Why is cleft lip & palate a debilitating problem?

Babies and children with cleft lip and palate may have*:

- Feeding difficulties

- Frequent ear infections and hearing loss (which often resolves with treatment)

- Speech difficulties

- Dental problems

- Psychosocial issues

Ear problems

Babies with cleft palate are more likely than other children to have frequent ear infections. The anatomical problems associated with the cleft car contribute to a buildup of fluid in the middle ear. If the fluid becomes infected, the baby can develop fever and an earache. Fluid buildup in the middle ear also can cause mild to moderate hearing loss.

If treated properly in infancy and childhood, the hearing loss need not be permanent. If not properly managed, speech development may be affected by the hearing loss and the hearing loss may become permanent.

Speech problems

Children with cleft lip generally have normal or near-normal speech. Some children with cleft palate may develop speech a little more slowly than other children. Their words may sound nasal and they may have difficulty producing some consonant sounds. However, after cleft-palate repair, most children eventually catch up and develop near normal speech, although some will require speech therapy or additional surgery later on.

Dental problems

Children whose cleft lip/palate extends into the upper gums (which contain the teeth) have special dental problems. Some primary and permanent teeth may be missing, abnormally shaped or out of position around the cleft.

Psychosocial issues**

Having a cleft palate/lip does not inevitably lead to a psychosocial problem. Most children who have their clefts repaired early enough are able to have a happy youth and a healthy social life. However, it is important to remember that adolescents with cleft palate/lip are at an elevated risk for developing psychosocial problems especially those relating to self concept, peer relationships, and appearance. It is important for parents to be aware of the psychosocial challenges their adolescents may face and to know where to find professional help if problems arise.

A cleft palate/lip may impact an individual’s self-esteem, social skills, and behavior. There is a large amount of research dedicated to the psychosocial development of individuals with cleft palate. Self-concept may be adversely affected by the presence of a cleft lip and or cleft palate. Research has shown that during the early preschool years (ages 3-5), children with cleft lip and or cleft palate tend to have a self-concept that is similar to their peers without a cleft. However, as they grow older and their social interactions with other children increase, children with clefts tend to report more dissatisfaction with peer relationships and higher levels of social anxiety. Experts conclude that this is probably due to the associated stigma of visible deformities and speech abnormalities, if present. Children who are judged as attractive tend to be perceived as more intelligent, exhibit more positive social behaviors, and are treated more positively than children with cleft lip and or cleft palate.Children with clefts tend to report feelings of anger, sadness, fear, and alienation from their peers. Yet these children were similar to their peers in regard to "how well they liked themselves."

*information courtesy of www.marchofdimes.com

** information courtesy of www.wikipedia.org