Soother for a cleft lip and palate
In the case of a cleft lip and palate, the first operation takes place quite early. A pacifier must not be used immediately after the operation, as there is a risk that the suture may burst open due to the sucking. Otherwise, pacifiers are allowed, but it is not easy to find the right pacifier. The simple ones often just fall out of the mouth through the crevice. Cherry-shaped soothers with a longer handle are recommended, but in general you should simply look to see which soother fits the child’s individual situation and which one the child accepts.
Bilateral cleft lip and palate
Bilateral cleft lip-jaw palate is the most severe form of the defect, in which patients have two isolated clefts to the right and left of the middle of the lip, which meet again in the soft palate. This variant of cleft formation was formerly known as “cleft palate”. In several operations performed by oral and maxillofacial surgery combined with an ear, nose and throat specialist, orthodontics and speech therapy, the clefts are closed and an attempt is made to restore the defect.
The two primary operations are lip closure and palate closure. During the course of growth, the patient may also undergo cleft-jaw osteoplasty, rhinoplasty and oral surgery. Therefore, each case is individually different and is planned differently, depending on whether a cleft is complete, incomplete or isolated. The more pronounced the shape of the cleft, the longer the treatment path. In the case of a double-sided cleft lip-jaw-palate-palate, the greatest amount of therapy is necessary.
Diagnostics
The first signs of a cleft lip and palate can already be seen in ultrasound. Especially modern ultrasound devices have very high accuracy. An experienced practitioner can detect a cleft from as early as the 14th week of pregnancy, provided that the child is in a favourable position during the ultrasound examination.
The suspicion is also immediately communicated to the expectant parents so that they can be informed about treatment options as soon as possible. The gynaecologist and obstetrician do this even before the birth. Sometimes, however, the cleft is only recognized after birth.
This happens especially in the case of very little pronounced or internal clefts. A fine diagnostic examination must be paid privately by the parents, it costs between 200€ and 400€. A referral from the gynaecologist for the health insurance to cover the costs can only be made in special cases – for example, if there is already a case of cleft lip and palate in the family.
In families with multiple occurrences in the family tree, there is an increased risk that the unborn child also has this defect. Prenatal ultrasound diagnostics, however, only allows us to see the cleft lip, but for cleft lip and palate, the inside of the mouth of the fetus would have to be inspected, which is not possible before birth. If the cleft is discovered early during pregnancy, other organ systems should be scanned in detail.
The risk of further malformation is about 30%. The basic risk of a child suffering from a cleft lip and palate is about 0.2%, i.e. 1 child in 500 is born with this condition. This malformation is more common in families in which a cleft lip and palate has already occurred.
If one parent is one of the victims, the risk for the first child is about 3%, for the second even 15-17%. If both parents are affected, in about 35% of the cases one can expect that the children will also fall ill. If the disease occurs for the first time in the family with the child, the risk increases to about 4-6% that another baby will be born with this disease.
If two babies are born like this, the risk increases even more. According to several studies, clefts are more common among aboriginal people in Australia or America, with Europe in the middle of the field.In Africa, the cleft lip and palate is the least common. The exact course of the inheritance is not yet clear at this stage of research.
The frequency of occurrence of a type of cleft lip and palate is 1:500, but with the exception of van der Woude syndrome, it is not an isolated genetic defect. It is an interplay of multifactorial environmental influences, but further research is still being conducted, as in some cases it is still not understood why this malposition occurs. Cleft lip occurs during development in the 5th-8th embryonic week, cleft palate and jaw during the 7th-9th embryonic week.
Therefore, the risk of cleft lip and palate is increased by external use of drugs and medicines in the first trimester (1st-3rd month of pregnancy). These include primarily smoking and dioxins, which are still considered carcinogenic and are hidden in many foods. In addition, benzodiazepines, which are commonly known as sedatives or sleeping pills, are considered a possible factor in cleft lip and palate.
These include valium, diazepam or oxazepam, which are commonly used to help people to rest. Other factors include mental illness of the expectant mother and chronic hunger such as eating disorders. According to the latest research, a rubella disease in the first trimester of the mother is also considered a cause of cleft lip, jaw and palate.
