Mothers breast feed is the best feed for a new born, if due any reasons mothers milk is not available in sufficient quantities it can be supplemented with cow/buffalo milk without diluting it with water. Various formula preparations available in market can also be used taking care that they are prepared following exact instructions as mentioned by the manufacturer. All utensils used to feed the child should be boiled in water before use and parents should wash hands before feeding the child. Solid food should be added to the diet at 6 months age and the child should be on solid diet by one year of age. Gain in weight is a very important indicator of a child’s development. All these children should be monitored by a paediatrician and should grow along the same parameters as those for normal kids.
All children should receive vaccination as other kids do.
Immediately after birth feeding is a main concern in children born with cleft palate. (See section on feeding) Once feeding has been taken care of the parents should get in touch with a Plastic Surgeon as soon as possible.
Children who have repeated chest infections / cough or those who choke during feeds are probably not being fed as instructed.
Solid food should be added to diet at the age of 6 months, in cleft palate patients this often gets struck in the nasal cavity, this should not deter the parents from feeding the child, all kids get used to this and accept normal feeds
Ear infections are pretty common in children with cleft palate. Middle ear has a connection with the throat via what’s called as Eustachian tube. The opening of this tube in the upper part of throat is controlled with muscles which are attached to the palate. Malfunction of these muscles leads increase incidence of middle ear infections. Since children small as these cannot communicate these infections can be missed and cause ear damage. Children who seem to be in pain and who put their hands to their ears repeatedly or older children who complain of pain in ear should be examined by an ENT surgeon.
Children with complete cleft of lip and palate should be treated in association with an cleft orthodontist for nasoalveolar moulding(NAM). ( see section on NAM ) In NAM the child is given a device to wear in his/her mouth which will gradually create a better upper jaw symmetry and also improve the nasal shape. Children who have received NAM have significantly better results as compared to those who have not received NAM. Newly born children have soft bones which respond well to NAM.
In children with bilateral cleft lip the central segment containing the central part of the lip and upper jaw is not attached to any bone and thus experiences unhindered growth in forward and upward direction. In new born children the bones are soft and treatment under the guidance of a plastic surgeon and/or an orthodontist can replace this protruding bone back in its normal position. If delayed the bones harden and response to this treatment is not good .Many patients in this situation might require two surgeries for correction of lip deformity.
M.B.B.S., M.S., MCh. (Plastic Surgery) Senior Consultant Aesthetic & Reconstructive Surgery. ( Omit gen surgery)
