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Management of Cleft Lip and Cleft Palate

Cleft lip and cleft palate are two conditions that can occur either in combination or in isolation. The condition can also demonstrate varying degree of manifestations and some of these manifestations does not even warrant any interventions. But, the condition would be one instance which can significantly influence the learning as well as the social development of a child.

The article hopes to identify several concerns associated with cleft lip as well as cleft palate and discuss issues pertaining to these concerns and the available management options in order to minimize its effect on the childs development.

1. Feeding

Perhaps the most important initial concern would be the feeding. Although most instances of cleft lip and palate would not affect the feeding, some instances would not allow the child to grasp the breasts and perform sucking. This is relatively true when both the cleft lip and palate occurs together. In other instances, the child would not be able to swallow the milk without getting aspirated. Thus, wider cleft palates are such instances where the sucking of milk will be both ineffective as well as give rise to choking.

Children with cleft lip and narrower cleft palate can usually be nursed and would not require bottle feeds. But, in other instances, the child may need to be fed through a soft bottle and special teat in order to control the flow of the milk as well as to prevent choking.

2. Language development

Children with cleft lip should not have a problem in generating sounds and starting to talk as the lips does not take much part in producing the sounds. But, if the palate is affected, it can influence language development and result in a delay in speaking.

Language development will need multi disciplinary approach as it should involve the physician, ENT surgeon, other types of surgeons, speech therapist, psychologist…etc. Surgical correction will have to be done in order to give the child the ability to generate sounds more easily. But, the timing of the surgery will wait for the child to achieve the correct weight as well as age. Usually, the earliest surgery will weigh at least 10 weeks for the child to gain at least 10 pounds. Even then it will take several stages in correcting the entire problem. Thus, the delays are inevitable with the necessity to wait.

It should also remembered that even after the surgeries are done, although they are cosmetically very effective, it cannot make the child talk properly unless it is supported by all other multidisciplinary stake holders.

3. Infections

Cleft palate and cleft lip children will face the possibility of introducing pathogenic organisms into the middle ear and are more likely to develop dental related infections as well as dental carries. Thus, they will need continuous attention on this department and at times might have to undergo surgical procedures to alleviate these problems.

4. Social interaction

Many parents will worry about the social status of their child with either cleft lip or palate. It is true that these children are more backwards in their interaction with other children as well as other instances requiring social presence. But, with enough caring and kindness, these children will be able to overcome these barriers and surgical means would make them relieved of their physical disfigurement. In rare instances, the parents may want their children to undergo psychological treatment in order to build up their self esteem or in order to treat depressive and social withdrawal symptoms.

Therefore, as discussed in this article, cleft lip and cleft palate are conditions that need multi disciplinary interventions and with good social support these children will be able to live an ordinary life as with all other children.