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Complications
By Mayo Clinic staffChildren with cleft lip with or without cleft palate face a variety of challenges, depending on the type and severity of the cleft.
- Feeding difficulties. One of the most immediate concerns after birth is feeding. While most babies with cleft lip can breast-feed, a cleft palate can make sucking difficult or cause gagging or nasal regurgitation. Your health care team will discuss feeding strategies with you, such as using a special bottle nipple or a small artificial palate (obturator) that fits into the roof of the mouth.
- Ear infections and hearing loss. Babies with cleft palate are especially susceptible to middle ear infections. Over time, repeated ear infections can damage hearing, but hearing loss may resolve with treatment. It's important for children with cleft palate to be evaluated regularly by an audiologist or an ear, nose and throat doctor. Most children with clefts have tubes inserted in their ears to drain fluids and help prevent infections.
- Dental problems. If the cleft extends through the upper gum, tooth development will likely be affected. A pediatric dentist should monitor tooth development and oral health from an early age.
- Speech difficulties. Because both the lip and palate are used in forming sounds, the development of normal speech can be affected. A speech pathologist can evaluate your child and provide speech therapy.
- Psychological challenges. Children with clefts may face social, emotional and behavioral problems due to differences in appearance and the stress of intensive medical care. A psychologist and a social worker can help you and your child deal with the stresses your family encounters.
References
- Cleft lip and cleft palate. March of Dimes. http://www.marchofdimes.com/printableArticles/14332_1210.asp. Accessed April 5, 2009.
- Moreau JL, et al. Tissue engineering solutions for cleft palates. Journal of Oral and Maxillofacial Surgery. 2007;65:2503.
- Cleft lip and palate repair. American Society of Plastic Surgeons. www1.plasticsurgery.org/ebusiness4/ProductCatalog/pdf/brochures/Cleft_Lip.pdf. Accessed April 5, 2010.
- Mossey PA, et al. Cleft lip and palate. The Lancet. 2009;374:1773.
- Hoffman WY. Cleft Lip & Palate. In: Lalwani AK. Current Diagnosis & Treatment in Otolaryngology — Head & Neck Surgery. 2nd ed. New York, N.Y.: McGraw-Hill; 2008. http://www.accessmedicine.com/content.aspx?aID=2826340&searchStr=cleft+lip#2826340. Accessed April 5, 2010.
- Craniofacial abnormalities. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/print/see19/ch288/ch288d.html. Accessed April 5, 2010.
- Burns JL. Plastic surgery (cleft lip and palate). In: Townsend CM Jr, et al. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa.: Saunders Elsevier; 2008. http://www.mdconsult.com/das/book/body/1932697333/978681486/1565/708.html#4-u1.0-B978-1-4160-3675-3..50077-0--cesec9_4303. Accessed April 5, 2010.
- Wilkins-Haug L. Prenatal diagnosis of orofacial clefts. http://www.uptodate.com/home/index.html. Accessed April 5, 2010.
- Stothard KJ, et al. Maternal overweight and obesity and the risk of congenital anomalies: A systematic review and meta-analysis. JAMA. 2009;301:636.
- The school years: An introduction to psychology. Cleft Lip & Palate Association. http://www.clapa.com/news/article/901/. Accessed April 9, 2010.
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