Cleft Lip and Palate
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What is Cleft Lip and Palate?

A Cleft lip or palate might also be termed as a harelip. Cleft Lip is the split in the upper lip, while a split in the roof of this called a split palate. Cleft Lip or palate is one of most common birth defects found. The condition occurs when the tissue forming the roof of the mouth does not join with the upper lip before the birth.

The reasons may be various but the problem can be solved after the birth of the child. The problems associated with the defect might include recurrent ear infections, aspiration pneumonia and speech problems later in life, if the treatment is not given at the right time. This defect can change the child's face.

In UK, almost one out of every 700 babies is born with this defect, while in US around 6800 babies are born every year with this defect. Sometimes the disease runs in the family. But usually it happens due to a genetic disorder, though the risk of the defect increases if the mother's taking alcohol or certain medicines like anticonvulsant drug phenytoin during pregnancy. This disease can also be caused due to the deficiency of folic acid or maternal infection during childbirth.

Causes

Since the baby is born with a cleft palate, the child may face difficulty in feeding. At the same time a cleft lip or palate might also render the child to face a complete loss of hearing eventually. The babies suffering from Cleft lip or palate may also have dental problems.

Diagnosed and treated

A Cleft lip can be diagnosed while an ultrasound screening, while a cleft palate is not detectable before the birth. It usually takes a surgery to treat the Cleft Lip. This surgery to repair a cleft lip can take place when the baby is three months old. For a cleft palate to be repaired, the child should be between six to fifteen months old. During the surgery, the doctors join the lips or the palate back together. Other than the surgery, the babies are then given speech and hearing treatments depending on the need and requirement.

While speech problems can be treated with the help of a speech pathologist / therapist, for the benefit of the hearing ability of the child, the doctors insert a tympanostomy tube into the eardrum to aerate the middle ear. Usually a complete team of therapists including a pediatrician, a plastic surgeon, dental specialists, an otolaryngologist (ear, nose and throat specialist), an audiologist, and a genetic counselor needs to be coordinated to treat the child.

While feeding the child, one can use special bottles with nipple designed specifically for babies suffering with the cleft lip and palate. While babies with the cleft lip can be breast fed easily, the ones with cleft palate cannot. For such babies, the mother can feed the baby breast milk from a bottle. The doctors may also recommend using a plastic plate called an obturator, which fits into the roof of the mouth of the baby with cleft palate and prevents the milk form coming out from the nose by blocking the opening.

For the ear problems, if the treatment is done early, the loss of hearing can be avoided. Babies suffering from cleft lip or palate should have a yearly check up done for the ears. If any sort of fluid formation is seen, it can be treated with the help of the medicines.

Advice

The children suffering from cleft lip can have a near normal or near normal speech, while children having a cleft palate might be slow on developing the speech. However, surgery and speech therapy almost always helps the children attain a near normal speech. The children need to be supported throughout for they have an unusual appearance and might shock the people in general.

The defect may also cause some dental problems like missing teeth or abnormally shaped and out of position teeth due to the cleft palate. One also needs to be cautious about the psychological problems that the growing adults might form as they have a cleft lip.

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