When your child has cleft lip and palate

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 A cleft lip is a birth defect that affects newborn babies. Several researches have shown that about one in 1000 babies in the world are born with cleft lip or palate, a situation that can create many problems and possible complications that people do not know about. Rather than treat the condition with the seriousness it deserves, some are quick to disregard it as a cosmetic problem that one can live with.

A cleft lip is a split in the upper lip while a cleft palate is a split at the roof of the mouth, which leaves a hole between the nose and the mouth. It is possible for a cleft palate and lip to occur together in the same person. This could be a serious medical condition depending on the severity of the cleft. The good news is that advances in medical treatment have made it possible to correct this defect early in the life of the child.

The exact cause of clefts is not known but research points to three probable factors:

  • A hereditary characteristic gene from one or both parents.
  • Environmental factors such as poor early pregnancy health or exposure to drugs or alcohol.
  • Genetic syndrome or abnormality.

Complications arising from cleft palate…

 Dental problems. A cleft may involve the gums, which could affect the proper growth of teeth and alignment of the jaw. As a result, the child may have small teeth, missing teeth, extra teeth, or crooked teeth.

 Breathing difficulties. A malformed plate jaw makes breathing difficult.  However, it can be treated through surgery and oral appliances.

 Speech and language delay. Cleft defects may interfere with the ability of a child to form sounds properly and speak clearly. Speech therapy helps with language development while cleft surgery is advisable to correct the defect.

 Feeding. Children, especially infants, with cleft palates commonly have feeding problems as they lack a complete palate, which prevents food and liquids from going up the nose. It is advisable to seek advice from a doctor or feeding specialist on how to help your child swallow food. In addition, special feeding devices are also available and these can make feeding your child easy.

 Ear infections and hearing loss. A defect in the upper airway can affect the functionality of the Eustachian tube and increase the possibility of persistent fluid in the middle ear. This is primarily the cause of repeated ear infections, which can cause hearing loss. Tubes can be inserted in the ear by an otolaryngologist (ear and nose specialist) to alleviate fluid build up and restore hearing.

 Treatment of cleft palates…

A paediatrician dentist or orthodontist (dental and facial irregularities specialist) can assist with this problem and may give braces to ensure the teeth grow, as they should. A cleft lip is usually repaired by the time a baby is three to six months old. During surgery, the doctor closes the gap in the lip and corrects the nostril.

A cleft palate is usually repaired at age nine to 12 months. During this surgery, doctors close the hole between the roof of the mouth and the nose and reconnect the muscles in the soft palate. However, if your child did not get the opportunity to have surgery done when they were young, it can still be done when they are older. Many hospitals and voluntary doctors offer these surgeries in the country for free and you can call Kenyatta National Hospital for more information or contact the district hospital near you.

Once the surgery has been done, a child should get regular hearing tests to check for hearing problems caused by fluid building up in the ears. Some children may also need speech therapy. Children who have gone through a cleft palate repair may have a flattened nose or small jaw. It is therefore very important that you support them in their new appearance. Friends may tease or bully them, hence the need to constantly affirm them that they are beautiful and special.

Published in August 2013

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