Cleft lip and cleft palate, which can occur together as Cleft Lip and Palate, are types of congenital deformity caused by abnormal facial development of fetus during gestation. A cleft is a gap or opening due to the non-fusion of the body’s natural structure that form before birth. About 1 in 700 children is born with a cleft.
The most important thing to remember is that cleft lip and palate are completely treatable. You don’t need to worry if your baby is born with a cleft. Research concluded that children (age 3-5) with cleft tend to have a self-concept that is similar to their peers without a cleft. But, as they grow older, their social interactions increase, and children with clefts tend to experience more dissatisfaction with relationships and higher social anxiety.
Timely treatment is a key. Children with cleft are able to lead absolutely normal and happy lives if they are taken care of from very beginning – before they develop physical deficiencies or psychological problems. A typical care plan for children with cleft lip and palate is explained below.
Feeding is the first issue for babies with cleft. These babies usually have difficulty with breastfeeding. There are special bottles to feed babies with cleft. The baby should be positioned in a way that the gravity helps to feed smoothly. A specialist cleft nurse can guide you about the bottle and the feeding position according to the specific needs of the baby.
The surgery to repair lip is usually carried out when your baby is three months old. The surgery is done under general anesthesia, and cleft lip along with nose and underlying muscles are repaired at the same time. A scar remains at the site which becomes less visible with age.
The surgery to repair palate is generally carried out when your baby is six month old. The muscles and the palate lining are rearranged. This operation is also done under general anesthesia.
Sometimes, additional surgery may be required to improve the appearance and function of the mouth and lip. For example, if there is a cleft in the gum, a bone graft operation will be performed between the age of 9 and 12 years. If the jaws have not grown properly, they will be corrected by braces and jaw surgery at approximately 18 years of age.
Children with a cleft palate often develop a condition called glue ear. ENT surgeon may recommend inserting a tiny plastic tube into the eardrum. This allows air in and lets out the sticky secretions.
It is necessary to regularly monitor the child for any hearing difficulties starting from birth. An undetected hearing impairment can have serious consequences.
Repairing a cleft palate significantly reduces the chances of future speech problems. However, about half of all children with repaired cleft palate need some form of speech therapy. It is necessary to have your child assessed by a speech and language therapist (SLT) after the corrective surgery and when he reaches three years of age. If the assessment reveals problems with your child’s pronunciation and language use, the speech and language therapist will teach special exercises to help your child’s development.
If the cleft involves the gum area, it is common for teeth on the sides of the cleft to be tilted or out of position. Often, some teeth may be missing, or there may be an extra tooth. Your pediatric dentist will examine the teeth of your child and recommend treatment accordingly.
With proper and timelytreatment, chances are good that your child will have fair chance of leading a happy and successful life.