Cleft lip and Palate Cleft lip and palate is a birth defect that affects approximately one in a thousand born children. Hereditary factors are important to this occurrence but often no cause or connection is found. Cleft lip can involve one or both sides of the lip. Although the initial appearance and problems of the child can be very distressing to family and friends, with modern treatments, cleft children may now lead near normal lives with normal developmental progress and excellent cosmetic correction of their defects.

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Management of the cleft child requires a great deal of support from many varied medical specialities. Feeding difficulties is often an early concern and speech therapists are involved in this. Plastic Surgical, orthodontic, paediatric and ENT surgical management all play a pivotal role in the care of the cleft child.

The early surgical management of the cleft child revolves around correction of anatomical deformity that cause functional and cosmetic problems. The early aim is for the baby to thrive and put on weight normally. Special bottle-feeding is used for this as the baby usually has difficulty sucking normally. At three months of age cleft repair is usually undertaken. This involves surgical release of tethered structures (separated lip and the slumped nose). This operation takes about 2 to 3 hours and involves a 2 to 3 day hospital stay. Babies are remarkably robust and recover from their surgery very well. Feeding is commenced about 6 hrs following surgery. Following surgical correction of the cleft lip, a splint is worn in the baby's nose for up to 6 weeks. This splints helps to round out the nostril shape.

At about 9 months the baby is weaned off bottle-feeding and on to a trainer cup in preparation for cleft palate repair. The palate separates the nose from the mouth and closing the hole these children have is crucial for normal speech development. This operation takes about 2 hours and requires a 2 to 3 day hospital stay. Again recovery is quick with normal feeding commencing the night of surgery.

Restoration of normal anatomy is crucial to these children. With the advent of modern techniques in cleft lip and palate repair, these children are now able to enjoy an essentially normal life and body image.

Dr Drielsma has undergone extensive training in paediatric plastic surgery and in particular surgical management of cleft lip and palate. Surgical management can be undertaken at the Prince of Wales Private Hospital in Sydney or the National Capital Private Hospital, Canberra.