What you need to know about cleft palate

Learn about cleft lips and cleft palate and how it affects babies

Many thanks to the charity Smile Train for this helpful feature.

Every year, around 200,000 babies are born with a cleft lip and / or a cleft palate globally. This includes the UK; however, we rarely see children with untreated clefts because the NHS provides treatment, free, very soon after birth.  

Due to this quick and easy access to medical care, many people in the UK may be unfamiliar with clefts and the long-term impact that this can have on a child’s life – particularly if it’s left untreated.

To help people understand more about the condition, Dr Peter Mossey, an expert in craniofacial anomalies and a member of Smile Train’s Medical Advisory Board,  shares five key facts that everyone should know about clefts. 

A cleft lip is different from a cleft palate

Dr Peter Mossey says: “It’s common for the general population to assume that a cleft lip and a cleft palate are the same; however, they are not. In fact, a cleft lip occurs when the top lip does not join together properly during foetal development, whereas a cleft palate is a gap in the roof of the mouth (which is made up of both the hard and soft palate) that does not close together properly.”

The condition isn’t always diagnosed at birth

Dr Peter Mossey says: A cleft of the lip is often identified during a woman’s mid-pregnancy ultrasound scan, which is offered to women who are between 18 and 21 weeks of pregnancy. However, this is not guaranteed, as sometimes clefts, particularly of the palate, can be difficult to detect.

If a cleft isn’t identified at this stage, then it is likely that it will not be diagnosed until immediately after birth. This is common for mothers living in developing countries, because they do not have access to the medical equipment or resources that can detect the condition.”

Clefts are not just a cosmetic problem

Dr Peter Mossey says: “Many people mistakenly believe that clefts are primarily a cosmetic problem. What they don’t realise is that, if left untreated, clefts can lead to neonatal death or very serious health issues for babies and children – such as difficulties with eating, hearing, breathing and speaking.

For this reason, cleft surgery and additional comprehensive cleft care is vital for children so that they can go on to lead long, healthy and productive lives.”

Feeding can be difficult                                                                         

Dr Peter Mossey says: “One of the critical challenges faced by parents who have a baby born with a cleft is difficulties with feeding.

Most babies with clefts will have difficulty breastfeeding, because they will not have the ability to suckle or swallow sufficiently to breastfeed. Mothers must be guided as early as possible about different techniques and positions for breastfeeding their baby with a cleft.

Bottle feeding or even spoon feeding can be an alternative option, although like breastfeeding, parents may find that with bottle feeding their baby struggles to create the necessary suction required to pull milk from a bottle, or they may experience “nasal regurgitation” which is where the milk comes out of the baby’s nose during feeding.”

Treatment is transformational

Dr Peter Mossey says: “Babies born with a cleft lip are typically treated around 3-6 months after birth through surgery and babies born with a cleft palate are usually treated between 6 and 18 months of age through a procedure called ‘palatoplasy’. Palatoplasy involves connecting the muscles of the soft palate and the tissue (oral mucosa) of the hard palate to close the cleft, and can take 45 minutes or more to complete.

The world’s largest cleft organization, Smile Train, empowers local medical professionals with training, funding, and resources to provide free cleft surgery and comprehensive cleft care to children globally.

Through the “teach a man to fish” model, the charity advances a sustainable solution and scalable global health model for in country cleft treatment, drastically improving the survival rates for infants born with clefts in low to middle income countries and enhancing children’s lives, including their ability to eat, breathe, speak, hear and ultimately thrive.

In addition to cleft surgery, the charity has also developed Comprehensive Cleft Care programmes which include pre-surgery and post-surgery treatments related to nutrition, dental and orthodontic care, speech therapy, as well as social and emotional support to ensure the best possible rehabilitation for its patients.”

To discover more about the work of the charity Smile Train, which helps treat cleft lip and palate worldwide, visit their website.

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