One of the most common congenital problems that occur in newborn infants is cleft lip and cleft palate malformation. It results from incomplete development of the lip or the palate during pregnancy. Though these congenital problems have been studied extensively, it is still not known exactly what causes them. It is however well understood that they are not due to something particular that the mother did during pregnancy. It is also know that there is a genetic component to cleft lip and palate. Those who have cleft lip and palate have an increased risk that their children with also have cleft lip and palate.
Proper care of an infant with a cleft deformity will involve the help of a variety of health professionals. In addition to surgery to repair the defects there may be other associated issues. Speech and hearing may be affected, requiring the care of an otolaryngologist and a speech pathologist. Dentition may also be affected, requiring the care of an orthodontist specialized in this type of care. Many University Hospitals have Craniofacial Teams that work with children with cleft deformities. The team approach to management is ideal for the child and the parents.
Initial closure of the cleft lip takes place at about 10 weeks of age. This surgery is typically done with an overnight stay in the hospital. The palate is repaired at approximately 9-12 months of age. This surgery requires at least one night in the hospital. It is important to be sure that your child is well hydrated and able to eat prior to discharge.
With lip repair an incision is placed from the lip up toward the nose. It is visible and will fade with time.
It is important to be honest and direct with your family and friends about the defect. Provide them with information that you have collected and received from your doctors. There is every reason to expect that your baby will develop normally.
They will thrive on love and attention. Seek out an environment of health professionals that encourage you to treat your baby as any other newborn.
Your child will be placed in "no-no" restraints. These are soft restraints that prohibit your child from bending his/her elbows. The surgical repair can be opened by the insertion of a fist in the mouth or by picking or rubbing the lips.
The outside sutures will dissolve in 4-5 days and replaced with a small tape dressing. Internal sutures will dissolve spontaneously and do not need to be removed.
Feeding a baby with a cleft lip or palate can present a large challenge to the mother. When a cleft lip is present it is hard for the baby to close tightly around the nipple. When a cleft palate is present the baby has difficulty sucking. Because of this the following things may happen:
Your doctor should provide you with detailed information about feeding. The Craniofacial Team will have a nurse specialist who can assist you.