Emotional impact of a cleft diagnosis, and support

Finding out that your baby has a cleft lip and/or palate can be a shock for parents, and the ongoing experience may be emotional. There can be many challenges for new parents in this situation including feelings of guilt, post-natal depression, getting used to the way your baby looks, and issues with feeding and treatment for the cleft.

In the UK, a child born with a cleft lip and/or palate will be cared for by a regional cleft specialist team and will undergo operations for lip and/or palate repair. He or she is also likely to receive lots of dental treatment and speech and language therapy. Throughout the child’s infancy, childhood and adolescence there will be many clinic and hospital appointments as well as meetings with different health professionals from the cleft service team.

Families who receive a diagnosis of cleft lip and/or palate should be contacted by a clinical nurse specialist (CNS) within 24 hours of the diagnosis. The CNS is usually the first point of contact and provider of information throughout all of the care the child receives, including giving information about support services. However, the other health professionals who provide care for the child may also refer parents to a relevant professional or local support group.

Most of the families we spoke to found a good level of support amongst their own family and friends but they also acknowledged more specific support from health professionals working in the cleft service.

Kerrey found a good level of support amongst her family and friends and found additional support through CLAPA and the cleft nurses.

Age at interview 27

Gender Female

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There are many ways in which parents can be supported in caring for their child. As well as formal care from health professionals, more informal care and support can be accessed by contacting other parents via the Cleft Lip and Palate Association (CLAPA) has trained parent contacts for one-to-one communication as well as organised parent contact groups and social media networks such as CLAPA Facebook pages and the Adult Voices network (a Facebook based forum for adults born with cleft).

Matthew and Rhiannon found that talking with other parents they met through CLAPA and Facebook to be a positive and supportive experience.

Gender Male

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Natalie explains how he became involved with CLAPA as a parent contact and how it has benefitted both her and her son who was born with a cleft lip and palate.

Age at interview 49

Gender Female

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Some parents find the impact of caring for a child born with a cleft lip and/or palate to be overwhelming. It is a very emotional process and parents may become depressed. Most specialist cleft teams have a clinical psychologist who can offer more specific support to families as well as to adults who themselves have a cleft lip and/or palate. However, some of the families who believe they would have benefited from psychological support did not know they could get this help from the cleft service.

Russell was finding it difficult to manage emotionally after witnessing his daughter’s breathing difficulties. He was prompted to seek professional help by a speech therapist and was able to get counselling through his employer.

Age at interview 23

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Mandy’s son had a late diagnosis of cleft palate. Not knowing the cause of her sons’ feeding and behaviour put a big strain on family relationships and she became depressed.

Age at interview 29

Gender Female

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Michelle experienced postnatal depression following the birth of her son and after his lip and palate repair. She was referred for counselling by her GP but did not know she could have received this support from the cleft team.

Age at interview 33

Gender Female

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Not all parents felt they needed support from others following the diagnosis or birth of a child with cleft. Some parents actively chose not to contact other parents in similar situations simply because their children had also been born with a cleft. Parents also noted that they needed time to get to know and live with their child before feeling ready to join in with support groups.

Jenny had good support at home. However, as her daughter developed speech and hearing problems Jenny felt there was a purpose in getting involved in support groups.

Age at interview 36

Gender Female

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(Also see: ‘The impact of a diagnosis of cleft on the pregnancy‘ and ‘Cleft treatment pathway‘).

The cleft treatment pathway

In the UK, a baby with a cleft lip has the cleft closed at approximately 3 months of age, and a cleft palate closed at...