What are the reasons for Cleft Lip and Palate?
- Genetical Factors
- Viral Infections,
- Consanguineous Marriage,
- Lack of Vitamins,
- Mother’s use of alcohol and tobacco products in pregnancy,
can cause anomalies.
The possibility of this anomaly increases for the second child of healthy parents whose first child is born with cleft lip and palate.
What Does A Baby with Cleft Lip And Palate Experience?
If there is no additional disorder, the baby born with cleft lip and palate can continue his life as a normal individual after good care, follow-up and surgeries.
However, these babies may experience nutritional problems at the beginning. The baby may have thympanitis and hearing difficulties, speech disorders, and psychological problems as a result of aesthetic concerns in the following months and years.
Babies with cleft lip and palate cannot be fed as easily as normal babies.
For the babies born with cleft palate, a feeding plate which closes the cleft palate and facilitate the feeding of the baby is made by dentists in order to feed the baby for the first days after birth.
Babies should be fed with their head up at a 45-degree angle and the teat of the feeding bottle should be enlarged. The feeding period should be kept longer, as they will get tired quickly compared to other babies.
Babies with cleft palate have impaired speech. If the surgery is performed on time and the baby is supported with speech therapy after the surgery, the child can talk close to regular. If these steps are disrupted, the child's speech will be impaired to varying degrees.
Those who have cleft lip surgery can return to normal life with the support of their families and the necessary treatment and therapies.
When Is the Best Time to Undergo the Surgery?
The Cleft Lip and Palate surgery should be performed as early as possible, prefereably during the first trimester after the birth.
The operation can be performed when the baby is 6-12 months old depending on the baby’s weight and blood tests.
The baby may need multiple operations for nose and lip shape, for speaking or fort he development of the teeth and the chin depending on the severity of the problem.
Is Cleft Lip Obvious on Ultrasound?
Ultrasounds performed between the first 18 and 20 months when babies are in the womb are scanned to examine the anatomy of babies more closely. Cleft lip can be detected on these ultrasounds.
What is a submucous cleft palate?
A submucous cleft palate is a congenital defect of the palate, which forms the roof of the mouth. The cleft (or opening) is underneath the mucous membrane, which is the tissue that covers the roof of the mouth.
A submucous cleft affects the uvula, which is the long tissue that hangs from the back of the palate. The cleft also goes under part or all of the mucous membrane covering the soft palate (also called velum). In severe cases, the submucous cleft can extend under both the soft and hard palate.
Can lip and palate cleft be detected during pregnancy?
The lip and palate cleft can be detected after the third month of pregnancy using ultrasound and parents can begin to look for ways to treat the child's lip and palate cleft and the problems they will face after the baby is born.
Do babies with cleft lip and palate face difficulty in feeding?
Babies with cleft lip and palate have difficulty feeding. Therefore, babies should be fed with their head up and the opening of their bottle should be expanded. Since babies with cleft lip and palate will get tired more quickly than other babies when feeding, feeding time should be kept long and we should be patient.
Does cleft lip and palate cause speech disorders?
Babies with cleft palate are speech impaired. So it is important to treat their cleft lip and palate without delay after that make them undergo speech therapy in order to avoid permanent disorders in their speeches. In case of speech therapy is not applied or applied late the speech disorder of the child might become permanent.
When should cleft lip and palate be operated?
Preferably, surgery should be performed in the first 3 months. The doctor decides the appropriate time of the operation during the first 12 months depending on baby's weight and blood values.
What happens if cleft lip and palate is not treated?
If not treated, babies will have a lot of problems; these problems start with feeding problems and continue with middle ear inflammation and hearing difficulties. Also a speech disorder will be noticed when the baby starts to speak, this speech disorder is permanent because it is not treated.
Apart from all these problems the baby psychology will adversely affected due to his/her different look from normal individuals
Facts about cleft lip and palate
- Cleft lip and palate is a congenital anomaly which is seen in one out of every 1000 babies.
- Cleft lip and cleft palate treatment should be completed when the baby is 1 year old. Serious speech disorders may occur when babies start talking if their cleft lip and cleft palate are not treated.
- The best time for cleft lip surgery is determined by considering the baby's weight and blood values.
- If babies with cleft lip and palate have problems in the shape of the nose, lip, jaw and teeth or speaking problems they might need to undergo an additional surgery to correct these problems.
- Babies who undergo cleft lip and palate surgery may also need speech therapy in the future.
- Cleft lip and palate treatment is a long process so families need to be patient and be aware of all details of this process.
How should the baby care be after cleft lip surgery?
Babies who had cleft lip surgery stay in the hospital on the night of surgery and they are discharged the next day after all checks. After surgery babies should be fed with small spoons in a sitting position.
Contamination of the surgical incision with nasal Mucus or baby food should be avoided. Cleanliness of the incisions is very important so after surgery it is recommended to dress the incision with antibiotic pomades daily until the incision heals. Incision should be kept dry and clean. All sutures are removed 1 week after the operation.
After cleft lip surgery, families should take a good care of their baby and if they see any changes in their baby they should contact with their doctor.
After cleft lip and palate surgery will speech disorder be completely corrected?
As well as cleft palate is a problem that negatively affects nutrition it also affects speaking. In cases of cleft palate, there are problems such as difficulty in speech and difficulty in making some sounds because soft palate movements are not fully carried out. So the palate muscles are repaired during surgery to prevent such problems. In such cases, surgery alone may not be enough and Postoperative speech therapies are needed.
Will be there obvious scars after cleft lip surgery?
No matter how advanced technology is, removing scars completely is impossible. Acne, birthmarks or sunspots can be removed by laser, but surgical scars cannot be removed. Still there are some specific techniques that help to reduce the size of scars as much as possible, also following the appropriate treatment and massage for 6 months after the surgery helps with reducing of scars size, at the end of treatment the scar become in the form of thin line.
Will be there obvious scars after cleft palate surgery?
Since the cleft palate surgery is performed on an invisible part of the body, the presence of these scars is not as important as the cleft lip scars. Cleft palate scars take the form of a straight line.
Is it possible to treat cleft lip and palate with one surgery?
The cleft lip and palate is formed as a result of a developmental disorder in the mother's womb. The cleft lip and palate can affect some other areas. That’s why it is often require more than one surgery to treat this condition. However, if there is only a cleft lip without any other abnormalities in other areas cleft lip can be treated with just one surgery.
Suction and swallowing problems after childbirth
Children who have cleft palate suffer from suction problems, if it is not a very extreme situation there will not be swallowing problems.
The cause of the suction problem is due to the fact that the negative pressure cannot be created because the palate and nose are open. The child can be easily fed with a spoon or with a wide-opening bottle until undergoing the surgery. In severe cases, the child can be fed with the help of a nasal catheter.
Can other problems be seen in babies with cleft lip and palate?
Cleft lip and palate is a problem related to the growth of the baby and mostly carries genetic features. Abnormalities can also be seen in other parts of the body. However, they are mostly born with cleft lip and palate deformity and no other pathology is seen.
How many days after surgery can babies with cleft lip and palate be fed orally?
Babies with only cleft lip can start feeding a few hours after surgery. However, babies with cleft palate begin feeding a few hours after the surgery, but they are fed with liquid foods that do not contain particulates from 5 to 7 days, after that they can gradually fed with solid food.
Does cleft palate-lip deformity pass from parents to children?
Cleft lip and palate usually carries a genetic characteristic so If the mother and father had it the child also might have it, the normal incidence of cleft lip and palate is 1 out of 1000 births, but in case one of the parents or relatives have had cleft lip and palate the incidence of it decrease to 1 out of 100.
By whom is the treatment and follow-up of children with cleft lip and palate done?
The treatment of cleft lip and palate is done by a team, this deformity is noticed by Midwife before the baby is born and can be detected at early time, Since these children will have ear problems, they are followed up by ear nose throat doctors. But the most important work lies on cosmetic doctors who are planning and implementing the surgery. The help of speech therapists is needed since speech problems will be experienced after the surgery, and the support of the family is very important in this process, it is also possible to take support from psychologists from time to time.
What are the complications of cleft lip and palate surgery?
All surgeries have certain risks and knowing these risks before the operation is very important.
The risks of cleft lip and palate are listed as the following:
- Respiratory problems
- Opening of the sutures
- Fistula formation
- Risks arise from anesthesia