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Children born with cleft palates are at a disadvantage almost from the day they are born. Though new parents may be aware their child will be born with a cleft while looking at an ultrasound, they must still be prepared for situations that all new parents face, plus other situations unique to them.

Having said that, this does not mean that children born with clefts are any less intelligent, loving, or anything else. While they will most likely go on to develop normal relationships, it is important to understand what the first year or 18 months of this child’s life, and your life with them, will be like.

A cleft is a space left in the lip and palate where tissue did not develop while the child was in the womb. Sometimes this can be detected on the ultrasound, but sometimes this is not detected until birth. The causes of cleft development are still vague, however, there are studies that link them to genetic and environmental factors. If you have had children who have been born with clefts already, the chances are higher than they are in the general population that any additional children may also have it.

Challenges

The first major challenge a newborn with a cleft faces is feeding. Because there is no way for the baby to create suction to get milk during breast feeding, this may simply be an impossible option for the child and mother. In this case, a special bottle can be used that has been created for feeding children with a cleft. The mother will have to pump her milk to put into the bottle. There are several different bottles created since all clefts are different.

Speech may sound abnormal and nasally due to the lack of movement in the child’s palate. This will occur even after surgery. Along with the nasal sound during speech, the child may also have to undergo nasal reconstruction. This corrects the symmetry of the nose affected by the cleft.

Because most cleft palates pass through the gum line, extensive orthodontic work will probably be in the child’s future, if not right away. This includes surgery to add a bone grafts, as well as properly aligning the adult teeth. This can wait until the child is between seven and nine years of age.

Surgery

Cleft palate surgery is performed to close the gap in the lip and palate, as well as to fix other affected areas, such as the nose, the teeth and gums, and the ear canals. The first surgery on the palate typically occurs when the child is no older than 18 months in age. Of course, this depends on the severity of the cleft. The lip can be repaired when the baby is three months old. An oral appliance, which works a little like a retainer may be used, and taping the palate to aid in tissue realignment can be done at this stage. This will also help the child and mother bond, as well as establish a feeding pattern.

Depending on the surgeon, palate surgery can occur between six and 18 months. Timing depends on speech development and how the face will develop in the future. Both the hard and soft palate are repaired during this surgery.

Fluid buildup in the middle ear is more likely in children with clefts. As a result, there is a better chance for ear infections. It may be recommended that tubes be placed in the ears during one of the surgeries to repair the cleft.

As the child grows and their face matures, several visits to your health care provider will be needed to keep an eye on speech, hearing, dental, and facial appearance.

If you are in the Albany, Saratoga Springs, Schenectady, or Troy, New York area, and you have a child with a cleft, please contact cleft palate surgeon Dr. Falk at Facial Plastic Surgery & Laser Skin Care for an initial consultation.