

Editor’s Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.

By Nicole Lapin

CNN.com Live anchor

In the middle of a crowded hospital hallway in Alexandria, Egypt, Adnan's  blue eyes pop.  He is sitting on the lap of his father, Mohammed Saleh.  Saleh looks at me and then at his pregnant wife next to him.  "I hope the new one doesn't have this condition," he says in his broken English.

 "This condition" refers to his son's cleft lip.   The Salehs are one of the more than 200 families who showed up at Shark Al Madina Hospital to try to receive free treatment for their child's cleft lip and/or palate.  It is Operation Smile's first mission in this city and the turnout is higher than expected.  

“I don’t know why he has it,” Saleh mutters as he kisses his 7-month-old son’s forehead.  I wish I had an answer for him.  I try telling him in my broken Arabic that the organization says it’s a combination of genetic, environmental and nutritional factors.  It means little to a father just trying to fix whatever caused his son’s deformity.

The global rate of cleft lip and/or palate is about 1 in every 750 births.  Unlike in the United States, the corrective surgery is costly and hard to come by in countries like Egypt.  I am here with an Operation Smile volunteer group- a mix of accomplished plastic surgeons, nurses and pediatricians from all over the world- aiming to change that for kids like Adnan. 

Running on adrenaline and Turkish coffee, the volunteers transformed one corner of the hospital into an eight-step screening process on the first day of the mission.  Benches turned into registration centers.  Markers and recycled paper became locator signs: “Vitals,” “Dental,” “Anesthesiologist.”  A bed sheet, beach ball and coloring book looked like an indoor playground in no time.

Women dressed in full hijab wait hours for their children to have a chance at getting the surgery.  An older woman walks up to me so fast she nearly stumbles over her long skirt.  “My grandson, my grandson, look, look,” she yells, holding the advertisement that appeared in a local paper in one hand and a wallet full of his pictures in the other.

The team will do approximately 175 surgeries during this mission.  Not everyone from two days of screening receives an operation.  The organization prioritizes the kids getting screened based on their chances for a successful recovery. 

The Salehs are Number 27 in this process.  I start following them when they got their number at 7 a.m.  They finish around noon and before they leave I ask Adnan’s father what he wants his son to be when he grows up.   Saleh answers quickly, “Whatever will make him happy.”  I say, “So, a doctor, lawyer, policeman…?”  He nods, “I just want my son to have the chance.”

A child whose cleft lip goes untreated will carry a social stigma in much of the world.  Some cultures believe it is “a curse” or “God’s will.”  A child  whose cleft palate, an actual split on the roof of his or her mouth, goes untreated can have difficulty eating and speaking.  In some pockets of the globe where malnutrition is prevalent, some of those youngsters won’t survive.   

I hear the last prayer call of the day echo outside the seaside hospital – that means it is 8 in the evening.  I just found out that Adnan has been accepted to surgery.  It’s scheduled for Saturday morning.  I can’t wait to see what he looks like when he smiles with more than just his eyes. 

 Editor’s Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.

As a new feature of CNNhealth.com, our team of expert doctors will answer readers’ questions. Here’s a question for Dr. Gupta.

Asked by Molly, Washington

"I am 35 years old and have spent much of my adult life focusing on my career, which I love! But it recently dawned on me that I may have missed my window of opportunity to have a baby naturally. Is that true? How concerned should I be?"

Answer:

Thanks Molly for the question. There are many women in the same position you are. They want to have a family, just not quite yet. And that’s not a bad thing! It's great to hear that you have a career you love and are so passionate about.

Let me first say, that no–you haven't missed your "window of opportunity" to have a baby. Many women in their late 30s, and early 40s get pregnant naturally. It may just take a little longer to conceive compared with women in their 20s. According to the March of Dimes, one in five women have children after age 35.

Of course, waiting doesn't come without risk. As you age the quality of your eggs and your ovaries’ ability to release them declines. As a result, the miscarriage rate for women age 35 to 39 increases to 20 percent. After age 40, it rises to 50 percent. Women over 35 are also at increased risk of developing gestational diabetes, and having a baby with a genetic disorder, such as Down syndrome.

You should begin evaluating your health patterns now, even years before conceiving, and make any necessary lifestyle changes. The basic rules apply: Don't smoke, limit stress, and stay physically active. But it’s also a good idea to meet with your OB-GYN and get a full preconception checkup. He or she will be able to offer tips specific to your body to help you down the road. Also, you may consider taking a daily prenatal vitamin. Even if you don't get pregnant for years, it provides great nutrients including calcium, iron, protein and folic acid. These nutrients are not only good for your body, but help prepare and strengthen the womb for conception. Be sure to choose a prenatal vitamin with at least 1 milligram of folic acid. It is an essential nutrient in the neurological development of a baby.

Molly, best wishes for a healthy life and pregnancy in the years to come.

By Jen Pifer
CNN Medical Senior Producer

After a particularly grueling editorial meeting a few years ago, one of my colleagues turned to me and said, "I need a drink." Now that's not an uncommon sentiment in many newsrooms, but in this case, it was kind of funny. My colleague was hugely pregnant and she meant it. We laughed, but I got the sense she felt a little bit guilty saying that. After all, who wants to be known as the pregnant woman who drinks?

Truth be told, I understood where she was coming from. Sometimes, a girl just needs a cocktail.

The issue of drinking while expecting comes up often with my other pregnant friends. One told me she asked her obstetrician about it. She says the doctor told her a drink now and then wouldn't hurt the baby. But he was quick to add that he was not recommending it. Another friend of mine was out to dinner when she was six months pregnant and ordered a small margarita. The waiter served her, but not before looking at her big old tummy.

There's a new study out today that is likely to get people talking. British researchers found that children whose mothers who drank up to one to two drinks per week or per occasion (for example at a party or on Christmas Eve) while pregnant are not at an increased risk of behavioral problems or cognitive deficits. It is important to point out that the study did not look at the physical problems associated with drinking while pregnant.”

The researchers are very quick to point out they are not out to set new guidelines; they just want to add to the debate. This has been a huge issue in England. Last year, the Royal College of Obstetrics said drinking one or two drinks once or twice a week is unlikely to harm your baby. (See Study) British public health officials say expectant mothers shouldn't drink, but if they do, it should be with great moderation. (See Study) In the United States, it's all about abstinence. The American College of Obstetricians and Gynecologists says drinking at any stage of pregnancy is a terrible idea. (Read More)

Now that the experts have weighed in, I am curious to know what you think. Is it ok to drink a little bit of alcohol while pregnant? Would you do it? Have you done it?

Editor’s Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.

By Miriam Falco
CNN Medical Managing Editor

Every year, we report on who should get a flu shot: the elderly; those over 50; children age 6 months to 5 years old; pregnant women; people with chronic disease.

But apparently the message isn’t getting through about pregnant women.

Both the Centers for Disease Control and Prevention and the American College of Obstetricians and Gynecologists recommend that women who will be pregnant during the flu season, which runs from October to May, get a flu shot.

However, a new poll commissioned by the non-profit National Women's Health Resource Center found that only 25 percent were aware of these recommendations and only 20 percent agreed that getting a flu shot while pregnant is important.

The latest data from the a CDC health survey show that less than 14 percent of pregnant women between ages 18 and 44 actually got a flu shot during the 2006/2007 flu season.

Flu kills an average of 36,000 people and leads to hundreds of thousands of hospitalizations each year, according to the CDC.

An informal (and very unscientific) survey of my own found that some women weren’t aware that young women who happened to be pregnant fall in the high-risk category. Others who already had children didn’t think it was safe to get a flu shot during pregnancy.

So how bad can it be if you get the flu during or right after pregnancy? Very bad, according to mother of four Lisa Madden. Three months after giving birth to triplets, “"for the first time in my life I got the flu,” she said. “I was the sickest I ever was in my life."

She was laid up in bed for 10 days, her mother and mother-in-law had to come in to help care for the babies, and even her husband had to take off work because she was so sick.

“That was the year I learned my lesson” (about not getting a flu shot), she said. She now preaches the vaccination’s importance.

Dr. Carolyn Bridges, the CDC’s flu expert, said that complications of the flu in pregnant women can be the same as in other people - pneumonia, dehydration, hospitalization. But the flu can also lead to pre-term labor, fetal demise and worsening respiratory function.

There may be other reasons that pregnant women don’t get a flu shot. Only 51 percent of women who participated in this new poll thought it was safe to get a flu shot during pregnancy. Dr. Jeanne Santoli, deputy director of the CDC’s Immunizations Services Division, said that flu shots are safe at any time during pregnancy - during all three trimesters.

Even though ACOG and the CDC say flu shots are safe; some women are concerned about the preservative thimerosal in flu shots. If that’s the case, women can request a preservative-free flu shot. It may cost a little more.

Convenience is another thing. Although many OB-GYNs may recommend that a pregnant woman get a flu shot, they may not offer it in their practice. Having to go somewhere else may contribute to not getting one. It’s inconvenient, you forget, you just don’t get around to it.

Some women just may not be aware of how serious the complications can be for Mom or baby.

Soon-to-be first-time mom Virginia Bader is seven and a half months pregnant. She credits spending a lot of time with her elderly grandmother for being aware of those at high-risk for complications of the flu. “It occurred to me that I was in a high-risk category myself,” she said. She asked her doctor two months ago about getting a flu shot. It was too early then, but she said, “I will be getting it soon now."

“You don't have a lot of control over many things when you're pregnant; this is something you can take control of.”

Are you pregnant or have a new baby? Are you planning on getting a flu shot during this flu season?

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.

By Dr. Sanjay Gupta

Chief Medical Correspondent

Sure enough, a lot has been made of women and their biological clocks. That ominous ticking seems to be heard by most women as they get into their mid-30s and 40s. On the other hand, men have thought themselves relatively immune to the ravages of time, at least when it came to their ability to conceive. Certainly stories of Tony Randall fathering babies in his 70s were widely circulated. At the same time, we are always reminded that 1/3 of women over the age of 35 had trouble getting pregnant; it went up to ½ when the woman was over 40. Incidentally, infertility is defined as not being able to conceive a baby after a full year of unprotected sex.

Just this week, French researchers tell us, “Not so fast.”  They looked at 12,000 couples being treated for trouble with fertility. They found most times, the couples were being treated because of the man’s infertility.  They also found miscarriage rates more than doubled when the man was in his mid 40s compared with those younger than 30. It could be DNA damage to sperm that accumulates over time, the quality of the sperm, and maybe lower levels of testosterone that are causing the trouble. (watch video)

Even more interesting, as much as older mothers are more likely to have a child with Down syndrome, recent research has shown older men are more likely to father a child with autism and schizophrenia.

So, does this surprise you? When a couple is having trouble getting pregnant, how often do you think they investigate the father-to-be as the cause?

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.

By Val Willingham
CNN Medical Producer

I'm not wild about babies. Don't get me wrong – it's not that I dislike them – I'm just not like a lot of my female friends who oooh and ahhh every time an infant enters the room. But I wanted to be a mom, so in my early 30s I did have a child. A beautiful little girl, who, even at the age of 21, still is my baby. My husband and I wanted our daughter. She was planned. We started thinking about having a child in September 1986. She was born in July 1987. We were blessed, and if you look at statistics, we also were lucky.

According to the American Fertility Association more than 15 percent of couples in the U.S. have difficulty conceiving a child. Many people are delaying having children – about 20 percent of women in the United States now have their first child after age 35. And as we age, it becomes more and more difficult to conceive. According to Dr. Robert Stillman, director of the Shady Grove Fertility Reproductive Science Center in Rockville, Maryland, "It's just the natural aging process, and women can make that worse by smoking, alcohol abuse, excessive weights - both high and low."

In her 30s and 40s, a female's reproductive cycle begins to change. As a woman ages, her eggs are more likely to develop abnormalities The probability of having a baby drops between 3 and 5 percent per year after the age of 30, a rate that can be even higher after 40. In fact a woman in her 40s faces a 50 percent risk of suffering from a miscarriage, and there can be other problems. "As women age, they can end up with uterine problems, such as fibroid tumors, ovarian cysts or growths endometriosis," Stillman adds. Many couples turn to expensive, state-of-the-art procedures such as in-vitro fertilization in order to have children.

When women get into their 50s, typically menstruation and ovulation cease with menopause. But you wouldn't necessarily know that by looking at Hollywood. Many stars are having kids well into midlife. Stillman says there is nothing wrong with that, but many older people come into his office wanting to get pregnant with their own eggs, because aging Celebrity X just had twins. Stillman knows that's not possible and says these actresses need to be honest. He feels it's frustrating. "If they are going to be on the cover of People, they have a responsibility to their following, not to mislead people that fertility is easy at 52. It's not. They are (using) donor eggs."

So yes, there really is a biological clock. And while it keeps tick, tick ticking, couples need to think about their odds when it comes to having little ones later in life.

Are you thinking of having a child? Are you having problems? Are you someone who was successful giving birth at a later age? Tell us your story. We'd like to hear about it.

Editor’s Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.

By Jennifer Pifer
CNN Medical Senior Producer

I am getting married in October.  Since my fiancé and I got engaged, most of our free time has been spent planning the wedding, selling our individual homes and looking for a new home to buy together. Getting married in your 30s seems much more complicated than getting married in your 20s. There are lots of balls to juggle.  Just when I think I'm getting into a rhythm, something else comes up.

Take what happened a few weeks ago.

My future in-laws were over helping us get my fiancé's house ready to put on the market.
My future mother-in-law and I were in the kitchen organizing the cabinets.

"Now I know it's none of my business," she said as she deftly sorted orphan silverware and mismatched mugs, "but if you are thinking about starting a family in the next year, you need to start taking folic acid."

I haven’t even found a wedding dress. Now I have to start planning for a baby?

Turns out, my betrothed's very wise mother is right. Doctors have known for years that women who take folic acid before they get pregnant cut down the risk of serious birth defects such as spina bifida. Now new research suggests women who take folic acid supplements for a least a year before they become pregnant can slash their risk of having a premature baby by half. That, in turn, can lower the risk of things like cerebral palsy, physical disabilities like blindness and mental retardation.

Intrigued and new to the world of all things prenatal, I called Dr. Radek Bukowski at the University of Texas Medical Branch. He's the doctor leading this research. "Folic acid has a lot of powerful effects," Dr. Bukowski says, but "nobody really knows why folic acid works." One of the leading theories, says Dr. Bukowski, is that if it is taken before conception and during the first few months afterwards "maybe it protects against infection."

Dr. Bukowski also told me the average woman, with no history of having children with birth defects, can get enough folic acid in a multivitamin. It seems like a simple step all women can take to increase the odds of having a health baby. Moms out there - what other things would you suggest? And what do you wish other moms had told you before you got pregnant?

As for me, I have some more research to do. Wonder if folic acid can help me lose 10 pounds in time for my wedding?

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.