Young child manages cleft lip and palate

Logan has come a long way in treating cleft lip and palate.

Three-year-old Logan Hatfield isn’t just asking to watch “The Lion King.” He lets out a loud roar and follows with a soft “king”.

It’s one of the many treasured memories he created for his parents, Jenna and Brad, and his two older siblings. It’s also a welcome contrast to the months before and after she was born, when her parents worried about how a cleft lip and palate would affect her development.

Logan, much to their delight, not only roars, but also wrestles his brother and lets his sister dress him. He’s like any other child, Jenna says, thanks to the treatment he received at Boston Children’s Hospital. “It’s really remarkable, especially thinking back to my anxiety,” she says.

He will undergo a second surgery in several years, after his facial features and bone structure have changed. So far, the treatment he received as an infant – including surgical cleft repair and some non-surgical measures – by the Department of Dentistry and the Cleft lip and palate program allows him to eat and drink without difficulty. Equally important, he can also display what his mother calls “his really big personality.”

Find a support system

Logan, a resident of New Hampshire, had a large bilateral cleft lip and palate. With openings on both sides of his lip colliding with his nose, it was, according to Jenna, difficult for Logan to feed and for her to manage.

But Jenna and Brad had prepared for these challenges before Logan was born. It all started when an ultrasound suggested he might have a genetic syndrome. To find out more, Jenna’s doctor recommended Boston Children’s, where an MRI ruled out any syndrome but confirmed he would have been born with a cleft lip. Although the identification of a cleft lip wasn’t necessarily good news, it seemed less shocking than the possibility of more serious medical conditions. Moreover, after meeting with Boston Children’s clinicians, she had “nothing but good feelings” about the care he would eventually receive — an understanding that his family would not be alone during what they acknowledged to be a difficult time. long journey with many ups and downs.

In a photo taken when he was 4 months old, Logan Hatfield sits on a sofa with a teddy bear and a copy of the book "Bright scars."
Because he couldn’t generate suction as a baby, Logan drank from a specialized bottle that let milk flow.

Overcome the first obstacles

Logan was first treated at the Boston Children’s days after he was born. Due to his cleft lip and palate, he could not generate suction and had difficulty feeding from a bottle. She was given a bottle with a one-way valve that allows milk to flow without suction and makes feeding easier – a temporary solution until the next stage of her treatment three months later.

To bring his gums and palate closer together, Boston children’s dentist Dr. Elizabeth Ross temporarily attached a brace known as a Latham-type appliance to the bone in Logan’s mouth. This preoperative step required Jenna to occasionally turn a screw in the appliance to tighten her gums and palate. “It was pretty tough,” Jenna recalls. “I had to feed him with a syringe for a month after that because he had to relearn how to eat.”

But Jenna remained aware that this difficult step was one of many that would lead to improvements in Logan’s condition. It also gave her a sense of accomplishment that she had helped with her recovery.

Another operation on the road

More progress came later in 2019 with the first of two transformation operations. Dr. Carolyn Rogers-Vizenaa plastic surgeon in the Cleft Lip and Palate program, repaired Logan’s lip by reposition and unite the skin, muscles and inner lining of the lip and gums.

Logan will have to wait until he’s at least 8 for another operation that will place bone in vacant spots on his gumline. But once a child is past the first stage of surgical repair — usually in infancy, as Logan did — their quality of life improves, and parents see that progress is possible.

Jackson, Logan and Adalyn Hatfield sit on a couch in a family photo taken in August 2019.
Logan loves playing with his siblings, Jackson (left), who is now 6, and Adalyn (right), who is now 5.

Life as it should be

For Logan and his family, life is now as it should be: mostly carefree. He loves being the younger brother of Jackson, 6, and Adalyn, 5, and he charmed his teacher.

And with Logan well into his recovery, Jenna decided she was in a position to support other parents trying to manage their children’s treatment for cleft lip and palate. She works part-time for Cuddles for Cleft, a non-profit organization that sends care packages to young patients.

Jenna remembers when Logan finally turned a corner. The progress was evident in the form of seemingly ordinary activity: A few months after his first surgery, Logan passed his mother, held his drink – and finally took a few sips through a straw.

Learn more about the Cleft lip and palate program and the Department of Dentistry.

Christine E. Phillips