Cleft Lip in Hong Kong: August 2013

August photos - lets talk about cleft palate

What is a cleft?

Cleft means gap!

What is a palate?

The palate is the roof of the mouth and separates the mouth from the nose.

What causes a cleft lip or palate?

A cleft lip and/or palate occurs when these areas of the face fail to fuse properly in the early stages of the pregnancy. Research has not yet found out why. It could be genetics or environment. To be honest, it is all academic to me. Ultan is here with us and I wouldn't change him.

If you run your tongue along the roof of your mouth you will feel a ridge. This ridge was formed when your palate fused - probably when your Mom was 4-7 weeks pregnant with you! And you have two palates, the front part where it is hard is aptly known as the hard palate and the back part where it is soft is know as the soft palate. Babies can be born with hard cleft palate or soft cleft palate or both. Ultan was born with both cleft hard and soft palate so if you look at the photos below you will see his cleft going from the front behind his gum to the back.

Treatment

Ultan's plastic surgeon repaired the front part of Ultan's cleft palate during his lip repair which helped in forcing the two sides of the cleft together. Ultan's surgeon Dr Lam Lai Kun uses the 'push back' technique when repairing. This technique helps Dr Lam guage the correct length of Ultan's palate which (no pressure Dr Lam) is extremely important for Ultan's speech.

For parents who are diagnosed, Ultan's cleft palate would be on the severe range. It is rather wide but as I say, all that is academic. He will have his palate repaired tomorrow and we know he will recover from a successful surgery.

So, yes, we are here the night before Ultan's palate repair. A little in denial, putting it to the back of our mind. I have to say, the run up to the palate repair has been a hundred time easier than Ultan's lip repair. I am not sure if it is because, as parents, we fall in love with our babies, we fall in love with babies cleft lips and to have to leave that go is extremely emotional. Or is it that we completely underestimate our babies, and we discover day 5 post-op that our baby has recovered while you, the parents, are slumped on the couch feeling the grey hairs arrive watching your wee baba chase the helium balloon at the end of the string as if nothing had happened? Or is it that we know repairing the cleft palate is medically necessary for speech, eating etc so we want what is best for our child and are willing for it to happen?

I don't have the answers but I am far less emotional this time around but it doesn't mean that I am not thinking about the external factors that I can't control. We will have three doctors in Ultan's theatre (as Ultan will have grommets inserted, there will be the ENT Surgeon and the anaesthetist CS Lam). We have left Dr LK Lam choose his two partners for we didn't want any egos to bloom nor deflate. However, we are relying on all these doctors to be on form, to deliver, to be partners. For this time I am not going to underestimate my son, I know he will fight for the recovery that is required. So, as I say, no pressure Dr Lam, we are relying on you to deliver!

The pictures below show some variations of cleft lips and palates.

Daddy and his wee Celtic Dragon!

A little while ago Mark was approached and was told this photo has been published in a Chinese Magazine.

We have no idea what the article was about but what we do know is that you will see this photo in the labour ward of Queen Mary Hospital to promote skin to skin contact after birth. There you go ladies, you get to see my Hubby while you are in the throws of labour!

I am extremely proud of Queen Mary for using this photo. As I have said before, there is on average a baby born with a cleft every other week in Queen Mary Hospital. Some parents know in advance, some don't. Hopefully, seeing how happy this man is after receiving his son in his arms will give them a little comfort :)

This photo was taken while I was still in theatre so Ultan was probably 15 minutes old :)

Would you find a prouder father?!

A few more of Daddy and his wee Celtic Dragon!

July is all about eating sand.....

July was for....

Beaches

Picnics

First Girls Day out ;)

Frolicking with the Brothers!

A little Dolphin watching

and a few Country strolls

June photos and it is all about Ma Ma Ma Ma Ma

Since Ultan was born he has been a bit of a talker. Constantly getting involved in telling stories. However, June was the month where I was able to see him purposely working to manipulate his lips to make the sound "Ma Ma Ma Ma".

Two emotions passed through my body. The first was my competitive side - yes, he had said Ma Ma Ma before Da Da Da. He was my third born boy and my olders sons had Da Da as their first words so this is my moment of complete joy. All those thousands of nappies later and I felt my third-born Son was acknowledging this by calling Ma Ma Ma first!!! Ultan's Dad Mark will try and plead the case that Ultan was attempting to say Mark......Ha! However, I had planned that if Ultan was to call out at 3AM, I would certainly agree that Ultan was indeed attempting to say Mark! In Ireland they say that if your baby say's Ma Ma Ma first your next baby will be a girl........ We will see ;) However, I should declare that the scientific reason for Ultan to say Ma first instead of Da is that he is unable to pronouce D with a cleft in his palate. But let's not let science take away from my special moment!!

The second emotion was a little relief; or you could say encouragement. One of the moments you read about regarding babies born with clefts is delayed speech. However, Ultan is hitting each milestone at the same age as his brother Kai (not Seán, I don't ever remember a time when Seán did not speak!!).

The fact that Ultan wants to talk and is constantly making noises is all extremely encouraging.

June was also the month when Ultan visited an ENT specialist for the first time - Dr Hui Yau. Cleft babies are more prone to ear infections due to fluid being unable to drain away. To my knowledge this is because the tubes between the ears and the back to the throat have not fully developed but usually do catch up and develop within first two years. To help drain the fluid away, grommets are inserted. I wasn't sure if Ultan would need grommets as he responds really well to noise but obviously I don't know if this noise is muffled. If you imagine being in a pool underwater, you can hear but it is all muffled. For the first 6 months Ultan had not had an ear infection and ironically a few days after his visit to the ENT he got an ear infection. A rather prolonged one as the antibiotic Augmentin didn't work and Ultan had to be admitted to hospital to receive the stronger Receptin through an IV. As with most kids, he got much better almost as quickly as he got sick.

Grommets have to be inserted under a general anesthetic. So we have arranged for Ultan's grommets to be inserted when his palate is being repaired. Inserting gromments is simple procedure and takes around fifteen minutes and to my knowledge they fall out themselves within a year or two.

Being introduced to Oma's handmade playmat. Thanks Oma :)

The Godfather!

Ultan after being admitted into hospital with an ear infection.

Ultan 12 hours later! This little guy is such a fighter :)

May Photos - Intoducing Solids at 6 months!

For me, one of the beauties of Hong Kong is the bright variety of fresh food available in the wet market. It only felt right to make a trip to our local wet market to choose Ultan's first taste of solid food and it felt even more right to visit the sweet potato man's stall where sweet potatoes are sold in abundance of different variety, color, size!