You will visit the combined Cleft Unit who will assess your baby’s cleft and decide on the careplan that they will work towards. The Plastic Surgeon, along with other members of the team are there to answer your questions and give you the information you require. Before surgery, a parent’s role is to keep baby well and establish good nutrition. You have the support of a Speech Language Therapist to help you with this. Some families also require the support of a Lactation Consultant and Nutritionist.
For some families you will only visit the cleft team once, and for others, ongoing visits with the orthodontist will be required to prepare your baby for surgery.
Text supplied by: Heather Keall, Orthodontist Middlemore Hospital and Peter Fowler, Orthodontist Christchurch Hospital
The Orthodontist sees some babies with clefts in the first few weeks of life in order to make a plastic plate used to re-shape the mouth so that the best plastic surgery result possible may be obtained when the cleft is closed. It can also aid with feeding. At the first appointment a dental impression is taken of the baby’s mouth and the plate is fitted later in the week.
Plates are usually acceptable to babies and many are unhappy when they are taken out. Plates are worn from around 2 weeks of age until the first operation at about 3-5 months. Adjustments to the plate by the orthodontist are required during this time.
Around 3 months of age it may be necessary to place some elastic strapping across the upper lip in order to mould the middle part of the jaw into a more normal relationship with the side parts. The strapping sometimes involves the making of a cotton bonnet (full instructions given) that comfortably fits the baby’s head and a removable piece of elastic that is attached to the bonnet on each side. This moulds baby’s upper lip and the front part of the jaw. When the lip is repaired, the early treatment is complete.