You'll find hundreds of files on cleft lip, cleft palate here on

This one is about: How Can we Minimize Ear Infections in our Children?

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by Carol Edson RN

Middle ear infections (Otitis Media) can be acute or chronic. Most cleft palate kids have more problems in that area than children with normal mouth and throat structures. The muscles that should help the Eustachian Tubes to function properly don't work well in kids with cleft palates. Hence, the Eustachian Tube is more vulnerable to blockage and reflux (fluid going into the middle ear).

Parents of these children frequently struggle with guilt and frustration at their inability to prevent recurrent infections. I can't promise that you'll never have to fill another Amoxicillin prescription, but here are the nursing tricks I found useful:

1) Learn to recognize upper respiratory infections early, and seek appropriate treatment. Otitis Media usually follows a "cold", since swollen mucous membranes contribute to the Eustachian Tube closing off. Most pediatricians will recommend a decongestant during colds to both prevent and treat Otitis Media if it occurs. Some children also manifest milk intolerance or allergy. Soy-based formulas can help to reduce ear problems in those children. Consult your pediatrician before changing your baby's formula.

2) Always feed your baby in an upright position. Babies can be propped while held against a bolster for added support - and to save the parent's arm from going numb! Never give your child a bottle when in bed or while lying down. This can "wash" bacteria from the nose and throat into the middle ear via the Eustachian tubes.

3) Burp your baby frequently. This helps to expel the swallowed air while the baby is upright. Otherwise she may spit up while lying down, again possibly resulting in bacteria entering the middle ear.

4) For older children, some literature supports having the child hold his breath and "push" as a way of helping to keep the Eustachian Tubes open. Always be sure to check with your pediatrician before attempting this.

Remember that the symptoms of Otitis Media may vary. They may range from a high fever and lethargy to no physical signs at all. If your child's behavior changes dramatically (irritable, fussy, etc.) my motto is "think ears until proven otherwise!" Be aware that a child can go from well to a full-blown ear infection in only six hours! So check with your pediatrician if you are suspicious.

---------------Carol Edson, RN is a registered nurse trained to work in neonatal intensive care units. She is also the parent of a cleft-affected daughter and the nurse consultant for WIDE SMILES Magazine.

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