Born With Cleft

With corrective surgery, anyone born with cleft lip and palate can lead a normal life without the stigma of looking different.

The sight of a baby born with a cleft lip can be shocking for parents. Some instantly blame it on the father having gone fishing before the birth, or the mother not cutting chicken at the joint, or even a full moon!

The risk of a child having a cleft is higher if his parents or sibling have it, or there is a history of clefting in the family. Data shows that 30% of people with cleft lip or palate have a relative with a similar defect.

If one parent has a cleft, or a sibling is born with one, the baby has a 25% chance of having it. The percentage is 50 if both parents have clefts.

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Clefts are more common in Native American, Hispanic and Asian children, but African American children are least likely to have them. Cleft lips are more common among boys and cleft palate, among girls. In twins, either both can be born with clefts or only one.

The cost and number of treatments needed to fix cleft palates can be quite substantial.

There are also the physical and emotional stress. For cleft lips, it usually involves one simple surgery.

Some mothers will be depressed with their baby’s condition and detach themselves from the baby. They need support and guide on how to feed and care for their babies to ensure good bonding between them.

Detecting and Treating Clefts

Thanks to medical advancement, clefts can be diagnosed by prenatal ultrasound. At the moment, surgery and therapy are the forms of treatment for clefts. Treatment can begin as early as when the infant is three months old and usually involves different specialists and a series of sessions and procedures.

Babies with a cleft palate can usually go for surgery at 9 months to a year. For cleft lip, it is earlier at generally three months or when the baby weighs 5kg. Cleft lip surgery can still be performed on an adult.

Alveolar bone grafting (ABG) is performed to fill gaps in the gum caused by a cleft palate. The alveolus is the bony part of the upper and lower jaw that holds our teeth. An ABG involves taking bone from usually the hip to fill these gaps in the gum.

Cleft Complications

Babies with clefts can face these problems :

Feeding. A baby with a cleft palate, or cleft lip and palate, may face problems sucking milk from a bottle teat. She may gag, choke or have milk coming out through the nose. Cleft babies should always be fed upright. Most babies with cleft palate cannot breastfeed. However, mothers can still express milk into a bottle and feed their babies. There are specially designed bottles and teats to cater to babies with clefts.

Ear infection and hearing loss. Cleft palate babies often face accumulation of fluid in the middle ear and therefore, repeated ear infections. Fluid in the ear, if not treated properly, can lead to hearing loss, which in turn can affect the child’s speech development. Medication or a procedure to drain the fluid can prevent these problems. Children with cleft problems need regular ear check ups. Cleft babies are also more prone to colds.

Dental and tooth development. Cleft lip and palate defects that affect the upper gum usually cause dental problems such as cavities, missing teeth and misshaped or unaligned teeth. It’s also difficult to clean between the teeth of a child with cleft palate as their teeth tend to be crooked and misaligned. Dental and orthodontic treatment can correct such problems.

Speech. Speech development may be slower in cleft palate children. A child with cleft lip faces lesser problems with speech but one with cleft palate may sound nasal or have difficulty pronouncing certain words. Speech therapy can solve such problems but the more severe cases require surgery. An artificial palate may also be inserted into the mouth before surgery to facilitate nursing and initial speech progress of a baby.

Psychological challenges. Due to the way clefts affect the child’s facial features or speech, he or she may feel insecure and develop an inferiority complex. It is important to give assurance, support and encouragement to the child to prevent this.

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