What is a cleft lip and palate?
A cleft is a gap or split in the upper lip and/or roof of the mouth (palate). Cleft lip and cleft palate result when facial structures that are developing in an unborn baby don't close completely.
What does a cleft lip and palate look like?
Babies can be born with a cleft lip, a cleft palate, or both. Cleft lip and cleft palate may appear as:
- A split in the lip and roof of the mouth (palate) that can affect one or both sides of the face.
- A split in the lip that can appear as only a small notch in the lip or can extend from the lip through the upper gum and palate into the bottom of the nose.
- A split in the roof of the mouth that doesn't affect the appearance of the face.
- Sometimes it can be hidden by the lining of the roof of the mouth.
What are the causes of cleft lip and palate?
Several factors may increase the likelihood of a baby developing a cleft lip and palate, including:
- Family history. Parents with a family history of cleft lip or cleft palate face a higher risk of having a baby with a cleft.
- Sex. Males are twice as likely to have a cleft lip with or without cleft palate. Cleft palate without cleft lip is more common in females.
- Exposure to certain substances during pregnancy. Cleft lip and cleft palate may be more likely to occur in pregnant women who smoke cigarettes, take certain medications(such as some anti-seizure medications and steroid tablets).
- Having diabetes. There is some evidence that women diagnosed with diabetes before pregnancy may have an increased risk of having a baby with a cleft lip with or without a cleft palate.
- Being obese during pregnancy. There is some evidence that babies born to obese women may have increased risk of cleft lip and palate.
- Lack of folic acid during pregnancy.
- Genetic syndrome that includes a cleft lip or cleft palate as one of its signs. Such as 22q11 deletion syndrome (sometimes known as DiGeorge or velocardiofacial syndrome) and Pierre Robin sequence.
What are the complications of cleft lip and palate?
Cleft lip and palate can sometimes cause a number of issues, particularly in the first few months, before surgery is carried out.
- Difficulty feeding. One of the most immediate concerns after birth is feeding. While most babies with cleft lip can breast-feed ,cleft palate may be unable to breastfeed or feed from a normal bottle because they can't form a good seal with their mouth.
- Ear infections and hearing loss. Babies with cleft palate are especially at risk of developing middle ear fluid and hearing loss.
- Dental problems. If the cleft extends through the upper gum, tooth development may be affected.
- Speech difficulties. Because the palate is used in forming sounds, the development of normal speech can be affected by a cleft palate. Speech may sound too nasal.
- Challenges of coping with a medical condition. Children with clefts may face social, emotional and behavioral problems due to differences in appearance and the stress of intensive medical care.
Most of these problems will improve after surgery and with treatments such as speech and language therapy.
How is cleft lip and palate diagnosed?
Cleft lips are usually picked up during the mid-pregnancy anomaly scan carried out when you're between 18 and 21 weeks pregnant. Not all cleft lips will be obvious on this scan and it's very difficult to detect a cleft palate on a routine ultrasound scan.If a cleft lip or palate doesn't show up on the scan, it's normally picked up immediately after birth or during the newborn physical examination done within 72 hours of giving birth.
How can I treat cleft lip and palate?
Your child will usually have a long-term care plan that outlines the treatments and assessments they're likely to need as they grow up.The main treatments are:
- Surgery – surgery to correct a cleft lip is usually carried out at 3-6 months and an operation to repair a cleft palate is usually performed at 6-12 months.
- Feeding support – you may need advice about positioning your baby on your breast to help them feed, or you might need to feed them using a specially-designed bottle.
- Monitoring hearing – babies born with cleft palates have a higher chance of glue ear, which may affect hearing; close monitoring of their hearing is important and if glue ear affects their hearing significantly, a hearing aid may be fitted or small tubes called grommets may be placed in their ears to drain the fluid.
- Speech and language therapy – if your baby is born with a cleft affecting their palate (cleft palate or cleft lip and palate) a speech and language therapist will monitor your child's speech and language development throughout their childhood; they will help with any speech and language problems as necessary.
- Good dental hygiene and orthodontic treatment – you'll be given advice about looking after your child's teeth, and braces may be needed if their adult teeth don't come through properly.
Coping and support
No one expects to have a baby with a birth defect. When the excitement of new life is met with the stress of discovering that your baby has a cleft lip or cleft palate, the experience can be emotionally demanding for the entire family.
- For parents and family
When welcoming a baby with cleft lip and cleft palate into your family, keep these coping tips in mind:
- Don't blame yourself. Focus your energy on supporting and helping your child.
- Acknowledge your emotions. It's completely normal to feel sad, overwhelmed and upset.
- Find support. Your hospital social worker can help you find community and financial resources and education.
- For your child
You can support your child in many ways:
- Focus on your child as a person, not on the cleft.
- Point out positive qualities in others that don't involve physical appearance.
- Help your child gain confidence by allowing him or her to make decisions.
- Encourage confident body language, such as smiling and holding the head up with shoulders back.
- Keep the lines of communication open. If teasing or self-esteem issues arise at school, this can help your child feel safe in talking with you about it.
Does my Insurance Policy cover cleft lip and palate?
NO. According to CCHI unified Policy terms and conditions, health insurance policies in Saudi Arabia doesn’t cover the treatment of cleft lip and palate, except hearing aids, small tube and dental hygiene.Please Click Here to access the Unified CCHI Policy Wordings.
References:"Cleft Lip and Palate." Cleft Lip and Palate. N.p., 29 July 2016. Web. 25 Sept. 2016.
"Cleft Lip and Palate." Cleft Lip and Cleft Palate. N.p., 17 June 2016. Web. 25 Sept. 2016.
"cleft lip and palate" Rules. N.p., n.d. Web. Aug. 2016.