Sometimes when you look at a newborn baby, you can see a small difference in the roof of their mouth. It means a small crack in the roof of their mouth. This is what we medically call `(Cleft Palate)`. Upon hearing these words, some parents may be a little scared and worried. "Oh, what has happened to our child?" You may think. But, there is really no reason to be scared or worried. If we are properly aware of this, we can cope with this condition successfully.
What is Cleft Palate?
Simply put, the English word 'cleft' means a crack or a gap. 'Palate' refers to the part of the roof of our mouth, the roof of our mouth. If you run your tongue over the roof of our mouth, you'll feel a small seam or knot in the middle, right? That's where, when you were a baby in your mother's womb, the right and left sides of the roof of your mouth were joined together. It's like sewing two pieces of clothing together.
However, when some babies are born, these two parts of the upper palate do not come together exactly. That is, the seam is not complete. That is when this condition called `(Cleft Palate)` occurs, that is, a crack in the upper palate. This is a congenital condition . That means it is something that the baby is born with.
Why does a cleft palate occur?
Parents often wonder, "Why did this happen to our baby?" "Did we do something wrong?" In fact, it's hard to pinpoint just one reason. There are several possible reasons. Let's take a look at what they are:
- Genetic factors: Sometimes, if someone in the family, that is, the mother, father, or someone in their family, has had this condition before, there is a small chance that the baby will also develop this condition. That means there is an influence from genes.
- Some environmental and other factors that affect the mother during pregnancy:
- Certain medications taken by the mother during pregnancy (especially those taken without medical advice, at will). For example, some medications given for epilepsy can have an effect.
- If the mother smokes or uses alcohol during pregnancy, these things directly affect the development of the fetus.
- During pregnancy, the mother may not get enough of the nutrients she needs, such as folic acid . Doctors often recommend folic acid pills to pregnant women to help prevent these conditions.
- Some viral infections that the mother may develop during pregnancy.
- If the mother has uncontrolled medical conditions such as Diabetes Mellitus .
- If the mother is obese.
But most of the time, a cleft palate can occur without any apparent reason. That is, there may be no obvious cause. So never feel bad about it thinking it's your fault. It can happen to anyone.
Are there types of cleft palate?
Yes, these cracks in the upper eyelid can be of different shapes and sizes. To be precise, there are slight differences depending on the size of the crack and its location.
- Some babies may only have a cleft on the top of their head .
- Some babies may also have a cleft lip and a cleft palate . This means that there is a cleft in both the lip and the upper palate. It may be just the cleft lip or just the upper palate.
- The cleft can be complete , meaning the cleft can extend from the bottom of the nose all the way to the back of the upper palate.
- Or it can be an incomplete cleft , meaning that the cleft is only in a small part of the upper palate.
- Another special type is the submucous cleft palate . In this case, the cleft is not visible from the outside. Although the skin (mucous membrane) over the upper palate is well closed, the muscles underneath it have not joined properly. This is sometimes recognized a little later, when the baby starts talking, as a change in the voice.
What problems can a baby have due to a cleft palate?
A cleft palate can cause a few minor problems for your baby. Let's take a look at what they are. Knowing these things is very important to help your baby.
- Feeding difficulties:
This is the main problem that is seen first. Imagine, when the baby sucks milk, the milk can go into the nose because of this gap between the mouth and the nose. Then the baby has difficulty sucking milk properly, it may be difficult to breathe while sucking milk, the milk can come out of the nose, and the milk can often go back to the throat. Because of this, the baby may not get enough nutrition and may not gain weight. For this, doctors advise using special feeding methods, sometimes specialized nipples/bottles.
- Speech problems:
As your baby gets older and starts talking, there may be a difference in their voice. Due to the cleft palate, it is difficult to control the amount of air that comes out of the nose when speaking. As a result, the voice may sound like it is being spoken through the nose (hypernasal speech / nasal voice) . Some letters, especially letters like 'প', 'ব', 'ত', 'দ', 'ক', 'গ', may also be difficult to pronounce correctly.
- Ear infections and hearing problems:
There is a small tube between our upper ear and the middle ear, called the Eustachian tube . This tube regulates the pressure inside the ear and drains the fluid in the middle ear. When there is a crack in the upper ear, the function of this Eustachian tube can be disrupted. Then, fluid accumulates in the middle ear, causing frequent ear infections (middle ear infections / otitis media) , and therefore, hearing loss. If this continues, it can also affect the baby's speech development.
- Dental problems:
Depending on the location of the cleft palate, minor problems may occur when teeth come in. Teeth may be pulled out, some teeth may be missing, teeth may come in late, or extra teeth may need to be inserted . Therefore, the advice of a dentist (`(Dentist)` or `(Orthodontist)`) is always necessary.
How is this cleft palate diagnosed?
Most of the time, this cleft is discovered when doctors examine the inside of the baby's mouth in the hospital right after the baby is born. That's the most common way.
Sometimes, prenatal ultrasound scans performed during pregnancy can provide clues to the presence of this condition, especially if a cleft lip and palate are present. However, if there is only a cleft palate, that is, without a cleft lip, it may be difficult to identify it on the scan.
The submucous cleft palate I mentioned earlier is sometimes only recognized when the baby is a little older, for example when they start talking and have voice problems, or when they get frequent ear infections.
What are the treatments for this? Is it something to be afraid of?
First of all, this is a completely curable condition . So don't worry. With the advancement of modern medicine, there are very effective treatments for this baby.
The main treatment is to close the cleft with surgery . This is called palatoplasty . This operation involves joining the tissues on both sides of the palate and stitching the cleft together. This restores the structure of the palate.
When will the surgery be performed?
This surgery is usually performed between the ages of 6 and 18 months . However, the doctor will determine the best time based on the baby's health, developmental stage, and weight. Sometimes it can be done earlier or later.
What are the goals of the surgery?
- Making it easier to eat and drink by eliminating the connection between the mouth and nose.
- It helps to keep the muscles of the upper jaw functioning properly and speak clearly when speaking .
- Restores the function of the Eustachian tube and reduces the occurrence of ear infections .
The treating medical team
When treating a baby like this, not just one doctor, but a team of specialists (a ``Multidisciplinary Team'') works together. This team usually includes the following people:
- Plastic and Reconstructive Surgeons : They perform the main surgery.
- Ear, Nose and Throat Specialists (ENT Surgeons) : They treat ear-related problems and perform hearing tests.
- Speech and Language Therapists : They treat and advise on speech difficulties.
- Orthodontists and Pediatric Dentists : They look after dental problems and jaw development.
- Pediatricians : Focus on the overall health of the baby.
- Perhaps psychiatrists and social workers could join this team to provide the parents with the psychological support they need.
All of these people work together to create and implement the best treatment plan for the baby.
What happens after the operation? What is the long-term care like?
Even after the operation is successful, the baby will need special attention and follow-up for some time.
- Speech Therapy (`(Speech Therapy)`):
Some babies may have some difficulty speaking even after the operation. In such cases, the help of a speech therapist is essential. They are the ones who teach the baby to pronounce words correctly, speak clearly, and use the muscles of the upper jaw properly. This may take some time.
- Dental and Orthodontic Care:
When teeth come in, special attention should be paid to the position of the teeth. Therefore, it is always a good idea to visit a dentist and get advice. If there are any gaps in the teeth, things like orthodontic treatment / braces may be done when the baby is a little older.
- Hearing Care (`(Hearing Checks)`):
Because ear infections are more likely to occur, it is important to have your hearing checked regularly. If you have any problems, you can seek treatment immediately. Your ENT doctor may also decide to insert small tubes (grommets / ventilation tubes) into your ear.
- Will more surgeries be needed?
Sometimes, one surgery may not fix everything. As the baby grows, depending on the way he speaks and the development of his jaw, he may need one or two more minor surgeries. For example, surgeries to make his speech clearer, or surgeries to correct the position of his jaw. This is decided by the treating medical team.
Remember, this condition will not hinder the baby's future in any way. They have the full potential to go to school, play, learn, make friends, and grow up to have a job they love, get married, and live a successful life just like other children!
How this affects parents psychologically and support
It's normal for parents to feel sad, worried, scared, and perhaps even guilty when they learn that their baby has this condition. Questions like "Why did this happen to us?" "Did we do something wrong?" may come to mind.
Know that you are not alone at this time. Talk openly with your doctors and nurses about this. They will provide you with the medical information you need as well as emotional support. Share with them all your questions and fears.
Also, if there are other parents who have faced similar situations, it can be a great encouragement to share their experiences. Some hospitals even have support groups for parents like this. If you can join one, it would be very valuable.
The most important thing is to think positively and give your baby the love, care, and encouragement he needs . Your strength is his greatest strength.
So, what are the most important things we need to remember from all of this?
Okay, here are some things to keep in mind from what we've talked about:
- Cleft Palate is a split in the roof of a baby's mouth. This is a congenital condition, meaning it is present at birth.
- This can be due to one or more reasons, but most of the time it is difficult to find a clear cause. This is not something that is due to the parents' fault.
- This may cause the baby to have difficulty eating, speaking, and hearing.
- Surgery can largely cure this condition. The main surgery is usually performed when the baby is between 6 and 18 months old.
- Speech therapy, dental care, and hearing care may continue to be needed after surgery.
- With proper treatment and follow-up under the supervision of a multidisciplinary team, this baby can live a healthy, happy, and successful life like other children.
- You are not alone in this journey. Get the support and information you need. Don't panic, be positive, and be patient. Your child has a beautiful future!
` Cleft Palate, Baby Health, Birth Defects, Surgery, Speech Therapy, Parenting Advice
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