Lei Mai

Seven-month-old Le Mai was seen at the OMFH in Ho Chi MInh City on April 10, 2010. It was obvious how much her father loved her by how he tenderly and proudly held her during the pre-operative screening. She was a contented baby with a ready smile which opened widely due to her complete cleft lip that advanced into her nose. She had her cleft lip closure done on April 12, 2010 and was brought to the recovery room where her parents held her, repeatedly looking at their daughter with a new appearance. And now they had a new outlook.

Her mother cried silently, holding her close. As is often the case, the infants and toddlers after their cleft lip repairs tend to be more hungry than in pain from their surgeries. So when they are awake enough and their blood oxygen levels are adequate, they can be fed infant formula through a syringe. Le Mai's father was intent on getting her the first few ounces of formula after her last meal on the previous night.

Once their hunger is resolved, Le Mai and the children tend to calm down and rest without much discomfort. The sutures are a combination of absorbable suture that dissolves in time and non-absorbable suture that needs to be removed about a week later. The incision line tends to fade in a few months.

Ideally, we try to do the cleft lip repairs before the infants are 12 months old. This way they have less problems with ear and sinus infections and reflux of stomach acid or drainage of saliva into the lungs. Eating is then done with greater ease and the babies have fewer problems with choking. And they have a greater chance to speak normally with the mouth muscles in more normal alignment for speech.

Twelve months of age tends to be the critical age for speech. If the cleft is closed later, the musculature is more "set" in its position and function for speech, so the speech will be affected thereafter. Cleft patients can also have problems with chronic hoarseness due the forced effort to speak and strain on the vocal cords.

In contrast to the cleft lip repairs, the patients who have cleft palate repairs struggle more in their recoveries as the surgeries are more involved technically. The children tend to be older and stronger and more vocal. Their surgeries involve closing the hole in the soft and/or bony part of the roof of their mouths, which may mean pulling together muscle, repositioning bone, and greater tension on the surgical site to keep the incision closed. Their mouths are numb and this sensation agitates them. So they generally have to wait longer before they are fed. This initial time is more trying for their care providers and parents.

Our Face the Challenge team loves getting to help these children! They are so dear and their parents are so thankful. These surgeries makes such a long-term difference in the lives of the children and their parents. We are glad.