In Europe around one in 700 babies is born with cleft lip and/or palate. Estimates indicate there are over 900,000 individuals (babies, children and adults) with clefts in Europe – a significant figure, especially when one considers that not only the patients but also their families are affected in terms of the long treatment pathway. Access to good care varies widely throughout Europe, meaning that many children born with clefts may not have the opportunity to realise their full potential. The concept of a comprehensive specialist-team approach to care is not universal.
Treating cleft lip and palate
Cleft lip and palate is usually treated with surgery. Other treatments may be needed to treat associated symptoms, such as speech therapy or dental care.
Cleft clinics and treatment teams
The cleft treatment team should be made up of healthcare professionals from different specialist backgrounds who work closely together. They comprise:
a care coordinator/manager of the service; a surgeon trained in primary cleft surgery; a surgeon specialising in secondary cleft surgery such as bone grafting and orthognathic surgery; an orthodontist; a speech and language therapist; a nurse specialising in cleft care; a psychologist with recognised clinical training; an audiologist; an ENT surgeon; a geneticist; a restorative dentist; a paediatric dentist; a dental technician.
Whilst not all specialities will be required for every patient, access to all these practitioners should be available when needed.
If your baby has a cleft, their feeding will need to be assessed so any problems can be resolved. Many babies with a cleft palate have problems breastfeeding due to the gap in the roof of their mouth but with supervision from a qualified nurse/advisor most babies feed well using a specially made squeezable bottle or teat. In some countries a palatal plate may be used to facilitate the feeding process. A nasogastric tube should be used only in cases where specific needs exist e.g if other anomalies are present.
A typical care pathway from birth to maturity will comprise the interventions set out below.