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Cleft Lip Repair & Palate Repair in Manhattan, New York City

A cleft lip and palate is the most common birth defect of the face that involves a split in the upper lip and/or gap in the roof of the mouth. Over 6,000 infants are born in the US each year with this condition, which is caused by abnormal development of the lip and palate. A cleft lip and palate can cause feeding, speech, ear and dental problems.

A cleft can appear in the lip or palate alone, or in both areas and on one or both sides of the mouth. Children with clefts are at higher risk for ear infections and dental problems. Feeding is usually difficult as well.

Reconstructive surgery is the recommended treatment for clefts. This surgery is usually performed when the child is 3 to 6 months for a cleft lip and 9 to 14 months for a cleft palate. It is recommended for your child to regularly meet with different specialists in order to help develop the areas that may be affected by the clefts. Although this condition requires a lot of care, it is manageable and can be overcome by many children with the help of a trusted team of doctors.

Cleft Lip & Palate - Genetics

It is extremely important to obtain a genetics evaluation. Most families find this to be extremely informative and helpful. In general, every parent has approximately a 1 in 700 risk of having a child with a cleft. Once parents have a child with a cleft, the risk that the next child (and each subsequent child) will be affected is 2-5% (2 to 5 chances in 100). If there is more than one affected person in the immediate family, the risk rises to 10-12% (about 1 in 10).

For an individual with a cleft (who is the only one affected in the family), there is a 2-5% chance that his/her child will have a cleft. If that individual has a close relative with a cleft, the chance increases to 10-12%.

The unaffected sibling of an individual with a cleft has roughly a 1% chance of having a child with a cleft. If there is more than one family member affected, the risk rises to 5-6%.

If a syndrome is involved, the risk within the family may be as high as 50%.

For additional information, you may refer to the Cleft Palate Foundation.

Source: The Genetics of Cleft Lip & Palate, Marilyn Jones, MD, Cleft Palate Foundation, 2000

Cleft Lip & Palate - Feeding Your Baby

How you feed your baby may be influenced by family tradition, social trends, cultural values, and previous experiences. Babies with a cleft lip and palate will have their needs met with appropriate positioning, feeding supplies, and your adapted techniques.

A full-term newborn generally needs 2-3 ounces of breast milk or formula per pound of body weight per day. A newborn will normally lose up to 10% of its birth weight during the first week of life. The quantity that the baby consumes, however, should continue to increase. Weight should be checked weekly on the same day, at the same time, on the same scale for the first 6 weeks of life.

An infant with cleft of only the lip or lip and gum will not usually have feeding problems. As is true in all newborns, learning how to "latch on" for each feeding will become natural with some patience.

An infant with a cleft palate will need some modifications in feeding technique, supplies, and positioning. This happens because there is no separation between the mouth and nasal cavity. There may be a weak sucking ability, longer feeding times, nasal regurgitation, and difficulty coordinating breathing and swallowing. The baby may swallow a lot of air with feeding and will need more frequent burping.

The American Academy of Pediatrics recommends breast milk for children under one year of age. If breast milk is not an option, your pediatrician will help you select an appropriate formula.

Some of the commercially available feeders include: the Haberman Feeder, the Mead-Johnson Cleft Palate Nurser, the Ross Cleft Palate Nurser, the Pidgeon Cleft Palate Nurser and NUK Nipples.

For additional information, you may refer to the Cleft Palate Foundation.

Source: Feeding An Infant With A Cleft, Kim S. Uhrich, MSW, CCSW, Cleft Palate Foundation, 2001

To learn more about our Cleft Lift & Palate Repair in Manhatten practice, make sure you contact us to hear from Dr. Staffenberg, or call us at 212-263-8065

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