What does the future holds for your child and what operations will be necessary? The Cleft Lip and Palate Association has the answers for parents.

One in every 600 babies in this country is born with a cleft lip or palate – that’s about 1000 a year. It is the most common birth defect of the head and neck and can cause great distress to the child, as well as the parents.

Cleft means 'split' or 'separated'. During early pregnancy, separate areas of the face develop and then join together. If some parts do not join properly the result is a cleft. Cleft lip and palate can occur alone or together.

A cleft lip can range from a slight notch in the coloured part of the upper lip to complete separation in one or both sides of the lip, extending up and into the nose.

A cleft palate occurs when the roof of the mouth has not joined completely. If your baby has a cleft palate, the cleft itself may not be visible unless you look inside his or her mouth.

How does it happen? While we know what happens, we don’t know why it happens. Sometimes clefts run in families and sometimes a baby is born with a cleft when there is no previous family history of the condition.

Will my baby need treatment? Your baby will be cared for by a specialist team, which may include a surgeon, cleft nurse, orthodentist, paediatrician, child psychologist and a speech therapist. You should be referred to the specialist cleft team soon after your baby’s cleft has been diagnosed, either antenatally or once he or she has been born. You can talk to them about your child’s particular needs, as well as your own feelings and emotions.

A cleft lip is usually repaired within the first six months of a baby’s life. A cleft palate is usually repaired a little later, probably by the time a baby is a year old. If there is a gap in your baby’s gums, this will be repaired as his or her second teeth are coming through.

Is my baby healthy? Parents are often worried that a cleft lip and/or palate might be associated with learning difficulties, heart conditions, or other disorders. This is very unusual and most babies born with cleft lip and/palate are perfectly healthy. However, as your child grows, he or she may need more encouragement and support than other children.

Feeding A newborn baby with a cleft palate may need extra help. The most common problems are:

• feeding slowly
• taking in too much air while feeding
• bringing milk up through the nose

Speech Some children with cleft palate have difficulties when they begin talking, as air can escape down their noses when they make certain sounds. The palate is a working muscle that goes up and down when we speak, controlling how much air goes through the nose and the mouth. It’s a bit like the dryers in some public washrooms which can be positioned to blow hot air downwards to dry your hands, or upwards to dry your face. Most difficulties can be sorted out at an early stage with the help of a speech therapist.

Hearing Some children born with cleft palate can have temporary hearing problems. This is usually caused by excess fluid in the middle ear, known as ‘glue ear’, and can be treated.

Teeth If your baby has a cleft palate, it could be that there is not enough space for teeth to grow as he or she gets older. The orthodontist on the cleft team will keep a close eye on the growth of your child’s teeth, making sure that they are correctly positioned to bite as they should.

Parents are often distressed when they find out that their baby has a cleft lip or a cleft palate and find it helpful to speak to others who been through similar experiences. CLAPA – The Cleft Lip and Palate Association, has 40 groups across the country providing support for parents of children born with a cleft palate. You can get more information from their website CLAPA