Cleft lip and cleft palate are congenital abnormalities occurring during gestation (pregnancy). These abnormal facial developments may occur individually or together as cleft lip and palate. Cleft lip is visible, and represents a gap of missing tissue in the upper lip. In most cases of cleft palate the lip is also involved. Cleft palate occurs when the bones of the skull do not connect to form the hard palate (roof of your mouth). More often than not, the soft palate is affected also. As a mother or caregiver, certain techniques should be modified when caring for a child with a cleft of some kind.
Many mothers question whether or not their children can breastfeed. Newborns with cleft lip can most often breastfeed; you may need to try different positions to ensure the baby can get a proper latch. As far as cleft palate, this may be a little more difficult for the baby. The gap in the roof of the mouth makes it very challenging to maintain a vacuum seal needed for sucking. As a result, the infant could suck in a lot of air when trying to feed. If your baby is having trouble sucking, specific cleft palate nipples and bottles help solve this problem. Mothers can pump their breast milk or use formula for nutrition.
Children with cleft lip and/or palate usually develop speech normally. Sometimes, certain words or syllables are difficult to pronounce, and some healthcare providers may recommend working with a speech therapist.
Hearing problems have also been linked to cleft lip and palate. Generally, excess fluid drains through the Eustachian tube to the throat. In some cases with cleft palate, the tube is distorted and fluid can accumulate in the eardrum. If surgical treatment is provided for the cleft palate, the surgeon will often put a tiny plastic tube (a grommet) in the eardrum to allow the fluid to drain.
Family and physicians will determine the child’s treatment. Children with cleft lip often undergo surgery to repair the gap as an infant (generally during the first 1-4 months of life). Some surgeons follow a “rule of tens,” where the infant should be at least 10 weeks old, weigh 10 pounds, and have at least 10g hemoglobin. Cleft palate is usually treated later in infancy, around 6-12 months. Surgery may also repeat as the child develops, and skull grows.
If you have had a child with cleft lip or palate, the chances of having another child with a cleft may be slightly increased. Daily folic acid consumption (at least 400 mcg) prior to conception and during the first two months of pregnancy may help reduce the chances of genetic abnormalities like cleft lip and palate.
For further information, check out the Cleft Lip and Palate Association (CLAPA) at www.clapa.com.