Medical: Cheilo-Gnatho-Palatoschisis,
Symptoms
In the case of cleft lip and palate, one does not speak directly of the symptoms that occur in the patient. Rather, they are various effects or functional disorders that are caused by the disease. These disorders mainly affect the nose, ears and the speech organ.
Breathing difficulties often occur because the nostrils may be flattened or the nasal septum may be curved. The intake of food is difficult because sucking does not work properly. However, drinking plates can be made for the youngest children a few days after birth to circumvent this problem.
Many children also find it difficult to speak, with the pronunciation of rubbing and closing sounds and vowels being altered. One last important point is the problem of middle ear ventilation. A cleft palate can alter this, which can lead to permanent otitis media or reduced hearing.
This can be prevented by inserting a tube. If the upper jaw is affected by the cleft, malpositioned teeth are possible. Sometimes some teeth are not even attached at all due to the gap. At an advanced age, operations are often necessary to connect the parts of the face that have not grown together. Often the psyche also suffers from this.
Problems with breastfeeding
Since a cleft lip and palate is equivalent to a connection between mouth and nose, problems of food intake and absorbency arise. It is important to know that the feeding of newborns with cleft lip and palate always takes up to 30 minutes longer than in children without cleft lip and palate, regardless of whether they are fed with a bottle or breastfed. If sucking using a custom-made drinking plate, which separates the two rooms and thus in many cases makes feeding easier, is not possible, other aids must be used.
In this case, an attempt is made to feed the baby with the help of a syringe while it is attached to the breast. The milk can be pumped out in advance with a pump. Another variant is to put a finger in the baby’s mouth and simultaneously inject milk with a syringe.
This variant is called finger feeding. There are also extended bottles for feeding when breastfeeding does not work. These so-called Habermann teats have a longer mouthpiece, which should make the swallowing easier.
Also “SpecialNeeds teats” are helpful, which have been developed especially for children who cannot exercise the sucking reflex due to diseases and genetic defects. With a return valve no air can enter the bottle and with a slit valve you can regulate how much milk enters the mouth of the child. For example, an isolated cleft lip can be easily covered with a finger so that the baby can suck on the breast.
Of course, many operations are also scheduled in the first weeks and months so that all disorders are corrected as quickly as possible. In most cases, however, these aids are not necessary and the drinking plate is sufficient for proper sucking. If you have any questions, it is advisable to consult with the treating physicians, orthodontists and midwives.
In order to improve food intake, the child must be helped as early as possible. A few days after the birth, a drinking plate can be made individually. It is inserted into the gap and thus separates the nasal cavity from the mouth and throat.
This spatial separation enables the child to swallow better and it gets used to the feeling of normal anatomical conditions. The drinking plate has recesses in places to allow the tissue to grow further. By the age of 3 years at the latest, the cleft lip and palate should be closed by surgery.
As a first measure, the cleft on the palate can be closed with a palatal plate. However, several operations are necessary to completely restore normal anatomical conditions. These eliminate both the functional and the aesthetic defects.
Early surgery is indicated by a rapid normalization of the esthetics and complete restoration of function. Minimizing the risk of the operation and the growth inhibition caused by the operation speak for a late date. It is usually said that the baby is ready for surgery when it weighs 10 pounds and is 10 weeks old.
After about 6 months, the first thing to be operated on is the lip, jaw and nasal entrance.With almost one year hard and soft palates are closed. Further operations are performed at an advanced age. Especially linguistic difficulties can be eliminated by surgical measures.
Positional anomalies of the teeth must be eliminated by orthodontic measures. The susceptibility to caries is increased in these children; they therefore require careful oral hygiene. If speech disorders are present, logopaedic speech exercises are indicated.
