His mother Craciele Leal knew nothing about cleft when she was given the diagnosis during pregnancy. “I felt lost, anguished,” she said.

Samuel spent his first two months fed via a drip in a neonatal ICU at the hospital where he was born and went through a hard transition to oral feeding. Craciele’s milk dried out, the baby rejected a plate inserted on his palate, and lost weight. “I was emotionally shaken,” Craciele said.

During the pandemic, Craciele and her husband are surviving on emergency state help of just over $100 a month and donations from relatives. Zélia da Conceição Alves, 67, lives close by and helps her daughter-in-law with chores and taking care of the two children. The first child of the family, Ana Vitória, is nearly 2 years old and still requires close attention.

After Samuel had a new plate inserted on his palate, Craciele had online consultations to adapt his feeding needs. She learned to hold him straight to avoid him sucking air instead of milk, to pierce the nipple of the bottle to ease the feeding, and to balance the amount of formula given to him during the day. "In the beginning, he struggled to suck and cried a lot," Craciele said.

The day Samuel managed to suck formula from a bottle for the first time was an emotional one for the family. Slowly, he is gaining weight and the days are getting lighter. “He takes his own time. When it’s feeding time, it’s only me and him talking inside the bedroom. I tell him, ‘You’ll eat everything today,’ it takes time for that,” she said in a gentle voice. “He’s a joyful child, and we have a very good connection.”

Samuel had his first consultation at the clinic in mid-August. The city hall is obliged to offer transport to the clinic, but in practice, the family had to rely on friends. In spite of this, Craciele’s mood is upbeat: “I’m excited,” she said. “ I feel welcomed by them.”