What is Cleft
Lip and Cleft Palate?
A cleft lip is an opening in the lip, which is seen at the
time of birth. A cleft palate is an opening in the roof of the mouth.
result from incomplete development of the lip or palate while the baby is in
the womb. Babies'
lips and palates develop separately during the first three months of pregnancy.
In most cases, the left and right parts of the lip come together, or
"fuse," creating the two vertical lines on the normal upper lip. In a
similar way, the left and right parts of the palate come together to create a
normal palate. If your baby has a cleft, this fusion failed to happen when he or she was developing.
How Do Parents
Feel When Their Child is Born with a Cleft?
It is natural for parents to feel upset at this time. Feelings of concern,
anxiety, and grief are not unusual. Your family physician and the hospital
staff members will guide you to a team of specialists who can provide you and
your baby with the help you will need. But do not blame yourself for what has
happened. It is not your fault.
Why Didn't Our
Baby's Mouth Fully Develop?
most cases, we simply don't know why lip and palate development
go wrong. Scientists have learned that there are many possible causes for
clefts. Research is under way to discover more about these causes.
- About 1 in 800 baby has a cleft lip and 1 in 1200 has a cleft palate.
- Boys are more often affected than girls.
- In some families, clefts appear in several family members, so heredity is important.
- Sometimes substances in the environment, called teratogens, may be associated with clefts.
most babies with clefts have no known relatives with clefts and no known
exposure to teratogens.
We still don't know the exact answer to this question, but it was not because you did something
Remember that cleft lip and cleft palate are not life threatening for your child.
Surgical repair of the cleft is done by choice.
So What Can Be
Done to Help Our Baby?
A cleft lip should usually be repaired in the first few months of life. A cleft
palate can usually be repaired some months later. The doctor who performs the
surgery will determine the exact timing of these repairs. i.e. it can be done
when the child is the right age and size and is in good enough general health
to tolerate surgery
is often done in several stages, for a complete cleft of lip and palate a
minimum of 4-5 surgeries are required. The total number of surgeries depends on
how the child has responded to the previous surgeries. Parents are usually
eager to have at least the visible cleft lip repaired early, but this is often
not done until the baby is 3 months or weighs around 4-5 kilos. Later, the
cleft can be corrected by bringing together the tissues that should have fused
before birth. Before the abnormality is corrected with surgery, a prosthesis,
or artificial palate, may be used (if recommended by your doctor) to fill the
gap in a cleft palate so that your baby can nurse.
What Are The
Problems My Baby Is Likely To Face?
Depending on the extent and location of the cleft the
following problems may occur.
and language problems
So How Can Our Baby Be Fed Properly?
Some babies with clefts have very few or no problems feeding, while others have
cleft of lips do not hamper the process of feeding. Depending on the extent of
the cleft in the palate the baby can have difficulty feeding.
of special bottles and careful positioning of the baby are sometimes helpful
milk or formula can be fed with a soft plastic bottle and an extra large nipple
opening. This special nipple allows
the milk to flow at a rate comfortable for the baby to swallow. But preferably
the best way to feed the baby is with a spoon and cup
Important Tips While Feeding:
the baby small frequent feeds and increase the number of feeds.
the feeding period to 20 min, certainly no more than 30 minutes.
the child after every feed.
monitor the weight of your child.
Feed the baby in a slightly elevated position. Do not keep the baby flat on the bed or your lap while feeding.
Will Our Baby's
Teeth Grow Properly?
If the cleft affects only the lip, the teeth will probably not be affected. If
the cleft affects the gums where the teeth grow, your baby will probably need
the care of dental specialists.
Will Our Baby
Have Trouble Learning to Talk?
If the cleft affects only the lip, speech problems are
unlikely. However, many children with cleft palate need the help of a speech
pathologist, and some may need an additional operation to improve their speech.
A cleft child generally has articulation problems.
Comprehension is generally not affected in these children. Monitor your childâ€™s
comprehension skills. Visit a speech language pathologist for advise on the
same. The goal is to help the child develop normal speech as soon as possible.
Problem is My Baby Likely to Have?
Children with clefts have ear infections more often than other
children. The cleft allows fluid and germs to enter your child's ear more
easily than normal. All children with clefts need to have their ears checked
regularly by their doctor. If the ear related problems are not tended to in
time, it could lead to a considerable degree of hearing loss.
Your child will also need to see a dentist often, because
children with clefts tend to have cavities and other dental problems more often
than other children.
You are naturally worried about your child's social growth.
Infants and children with clefts may become withdrawn from both family and
friends. It is very important to spend
as much time as possible with your baby, cuddling, talking, hugging and
so on. Later on, when your child is older and is making friends, it is
important for you to make your home a safe place for your child. If you are
worried about any problems with the growth of your child and his/ her making
friends, then you should talk to your doctor. You may also want to talk to a
psychologist or a psychiatrist.
Who is Going to
Help my Child?
As soon as a cleft is diagnosed, your doctor will probably
send you to a special medical team that will help you and your baby.
team may include
pathologists (for problems with talking)
(for problems with hearing)
nose and throat specialists (for ear problems)
surgeons, orthodontists and dentists (for dental problems)
social workers and others.
What is all This
Going to Cost?
Essentially surgery in a government hospital is free or with
minimal charges. But consult your surgeon to confirm the same.
How Can We Tell Our Relatives and Friends About the
new parents feel that this is a difficult task. Although you may feel uncomfortable,
it is important that you tell relatives and friends as soon as possible. Try to
be as direct and honest as you can. Your
baby is much more than his or her cleft, and everyone needs to remember
that. If the people closest to you can visit while the mother and baby are
still in the hospital, this is often helpful. You may want to use this booklet
to answer their questions.
If you accept your baby
for what he or she is, everyone else will do too.
Will it Happen
Again to my Next Child?
It may, although there are chances that your next child will
be normal. If several family members are affected, the risk of clefts is higher
in the children born in the family. Talk about this with your doctor, who may
send you to a genetic counselor.