No physical problems. Most infants with cleft lip only (the palate, or roof of the mouth is properly formed)have no physical problems. They can usually breast nurse, if mother wishes, or use a wide variety of stnadard commercial bottles and nipples. However, about 15% of cleft lip onlu children will ahve speech and/or hearing probles. Therefore they are followed by the cleft lip/palate team until 3-4 years of age.
Speech/hear/swallow. The issues other than cosmetic primarily relate to nutrition and swallowing adaptations, hearing impairment, and speech impediments. The is why a team of specialist are usually in the best interest of the child and include, speech therapist, audiologist, ent, plastic surgeon, maxilla facial surgeon, prosthedontist, nutritionist, etc.
Sort of. Cleft lip is a birth defect, and is always present at birth. It cannot develop later. Not all people are able to get their cleft lip repaired as babies, and so we often repair cleft lips at whatever age the patient comes in. This is commonly done even in adults in developing nations.
Often times. Taping or other devices are often used in babies with cleft lip (especially bilateral) to slowly bring the defect edges closer together and decrease the size of the gap that needs to be repaired.
Some do this. Some surgeons do taping prior to surgery, but most do not. There are other, more effective ways to bring the edges closer together prior to surgery if that is necessary.
May be. In experimental rats it has been shown that folate (folic acid) deficiency causes increased incidence of clefting of the face. Some people tried to extrapolate in human and feels giving extra Folic Acid during preganancy reduces the chance of having babies with cleft. But this has not been proven yet by clinical trial scientifically.
Not known. There are neural tube defects related to low folate (folic acid) levels during pregnancy but cleft lip and palate is principally felt to be related to environmental toxins and/ or genetic inheritance. Folic acid deficiency is still being investigated as a possible cause.
What recovery problems are to be expected from a cleft lip and palate surgery for a one-year old? We have adopted a one-year old child, that has a cleft lip and palate. What difficulties could be encountered during recovery? Will her breathing be affected
Cleft. Cleft lip and palate treatment consists of multiple staged operations that will occur over the life of your child as he/she reaches different developmental landmarks. Most typically, the cleft lip is repaired first and allowed to heal before proceeding to repair of the cleft palate. Because your child is older than the typical ages of repair of the cleft lip (3 months old) and palate (8-10 months old), some surgeons may decide to do more than one procedure in a single stage. This will depend on the experience and preferences of your surgeon, as well as considerations of your child's general health. Because repair of cleft lip and palate is an involved process involving multiple stages over the lifetime of your child, my strongest recommendation is to connect with an experienced craniofacial surgical center with an integrated, team approach. Excellent outcomes can be achieved when a child has integrated care from plastic surgeons, otolaryngologists, speech therapists, orthodontists, dentists, and social services coordinators. My own craniofacial surgery training was at stanford university, and I can personally recommend the stanford/ lucille packard cleft and craniofacial team to you as an excellent team. There are also other centers near you which have very good craniofacial programs. Please arrange to have your child evaluated by an experienced craniofacial team in order to get the best answers to your questions. All the best to you, dr. Skourtis.
Visit with a surgeon. The best answers can be obtained from the office of the surgeon who performs these surgeries. They can help you to anticipate what life would be like following surgery. They also understand the severity of this condition in your child.