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irth defects are on the whole rare and very minor, but they are nonetheless heartbreaking for new parents expecting a perfect baby. One of the most common congenital conditions is cleft lip and palate, affecting one in every 700 Australian babies. Clefts occur very early in a pregnancy, at about six to eight weeks. At this time the usual fusing, or joining up of tissues of the lip and/or palate does not occur, leaving an opening called a cleft. It can occur in the lip or the palate (soft or hard palates), or both the lip and palate together.
One in 700 babies will be born with a cleft – but it can be successfully treated, reports Shannon du Plessis
A cleft lip is sometimes called a “hare lip” which is a term derived in medieval times. It was believed a mother gave birth to a baby with a cleft lip because a hare had jumped across her path. Some cases are believed to be caused by a genetic link but most children have no family history of clefts, which means the cause is usually unknown. Some clefts are detected during a routine ultrasound in pregnancy but some are not detected, which can be due to the position of the baby, lack of amniotic fluid, or time of gestation. A diagnosis during pregnancy means you can prepare yourself emotionally and practically for the arrival of your baby. Clefts not detected by ultrasound are usually detected at or soon after birth. The good news is clefts can be treated. Most specialist appointments, surgery and hospital stays are covered by Medicare, which has a Cleft Lip and Palate Scheme. Cleft-affected children receive free dental and orthodontic work until
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22 years of age. Treatment includes surgically closing the baby’s lip by three to four months of age, and the palate between six to nine months. The surgeon and specialists such as a dentist, orthodontist, speech pathologist and ear/nose/ throat specialist will see the child regularly as they grow. Each cleft is individual and each child’s needs are different. After the initial surgery to repair the lip and/or palate, on-going check-ups continue for several years where further treatment may be considered. One of the first things mothers ask, is can they still breastfeed their baby. The answer is yes, but only once you have established a suitable position and the baby is latching on correctly. A cleft palate interferes with normal sucking and that means breastfeeding may need to be supplemented with either expressed milk or formula by another method such as a cup, specially designed bottle or supply line. After surgical repair, it is possible to achieve full breastfeeding. Children with clefts can lead normal lives if they are brought up with healthy self-esteem to cope with the outside world. It’s important to encourage a high standard of dental care, keep specialist appointments and encourage your child to communicate with others. A cleft diagnosis can leave parents shocked, confused, angry, often feeling guilt or blame, as well as uncertainty. All of these feelings are normal and CleftPALS – a national organisation of parents and professionals involved in treating clefts – can provide support. Check out: http:// homepage.powerup.com.au/~cleftpal/ www.pakmag.com.au
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