Cleft Lip and Palate

Common Complications
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Definitions and Causes
Common Complications
Feeding
Surgical
Emotional, Social, and Psychological Issues
Role of the Nurse
Conclusion
References

Other health related problems may occur in the child with cleft lip and/or palate. These can be associated with feeding, hearing, speech development, dental health, and/or orthodontics (Barthoshesky, 2000, CLPAI, 2000, MacDonald, n.d.). Most complications are temporary with some form of intervention by health professionals and/or parents (CLAPI, 2000). Early intervention and treatment are the keys to normal healthy development (MacDonald, n.d.). 

 

Hearing:

   A child with a cleft palate is more likely to experience hearing loss.  This hearing loss is usually temporary and can be treated with medication and/or surgery.  The loss is usually associated with waxy build up, a break in the bones of the middle ear, and more commonly with fluid in the ear(50-90% of children under age 2), otitis media (Sullivan, & Ouellette, 1999).

   It is very important to have a child’s hearing assessed as soon after birth as possible, or within the first three months of life.  Without proper hearing the child’s speech and/or language development may be affected(CLAPAI, 2000).

 

Speech Development:

   Not every child with a cleft will have speech difficulty (CLAPAI, 2000), but they are more at risk.  A speech or language problem can be associated with hearing trouble, incorrect tongue movement, and/or problems with the function of the palate (CLAPAI, 2000). 

     The CLAPAI (2000) suggests that any child with a cleft palate should be seen by a speech therapist by 6 months of age.  Even though the child cannot cooperate with the therapist, they can learn alot about the child.  They do this by listening to the childs "babbling" and observing their interactions with the parents.  This initial assessment also allows the therapist to develop a plan of care for the child in the future. At this visit parents can be given tools and activites to perform which can aid the development of good speech within their child.

 

Dental Health:

   Children affected with cleft palate can have weaker and more sensitive teeth. This makes the teeth more susceptible to cavaties and decay (Barthoshesky, 2000). Cleft lips and/ or palates usually require some form of surgery.  These surgeries within or around the gums may have ill affects upon the teeth. 

   It is very important to keep the teeth healthy. Children can do this with regular brushing, flossing(about school-age), and visits to the dentist (CLAPAI, 2000).

  

Orthodontics:

   An orthodontist is a dental specialist who practices the correction and prevention of tooth irregularities (Dirckx, 2001).  Children will usually see an orthodontist during the first surgical repair of the cleft (CLAPAI, 2000). 

   The orthodontist may have to perform future treatments later in life. These may be necessary to remove or rotate permanent teeth, prevent the permanent teeth from "coming in", and prevent or repair any defects in the upper gum (Barthoshesky, 2000). These treatments may accompany the placement of an expander (to widen the upper jaw), teeth implants, or braces, and are usually ongoing until the child is in their teens (Barthoshesky, 2000).