- What causes the cleft lip and cleft palate
- When the baby is known to have this malformation
- Surgery for cleft lip and cleft palate
- How is breastfeeding
- Baby care before surgery
The cleft palate is when the baby is born with the roof of the mouth open, forming a cleft there. Most of the time, the cleft palate is accompanied by the cleft lip, which corresponds to the opening in the lips, which can reach the nose. The cleft palate and cleft lip prevent the person from closing their mouth completely, making it difficult to eat and speak.
These facial fissures can bring some complications to the baby, especially in feeding, which can lead to cases of malnutrition, anemia, aspiration pneumonia and frequent infections, and for this reason every baby born like this must undergo surgery to reconstruct the tissues of the mouth, even in the first year of life.
The surgery is able to close the lip and the roof of the mouth, and the baby recovers completely in a few weeks after the operation, without complications in the growth of the teeth and in the feeding.
What causes the cleft lip and cleft palate
Both the cleft lip and cleft palate are caused by fetal malformation that occurs when the two sides of the face come together, around 16 weeks of gestation. Its causes are not fully known but it is known that there is a greater risk when women who do not perform prenatal care properly or who:
- Did not take folic acid pills before trying to get pregnant; Has diabetes and is not controlling blood sugar levels; Took antibiotics, antifungals, bronchodilators and anticonvulsants during pregnancy; Consumed illicit drugs or alcohol during pregnancy.
However, a healthy woman who has performed prenatal care properly can also have a baby with this type of fissure on the face and that is why its causes are not fully known.
When the doctor verifies that the baby has cleft lip and cleft palate, he can investigate whether he has Patau syndrome, because in half of the cases of this syndrome they have this type of change in the face. The doctor will also investigate the functioning of the heart, because it may also be altered as well as the ear, which is more likely to accumulate secretions, which increases the risk of ear infection.
The cleft lip and cleft palate, despite being genetic characteristics, are also hereditary and that is why when a parent has one of these fissures, their child is 5 times more likely to have it as well.
When the baby is known to have this malformation
The doctor can diagnose that the baby has cleft lip and / or cleft palate through morphological ultrasound in the second trimester of pregnancy, from the 14th week, also by 3D ultrasound or at the time of birth.
After birth, the child needs to be accompanied by a pediatrician, otolaryngologist and dentist because the cleft palate can compromise the birth of teeth and the cleft lip usually interferes with breastfeeding, although the baby can take the bottle.
Surgery for cleft lip and cleft palate
The treatment for cleft lip is done through plastic surgery that can be performed when the baby is 3 months old or after this period at any stage of life. In case of cleft palate, surgery is only indicated after 1 year of age. Surgery is quick and relatively simple and can achieve great results. For the plastic surgeon to be able to perform the surgery it is necessary that the baby is more than 3 months old and does not have anemia, in addition to being healthy. Understand how the surgery and care is done after the procedure.
Recently, the participation of the Unified Health System (SUS) in the treatment and monitoring of patients with cleft lip and cleft palate was approved. It is the responsibility of SUS to provide surgery to correct these malformations, and the baby should be referred soon after birth, in addition to ensuring follow-up and complementary treatment for babies with speech therapy, psychology and orthodontics in order to stimulate the development of speech and suction and chewing movements.
How is breastfeeding
Breastfeeding is still recommended because it is an important bond between mother and child and although it is difficult to breastfeed, because the vacuum does not form and therefore the baby is unable to suck the milk, it is important to offer the breast for about 15 minutes on each breast, before giving the bottle.
To make it easier for the milk to escape, the mother must hold the breast, pressing behind the areola so that the milk can come out with less suction. The best position for this baby to breastfeed is upright or slightly tilted, avoiding leaving the baby completely lying on his arm or on the bed to breastfeed because this increases the risk of him choking.
If the mother is unable to place the baby on the breast, the mother can express the milk with a manual pump and then give it to the baby in a bottle or cup because this milk has much more benefits for the baby than the infant formula, because it you have less risk of ear infection and difficulty speaking.
The bottle does not need to be special because there is no specific one for this type of health problem, but it is more advisable to opt for the rounded bottle nipple, which is more similar to the mother's breast, because the fit of the mouth is better, but another option is to offer the milk in the cup.
Baby care before surgery
Before surgery, parents should take some important precautions such as:
- Always cover the baby's nose with a diaper to warm up the air the baby breathes a little, so there is less risk of colds and flu that are very common in these children; Always clean the baby's mouth with a clean diaper wet with saline, to remove the remains of milk and food after he has eaten. If necessary, you can also use cotton swabs to clean the crevice in the roof of the mouth; Take the baby for a consultation with a dentist before 4 months of age, to assess oral health and when the first teeth should be born; Ensure that the baby feeds well to avoid being underweight or anemia, which will prevent mouth surgery.
In addition, it is important to keep the baby's nose always clean, using a cotton swab dipped in saline to remove dirt and secretions at least once a day.
