Cleft Lip/ Palate

FACTS:

A cleft is a gap in a body structure that results from incomplete closing of a specific structure during prenatal development. Clefts that occur in the lip and palate (roof of the mouth) are called oral-facial clefts. There are two main types of oral-facial clefts: cleft lip/palate and isolated cleft palate.
Some babies have only a cleft lip. However, most babies with cleft lip have a cleft palate or cleft in the gum line as well. Cleft palate also can occur by itself without cleft lip. This is called isolated cleft palate. Cleft lip/palate and isolated cleft palate are considered separate birth defects.
Isolated oral-facial clefts are among the most common birth defects. Studies suggest that a number of genes, as well as environmental factors, such as pollution, maternal smoking and drugs such as anti-seizure medications, may contribute . Other environmental factors that are suspected of playing a role include infections, maternal alcohol use and deficiency of the B vitamin folic acid.
Children with cleft lip/palate may have difficulty speaking clearly or may sound as if he or she speaks through her nose. Also, food or liquid may come through the nose when eating or drinking.
Children with cleft lip/palate may have frequent middle ear infections and may tend to have dental cavities.

TREATMENT:

Cleft lip/palate is surgically corrected. The number of surgeries will vary from child to child. Each cleft varies and treatment will be individual to each child.
It is important to consult and work with a Cleft Team at a Cleft Center for treatment.
Middle ear infections are more common and may be treated by antibiotics and/or possibly "ear tube" placement by a physician.
Speech therapy is usually necessary to assist the child in speaking more clearly.
Several surgeries are usually needed to close the lip, the palate ( the hard and/or soft palate may be involved), bone graft to the jaw, if necessary, and possibly cosmetic surgery as a teen to remove any scars or straighten the nose further.

SPEECH:

Reward a child for trying to speak.
Look directly at the child when you speak so he may see how your lips and tongue move to produce sounds. Make sounds clear and precise. Practice simple words together.
Play copycat games, for example, the child imitates or copies what you say.
Blow bubbles, whistles or horns, hold a tissue and try to make it move by blowing.
Work together with a Speech Therapist to help the child learn to speak clearly. An Occupational Therapist can assist with feeding and /or swallowing difficulties.

FEEDING/ SWALLOWING:

Food may come out of the nose of a child with an unrepaired cleft, always have the child sit upright when eating.
A specially designed bottle may be needed to feed a baby with an uncorrectedpalate or fistula (opening in roof of mouth). If a special bottle is not available use a squeezable bottle with an orthodontic nipple and cut a larger “X” hole.
Babies will take longer period of time to feed.
Baby may need to eat smaller amounts but feed more often.
Children with clefts can eat most foods even before surgery.
Special diets of soft or liquid foods may be prescribed after surgery for a time specified by the surgeon.

PROGNOSIS:

Clefts are sometimes associated with other "midline" defects (defects in the middle of the body) and rarely to syndromes. Clefting may occur as an illness or other maternal problem at that development stage of pregnancy. If other birth defects are present, it is important to have the child assessed by a specialist for each defect and a geneticist if a syndrome is suspected.
Most children born with cleft lips or cleft lips/palates are normal children, in every other way, and can lead very active, happy and successful lives.

ADDITIONAL RESOURCES:

adoptspecialneeds.org