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WHILE PARENTS and their children are coping with the psychological stigma of clefts, they also must deal with the medical treatments.

Cleft lips usually can be surgically repaired within the first few months after birth and, depending on the severity of the clefting, several operations may be necessary to accomplish a satisfactory final result. The closure improves facial appearance and aids in feeding.

Reconstruction of a cleft palate usually begins when the child is between 12 and 18 months old. Depending on the severity, a series of surgical procedures may be required.

More than surgery, however, is involved in the successful treatment of children with cleft lips and/or palates.

The modern approach requires the expertise of a team of medical and health specialists trained to deal with feeding problems, speech and language development, special problems of the ears and teeth, and the psychological welfare of the child.

"New developments include improved surgical techniques that result in a better appearance of the lip and nose," said Dr. Emma K. Herrod, medical director of the J. Sutton Regan Cleft Palate Foundation Clinic. And, more aggressive treatment of ear disease has resulted in a decline in hearing loss, she said. Ear problems and infections are due to inadequate function of the palatal muscles needed to open the eustachian tubes that connect the throat with the middle ear.

"There's an even greater emphasis today on speech therapy," Dr. Herrod said. "We now believe that no child should have a speech defect because of a cleft palate. If treated properly and intensively enough, by the time the kids get to kindergarten, or soon thereafter, their speech should be relatively normal."

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