Question

my patient is a 10-month-old boy with cleft palate and cleft lip. The chart states the uvula and soft palate structures are affected, and the defect may extend into the hard palate. The child is fussy a lot of the time and appears malnourished.

Question: how do i explain to this mother the reason surgery is needed for this child’s well-being. 

Answer 1

Ans) The treatment for your child’s cleft palate or lip will depend on the severity of the condition. Treatment often involves several
surgeries to close the opening and reconstruct the face. A team of specialists may work with you and your child. For example, if your child has problems with speech because of their cleft, they might work with a speech pathologist. Your child’s team may also
include a plastic surgeon, an oral surgeon, and/or an orthodontist.
Surgery:
Surgery to repair a cleft palate or lip is ideally performed in your child’s first year. However, additional reconstructive surgeries may be required well into your child’s teenage years.

Cleft Lip
It’s recommended that you get your baby’s cleft lip repaired when they’re between 10 weeks and 1 year old. If your child has a particularly wide cleft, your child’s doctor may want to do a lip
adhesion that involves sewing the cleft together temporarily until a surgeon performs the repair. During surgery, your child will be put under anesthesia and a surgeon will use tissue and skin from both sides of the cleft lip to make the lip wider and close the gap.
Cleft Palate
Doctors usually perform surgery to repair a cleft palate when a child is between 6 and 18 months old. During surgery, the muscles and tissue on the two sides of the palate are connected together to close the cleft.
COPING WITH YOUR CHILD’S BIRTH DEFECT
Ask your child’s treatment team about support groups in your area for families of children with birth defects. Communicate openly with your child and help to build their self-esteem by
letting them know that they are not defined by their defect.
PROBLEMS RELATED TO CLEFT LIP AND PALATE
Cleft lips and cleft palates can sometimes cause a number of issues, particularly in the first few months, before surgery is carried
out.
Problems that can occur include: • difficulty feeding – babies with a cleft palate may be unable to breastfeed or feed from a normal bottle because they can’t form a good seal with their mouth • hearing problems – some babies with a cleft lip are more vulnerable to ear infections and a build-up of fluid in their
ears (glue ear), which may affect their hearing • dental problems – a cleft lip and palate can mean a child’steeth don’t develop correctly and they may be at a higher risk of tooth decay • speech problems – if a cleft palate isn’t repaired, it can lead to speech problems such as unclear or nasal-sounding speech when a child is older.
Most of these problems will improve after surgery and with treatments such as speech and language therapy.