Prenatal Counseling of Cleft Lip and/or Palate

Prenatal diagnosis of a cleft lip and/or cleft palate is possible as advances in ultrasound technology occur. Most are diagnosed during a routine ultrasound examination in the second trimester, from 18-22 weeks of pregnancy. Most of the time, the diagnosis is unexpected and can create concern about the health of the baby and the effects on the entire family. Once the diagnosis has been made, I encourage expecting mothers to come in for prenatal consultation to explain what the diagnosis means for them and their family. This allows families to have all the information ahead of time so that the delivery can be as stress-free as possible and for families to enjoy welcoming a new baby to their family. Several benefits of prenatal diagnosis are listed below:

1. Helps the family prepare for the arrival of their child, both psychologically and practically. Some of the most common questions asked during this visit:

• Will I be able to breast feed my baby?

• What type of bottle/nipple do I need to purchase?

• Will my child have normal teeth?

• Will this be covered by my health insurance?

2. Helps families meet with members of the cleft and craniofacial team early on and develop a relationship with them.

The most common team members present during this visit is the cleft and craniofacial plastic surgeon (Dr. Sharline Aboutanos) and the team nurse coordinator. Meeting with a genetic counselor is also possible. The importance of the cleft team’s accreditation by the American Cleft Palate-Craniofacial Association (ACPA) and all team members is described.

3. Gain knowledge about the diagnosis and the expected treatment plan for possible cleft care.

• What does the diagnosis mean?

• Why did this occur?

• At what age will surgery occur?

• How many surgeries are required?

4. Gives families a chance to ask all of their questions ahead of the delivery and create a plan for a delivery that involves all necessary specialists to be present.

The most important fact shared with families during this visit is that children with a cleft lip and/or palate can become healthy, productive adults. With team care, children can grow up to be healthy and happy with friends, families and careers.