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Cleft FAQ's
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- What is a cleft lip?
- What is a cleft palate?
- What causes clefting of the lip and/or palate?
- How many babies are born with cleft lip and/or
palate?
- How early can cleft lip and palate be detected?
- When do the doctors at Johns Hopkins examine babies
for cleft abnormalities?
- What can surgery do for clefting of lips and palates?
- What is the surgery for cleft lip and when does
it happen?
- What is the surgery for cleft palate and when does
it happen?
- Will my child require additional surgery at a
later time in his or her life?
- What is the molding device and how does it work?
- What do the parents have to do with the molding
device?
- Does a cleft palate affect a baby's eating?
- What is different about the feeding bottle for
babies with cleft palates?
- What is a cleft lip?
A cleft lip is a separation of the middle (central) portion of
the upper lip. It occurs during the first trimester of pregnancy
when upper lip tissue fails to completely fuse. The separation
can also include the bone of the upper gum and/or the upper jaw.
The nose can also be affected. The cleft lip can be unilateral
(one sided) or bilateral (two sided).
A cleft lip can also be incomplete (stopping just below the nose)
or complete (extending through the nostril of the nose).
Reprinted
from Cleft Lip and Palate:
The First Four Years with permission of the Cleft Palate Foundation.
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- What is a cleft palate?
A cleft palate is a hole in the roof of the mouth (the palate)
that can involve the hard palate and/or the soft palate. It can
be unilateral (one sided) or bilateral (two sided). It occurs
during the first trimester of pregnancy when parts of the palate
fail to completely fuse.
Reprinted
from Cleft Lip and Palate:
The First Four Years with permission of the Cleft Palate Foundation.
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- What causes clefting of the lip and/or
palate?
The exact causes are not known, but experts agree that it can
be due to either genetic or environmental factors or a combination
of these. These abnormalities occur during the first trimester
of pregnancy.
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- How many babies are born with cleft
lip and/or palate?
About one in 1,000 babies are born with cleft lip and/or palate.
This is the fourth most common birth abnormality.
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- How early can cleft lip and palate be
detected?
In some cases, cleft lips and palates can be detected from routine
ultrasounds of the baby in the mother's womb. When this happens,
we encourage the parents to come in and see us so we can discuss
potential treatment for the baby. However, many cleft lips and
palates are not detected until birth.
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- When do the doctors at Johns Hopkins
examine babies for cleft abnormalities?
We like to meet the baby and his or her parents shortly after
birth. We will examine your child and discuss a treatment plan,
including feeding and potential surgery.
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- What can surgery do for clefting of
lips and palates?
The goal of surgery is to close the cleft lip and/or palate. This
helps restore normal eating and drinking and enhances the development
of normal speech. Surgery can also restore normal appearance to
the upper lip.
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- What is the surgery for cleft lip and
when does it happen?
Some children benefit from molding devices, which can be used
to lessen or decrease the size of the cleft lip or palate. Other
children benefit from a procedure called a cleft lip adhesion,
which is performed at two to three months of age. This is an interim
lip repair that brings the lip gently together to help decrease
the size of the cleft. Two or three months later, we perform the
final lip repair. We do these surgeries in two stages to minimize
scarring and help reduce the risk of the lip breaking open.
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- What is the surgery for cleft palate
and when does it happen?
Surgery for cleft palate occurs approximately between nine and
twelve months of age. The goal of the surgery is to realign the
muscles that are needed for speech and to close the hole in the
roof of the mouth.
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- Will my child require additional surgery
at a later time in his or her life?
Some children with cleft lips may need additional surgeries as
they grow. Each child's developmental situation is different so
we approach treatment on an individual basis. Sometimes, as children
age, scars may thicken and a revision may be necessary. As the
child's nose grows, further nasal surgery may be needed.
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- What is the molding device and how
does it work?
If the baby has a wide cleft, our pediatric dentist can fit the
baby with a special molding device that can help close the gap
between the lip and the palate. The molding device is an acrylic
plate that fits inside the baby's mouth. It is secured with small
rubber bands, which are taped to the baby's cheek. The baby may
need to wear this for the first few months. An extension may be
placed on the device to help mold the nose. The pediatric dentist
will see your child on a weekly basis to make adjustments to the
device.
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- What do the parents have to do with
the molding device?
There are several types of feeding bottles for babies with cleft
palates. Most of the bottles have a larger opening, which makes
it easier for the baby to feed. Using this method, any member
of the family can usually feed the baby.
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- Does a cleft palate affect
a baby's eating?
Children that have cleft palates have some difficulty
feeding right after birth. We use special nipples on bottles and
have a feeding specialist who works with parents. Almost all of
the children have few, if any, difficulties feeding after the
first week. Breast feeding is possible for some children with
cleft palates but it may be difficult.
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- What is different about the
feeding bottle for babies with cleft palates?
There are several types of feeding bottles for babies
with cleft palates. Most of the bottles have a larger opening,
which makes it easier for the baby to feed. Using this method,
any member of the family can usually feed the baby.
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