What happens to children born with clefts if they never receive corrective surgery?
One of the most immediate concerns after birth is feeding. Babies with clefts have trouble with feeding because it changes how parts of the mouth are formed and how they work and fit together.
- Cleft lip makes it hard for babies to make a good seal around the nipple.
- Cleft palate makes it hard to create suction because the mouth cannot be closed off from the nose.
Without proper education for the nursing mother or a specialized feeding bottle, the baby may not get enough milk, making it vulnerable to other health conditions associated with malnutrition.
Ear infections and hearing loss
Babies with cleft palates are especially at risk of developing middle ear fluid and hearing loss. These problems require management by ear (ENT) and hearing (audiologist) specialists. Over time, repeated middle ear fluid and repeated infections can increase the risk of permanent hearing loss. Inserting ear tubes to drain excess fluid is a minor procedure, but many children in developing countries never receive this care.
A cleft of the lip, gum (alveolus), and/or palate in the front of the mouth can produce a variety of dental problems. These may involve the number, size, shape, and position of both the baby teeth and the permanent teeth. The teeth in the area of the cleft may be displaced, resulting in their erupting into abnormal positions.
Missing teeth- 50%
Supernumerary Teeth- 20%
Dystrophic (hypoplastic) teeth- 30%
Disturbances of tooth eruption
Ectopic tooth eruption
Dental caries and gingivitis
When there is a cleft palate, there is a space between the nasal cavity and the mouth.This means that a) the child cannot build up air pressure in the mouth because air escapes out of the nose, and b) there is less tissue on the roof of the mouth for the tongue to touch. Both of these problems can make it difficult for the child to learn how to make some sounds. Without surgery and speech therapy, their speech will be affected for their entire life.
Fewer Educational / Occupational opportunities
Children with clefts may face social, emotional and behavioral problems due to differences in appearance. It is not uncommon for parents to keep these children at home, away from the judgements of their neighbors. Consequently, the children are isolated, with little or no access to school and socialization. Finding employment later in life can be close to impossible for adults with unrepaired cleft lips and palates.
Bullying, withdrawal, embarrassment, low self-esteem, anxiety – the emotional scars of cleft are far deeper than the physical. The minds of children born with clefts are bright and smart, and they are fully aware that their appearance is not normal. During adolescence, this awareness can be crippling.
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