Q & A
Posted on March 14th, 2007
Are there implications for my child’s intellectual development and schooling?
The presence of a cleft and any associated speech problem should not be interpreted as an indication of a learning disorder or slowness of learning. There is no co-relation between a child having a cleft and their intellectual ability.
There is the possibility that some children with cleft palate may lag slightly in their language development. This is something that the speech and language therapist monitors and address in the course of the therapy that the child will receive.
You may have a niggling worry as your child approaches school going age that a teacher may misinterpret the cleft condition and any associated speech problem. If this is your worry, a talk with the teacher ought to allay your fears. To this end, we have produced a Handout for Teachers which you can print out and hand to them.
Read the article Back to School by Dr. Kathy Kapp-Simon.
Cleft Lip & Palate: Handout for Teachers & Carers (pdf) (211.1 KiB, 3,184 hits)
What are the consequences for my child’s teeth growth and development?
A full orthodontic assessment is carried out when your child is 6 to 7 years old. Any supernumerary teeth which interfere with the proper development or eruption of second teeth may be removed. For some children simple orthodontic treatment involving braces to straighten the teeth may be all that is necessary.
In most cases expansion of the maxilla and bone grafting is of great advantage. Expansion should start at about 9 to 10 years of age. Bone grafting follows, and the expanded position of the dental arch is maintained for 6 to 12 months by which time the graft should have taken successfully. The procedure should be completed by the age of 10 to 11 years. When all the permanent teeth have erupted, usually by the age of 13 years, full orthodontic alignment can start with the use of fixed braces.
Can I breast feed my baby? What are the feeding implications for my baby?
Many children with a cleft feed without difficulty so you should not automatically expect problems. Breast feeding will depend on the type of cleft. If you have decided prior to the birth to breast feed, you should try. If you are unsuccessful, bottle feeding with expressed milk may be tried. The use of a breast pump may facilitate in this respect.
In normal feeding the upper lip does relatively little work so babies with a cleft lip only do not usually experience a difficulty. Babies with a cleft palate are more likely to experience feeding difficulties, because, without a properly functioning palate, it is difficult to gain and maintain proper suction. An extra hole in the teat can be made or the existing hole enlarged. Special teats may be recommended, or alternatively special squeezable bottles so that you can more easily control the milk flow.
There may be a problem with liquids coming down the nose, and there may also be temporary feeding difficulties following repair of the palate.
Remember, there is no one solution to feeding for all cleft babies, and it may often be a case of trial and error. Seek the advice of a nurse, or the speech and language therapist in the Cleft Team.
Can my baby use a dummy (’soother’)?
Babies with a cleft can usually cope with a dummy, although its use is best deferred until after the palate repair is fully healed. If your baby has Pierre Robin syndrome the use of a dummy can actually encourage the sucking reflex.
I was born with a cleft. What is the likelihood that my baby will be born with a cleft?
The chances of a parent who was born with a cleft having a baby with a cleft rises to approximately seven in one hundred. Remember, the incidence in the population in general is one in seven hundred.
Will my child have other health problems?
Clefts can be associated with a number of syndromes, but unless your child is diagnosed as having an associated syndrome, there is no reason to believe that he or she will not otherwise be perfectly healthy.
Velocardiofacial Syndrome (VCFS) is the syndrome most commonly associated with a cleft palate, most usually cleft of the soft palate. The cleft may be complete, incomplete, or submucus. There are up to 184 other anomalies commonly associated with VCFS. The incidence of VCFS is approximately 1:2000 of live births, and it occurs in 8% of cleft palate cases.
Another related syndrome is Pierre Robin Syndrome which is a common variation of simple cleft palate. The baby has a combination of cleft palate, a small underdeveloped lower jaw and a falling of the tongue into the back of the mouth. This never occurs in combination with cleft lip and is never inherited or passed on. The incidence is one child in every 30,000.
As a consequence of having a cleft, however, your child may have hearing problems requiring treatment with grommets, or speech concerns because of the cleft to the palate. Speech therapy is required in many instances.
Is there an Information Pack available?
Yes there is! If you would like one of our Parent Information Packs please contact committee member Sinéad Ní Allúin at 086 8438474 or email nialluin@cleft.ie
If your question is not here, please notify us so that we can address it (info@cleft.ie)
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