Cleft Palate birth

[stayinghome]

Hi all, I am wondering if any doulas or midwives here have attended a birth where the baby has been diagnosed with cleft palate. I'm looking for information about how best to help Mom and Dad in this situation, and how a doula can be prepared to handle the labor, birth, and pp period. Any special issues, medical or otherwise, to consider? Thanks for any help- it will be appreciated!

[wendy1221]

Sorry to butt in, I just wanted to mention, that sometimes it's very mild and causes no problems, and sometimes the baby is not able to nurse at all. This is something to be prepared for, since they already know the baby has a cleft palate. Make sure the mom has a good double electric pump and a Haberman feeder on hand, just in case. I believe this is the only real complication, feeding, and perhaps some feeding aspiration problems (and I believe hearing may also be affected.) Otherwise, I think emotional support is probably needed.

[CarolynnMarilynn]

It really depends on whether it is just soft tissue - so just the lip, or it is the hard palate as well. The babies with the full palate issues can have many more problems, from dehydration to severe feeding issues.

Above all, it is a wondrous new life, worthy of intense and joyful celebration. There is time after the birth, days even, when the baby may need some medical assistance/evaluation. It can be difficult to see the baby underneath the facial difference but you MUST. You must, as a birth supporter, find all the lovely things about this new one, and at the same time, give the parents the room they might need to process the difference. Take your lead from them.

I attended a birth where the baby was born with a cleft lip (not the more serious palate, where the scenario likely would have been different). The mom was a nurse and the dad was a paramedic and they knew the moment they saw the baby that there was a cleft lip. I congratulated them heartily, as always, and when the mom looked at me with a little look of worry, I said, "I noticed too, it's ok, we'll talk about that later but look what a wonderful baby you got!" and really tried to put the focus back on the lovely thing in front of us. Then a few minutes later, I told the mom that I had seen that it was just the lip and not the palate also, and she said she had seen too. I said that the next day we would get a paeds consult and that nothing needed to be done about it then. The rest of the early postpartum period focused on the other normal things we do when a baby has been born. It just wasn't the focus because it didn't have to be.

The baby nursed beautifully and had corrective surgery at 6 months. The family gave me feedback later that they appreciated that, while I recognized and diagnosed the problem in the moment, and although it was totally unexpected, that the wonderful moment of their baby's birth was special and unmarked by fear, apprehension, undue concern, or negative reaction.

HTH!

[stayinghome]

Thank you both for sharing!

[catherinevictoria]

Also not exactly the advice you are after, but...
I had my dd 34 mo at a hospital. I saw the lip the moment she was born, as they took her accross the room to the cold metal table to be examined. If you are attending a birth, just know that the sheer joy the mom and dad are probably feeling is so intense that nothing matters but that the baby is THERE. I was in love with dd the second I saw her, and I knew right away that she had a cleft lip, even before anyone else would just say so. I wish I had had the opportunity to have her at home, take her to me just after birth and give her the calm entrance into the world than every baby deserves. I would say prepare them, have a pump ready, but also read up on bfeeding a baby with a cleft lip and/or palate. I breastfed right after birth, because that's all I was prepared to do, and dd latched right on! It was amazing. Good luck! It will be a special baby and a great experience for you!