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March 2012 Plastic & Reconstructive Newsletter >>
Clinical Scenario: Prenatal Consultation for Cleft Lip/Palate
Prenatal/preadoption consultation for children known to have a cleft lip or palate helps parents understand and prepare for their child’s future medical needs.
A 31-year-old woman in her 25th week of pregnancy underwent a fetal ultrasound as part of a routine prenatal examination. Upon ultrasound, it was noted that fetus had a cleft lip, though the palate appeared intact.
After extensively researching cleft disorder and options for care both in-state and out-of-state, the parents scheduled a prenatal consultation at the Cleft and Craniofacial Anomalies Clinic at American Family Children’s Hospital.
During the consultation, a multidisciplinary team provided detailed education on surgical treatment, adaptive feeding systems, speech therapy, hearing assessments and interventions, and genetic counseling.
With this knowledge, the parents—one of whom has a family member with a cleft lip/palate—were better able to cope with the emotions around having a child with this condition. They were well prepared for potential feeding challenges and other related medical issues, and were able to set up insurance preauthorizations ahead of time.
The child was born in a normal delivery, and because the palate remained intact, was able to breastfeed successfully. Three weeks after birth, the family returned to the clinic for an initial surgical evaluation for cleft lip repair, which will take place at around 10 weeks of age.
Benefits of Prenatal/Preadoption Consultation
Parents who have learned via prenatal ultrasound that their child has a cleft lip/palate, or families who are considering adopting a child with a cleft lip/palate, highly benefit from early consultation with a comprehensive cleft clinic.
Prenatal/preadoption consultation teaches parents about the medical issues their child may be facing, and what care options are available. It helps them prepare emotionally for having a child with a cleft lip/palate, and helps them better navigate the first critical weeks after birth or adoption, minimizing the likelihood of unexpected or significant medical interventions.
What Patients Can Expect
Children with a cleft lip/palate usually undergo multiple operations. Cleft lip repair usually takes place between 2 and 3 months of age in a healthy infant; palate repair takes places between 10 and 12 months of age, to coincide with development of words.
Children with a cleft lip/palate also require evaluation, treatment, and long-term follow-up from otolaryngologists, speech-language pathologists, audiologists, dentists/orthodontists, genetics counselors, and social workers.
From birth until adulthood, we coordinate all these specialties in our multidisciplinary clinic, which is one of only two in Wisconsin certified by the American Cleft Palate-Craniofacial Association. Our nurse coordinator serves as the primary liaison between the clinic, the primary care physician, patients, and families.
Common Medical Issues
Children who have a cleft lip/palate often have common medical issues. Here’s how we address them at our clinic:
Consultation and More Information
For more information on the treatment of cleft lip/palate or other craniofacial conditions, or to contact us, click here.