Medical facts and stuff.

A cleft is an opening in the body. They can occur anywhere, but they are more common in the face. When your baby was about 5 weeks in gestation, lip and palate formation was taking place. All fetuses at this point have cleft lips and palates, but then the bones and tissues are supposed to fuse normally. It's not completely certain why some babies clefts don't fuse properly, but a combination of genetics and environmental factors are thought to be the cause. Asian and Native American children are more likely to have this condition, more boys than girls will have a bilateral cleft lip and/or palate, more girls than boys will have cleft palate alone. Women who smoke or take medications in the first trimester are more likely to have babies with clefts than those that don't, and being obese increases your chance of having a child with a cleft by 20%. Clefts are also associated with certain medical conditions, but some are just isolated cases. The condition can be diagnosed during pregnancy through an ultrasound.

And then there are those that just happen, with none of those risk factors at all. Just know that this was probably not something you did, or something you could have prevented. It happens, and doctors are not sure why.

Clefts are treated with surgery and sometimes with special non surgical procedures, such as molding plates and tape. (I'll got more in depth about that in a later entry.) Children with this condition often have trouble feeding. If a child has an isolated cleft lip, breast tissue can fill in the gap and breastfeeding might be able to be achieved. Nursing with a cleft palate is problematic at best, more likely impossible without pumping. The reason is that in order to make proper suction, the baby has to seal off the passage to the nose with his/her soft palate. If that is compromised, adequate suction is not being made. There are special bottles that can be used by babies with cleft palates. I've used the Special Needs feeder, Pigeon bottle, as well as a few other types of bottles.

Surgery is usually performed between 3-6 months of age to repair the lip, 9-18 months to repair the palate, and later in life, more surgeries to correct jaw and tooth trouble. I recommend finding a multi-disciplined craniofacial team that is used to treating children with this condition. It's made a world of difference with my son.