Above all else, we at North Texas Plastic Surgery want to say congratulations! Child birth is the most amazing experience a parent will ever have. One of the first things you need to know is that your baby will have a happy, healthy life. Dr. Obaid and Dr. Ver Halen treat babies with cleft palates from all over the Dallas/Fort Worth area, as well as Oklahoma and Louisiana. For the vast majority of babies, cleft lip and/or palate is their only health problem, and it is a treatable one.
One of the first challenges that a mother with a baby that has a cleft palate will face is how to feed the baby. Babies suck on a nipple by squeezing the nipple between their tongue and their palate to create a seal and then breathing in. Babies that have a cleft palate are unable to compress a nipple and, as a result, struggle to breastfeed or suck from a normal bottle.
There are a number of nipples that are commercially available now that are designed to overcome this problem. The two most common are the Haberman Feeder and the Pigeon nipple. If you are visiting Dr. Obaid or Dr. Ver Halen from the Dallas/Fort Worth area for cleft palate treatment, he will refer you to a speech pathologist with whom he works regularly to help you with feeding. If you are coming for cleft palate treatment from Louisiana, Oklahoma, or other surrounding areas, Dr. Obaid or Dr. Ver Halen will help you find a speech pathologist with cleft palate experience near you to assist you with feeding.
The most important thing to realize about a baby with a cleft palate is that you can feed them by mouth! It takes time and patience, but your surgeon and the speech pathologists that he works with will help you with this.
Dr. Obaid and Dr. Ver Halen typically perform cleft palate repair between 9 and 12 months of age. The timing of the repair is designed to have the surgery completed before the onset of speech while at the same time allowing your baby the maximum amount of time to grow healthy and strong prior to the operation.
If your baby has a cleft lip in addition to the cleft palate, his/her cleft lip will be repaired first at approximately three months of age. The cleft palate will be repaired separately at 9 to 12 months of age.
The most important long-term problem that can result from cleft palate is a problem with speech. In some patients, a repaired cleft palate may experience significant scarring and may not function properly. These children may experience a condition called velopharyngeal insufficiency. Children with this condition have air escape from their nose when they try to speak. The result is a high-pitched, nasal-sounding voice and difficulty making certain sounds in the English language. In rare cases, this difficulty can cause others to have a hard time understanding the patient’s speech.
Preventing speech problems is your surgeon’s number one concern in fixing a cleft palate. Your surgeon will close the cleft palate sometime between 9 and 12 months of age. The goal will be to close it prior to your baby beginning to speak. Once a baby starts to speak with a cleft palate, they will learn ways of speaking to compensate for the cleft. These attempts at compensating can be very difficult to unlearn, and many children who have learned them require years of speech therapy to correct them.
It is essential that you see Dr. Obaid or Dr. Ver Halen as soon as you are given the diagnosis of cleft palate, so he can examine your baby, plan for your baby’s cleft palate correction, and answer all of your questions.
In addition to speech production, an intact palate is necessary for proper inner ear function. Babies with cleft palates have non-functioning portions of their inner ears. As a result, they cannot drain fluid normally from inside the ears. This fluid can build up inside the ear, causing repeated ear infections. With time, multiple ear infections can lead to hearing loss and even deafness in severe cases.
When you meet with Dr. Obaid or Dr. Ver Halen to discuss your baby’s cleft palate, he will refer you to an experienced pediatric ENT, who will examine your child’s ears and follow their hearing. If you are coming to see your surgeon from outside the Dallas/Fort Worth area for your cleft palate care, he will refer you to an ENT close to you. At the same time as your baby’s cleft repair, your surgeon will have one of his ENT colleagues place ear tubes (myringotomy tubes) that will help drain the fluid from inside your baby’s ears. Most children will need multiple sets of tubes throughout their childhoods, as they outgrow them or they naturally fall out.
If your child has speech problems after a cleft palate repair, there is hope! Their speech can be improved. With intense speech therapy under the direction of your surgeon, many speech problems can be improved, if not completely fixed. There are some children who are unable to correct their speech problems despite aggressive speech therapy. For these children, your surgeon may be able to correct your child’s speech with an operation called a pharyngeal flap.
A pharyngeal flap is an operation that is performed in children who have persistent speech problems after their cleft palate repairs. Prior to performing a pharyngeal flap, children should have aggressive speech therapy to determine if therapy alone can correct the problem. If not, then your surgeon may perform a pharyngeal flap. It is important for parents to realize that while a pharyngeal flap will improve speech, children will need to continue in speech therapy post-operatively to get the maximum benefit from the operation.