Cleft lip and palate are among the most common birth abnormalities, affecting one in every 700 infants. Babies born with cleft lip and/or palate require specialized care from a multidisciplinary team of medical specialists. Because of the challenging medical, surgical, dental, and social elements that influence treatment decisions, their care must be effectively managed. To assist pediatricians in properly managing infants with cleft lip or palate, the American Academy of Pediatrics (AAP) issued the clinical study “The Primary Care Pediatrician and the Care of Children with Cleft Lift and/or Cleft Palate.”
The information provided below provides these recommendations to parents and families who are caring for a newborn born with a cleft lip and/or palate.
Different Types of Cleft Lip and/or Palate
A child’s cleft lip and/or palate will dictate the type of care that he or she requires.
A cleft lip refers to a gap in the baby’s lip. The cleft can occur on either one or both sides of the top lip and can extend to the nose. A gap in the upper gum is common in babies with cleft lips.
A cleft palate is characterized by a hole in the roof of the mouth that links to the nose.
A cleft lip and palate combination is more prevalent than either a cleft lip or a cleft palate alone.
Cleft Lip and/or Palate Detection:
The prenatal ultrasound informs many, but not all, parents that their newborn infant will have a cleft lip. The mother’s or the baby’s future doctor can assist parents in a meeting with experts known as a cleft/craniofacial team. Parents meet several members of the cleft/craniofacial team during prenatal consultation and learn about the care of infants born with cleft lip and palate.
A cleft palate is usually discovered after a baby is delivered. A nurse, doctor, or parent may observe that the top of the mouth is unusual. The cleft palate might affect the entire roof of the mouth or just the farthest part of it.
Common Parental Concerns:
It can be daunting to be the parent of a newborn with a cleft lip, cleft palate, or both. Simple tasks like feeding your infant may have become more difficult. Parents are concerned about how others will respond if they discover their child has a cleft lip and palate. Parents are also concerned about how their child’s cleft lip or cleft palate may affect him or her in the long run, both socially and developmentally.
If you are concerned about any of these or other issues, consult your child’s pediatrician. He or she can answer your queries and maybe point you in the direction of a parent support group near you.
Feeding a Baby with a Cleft Lip and/or Palate:
In general, babies with a cleft palate suck, whether they have a cleft lip and palate or a cleft palate alone.
Feeding a Baby with a Cleft Lip and/or Palate: In general, babies with cleft palates, whether cleft lip and palate or cleft palate alone, suck poorly and require a specific bottle to feed. Parents should seek the advice of a feeding therapist, professional lactation consultant, and/or nurse with expertise in feeding children with cleft palate.
A child born with a cleft lip but no cleft palate may require additional feeding assistance. Most babies with cleft lip and palate can, however, feed from the breast or a conventional bottle. This also applies to newborns born with cleft lip and cleft gum.
Cleft/Craniofacial Team Care and Treatment:
At various times and stages, your child will be cared for by a variety of specialists. Nurses, social workers, nutritionists, audiologists, speech-language pathologists, geneticists, pediatricians, dentists, orthodontists, and pediatric surgeons (otolaryngologists, oral and maxillofacial surgeons, and plastic surgeons) are common members of the cleft/craniofacial team. These providers are aware of frequent issues and can answer parents’ queries.
First Visit: A newborn should see his or her cleft/craniofacial team within one week (or as soon as feasible) of leaving the hospital. Initially, the team will ensure that the baby is feeding and growing normally. The team will also look for additional medical issues that are common in babies with cleft lip or palate, as well as address parents’ questions and outline the next steps in therapy.
Surgery: Surgical correction of a child’s cleft is one aspect of the care provided by the cleft/craniofacial team.
Cleft lip repair
When Will My Child’s Surgery Be Required?
The most frequently asked question among parents is, “When will my child have surgery to repair his or her cleft lip or palate?” The American Academy of Pediatrics recommends that initial reconstructive procedures for cleft lip or cleft palate be performed within the first year of life.
Cleft lip repair: A cleft lip is often fixed between the ages of 3 and 6 months. Many factors will influence the best time for surgery; what is best for one child may not be best for another.
Cleft palate repair: A cleft palate is typically repaired between the ages of 9 and 14 months. When a youngster is 8-10 years old, a separation in the gum line is frequently corrected. The ideal timing for cleft palate surgery will be determined by a child’s cleft/craniofacial team.
Each child will require a different number and type of procedures, which is why tailored coordination of care is critical. Most children born with clefts will need to see their cleft/craniofacial team frequently until they reach adulthood.
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