In the Loop

News and views from across Mayo Clinic

November 10, 2022

Every smile has a story: Cleft palate graduation ceremony honors littlest patients, parents

By In the Loop

Cleft palate treatment requires months of appointments and surgery. The team that helps care for patients with cleft palate found a way to infuse a little joy in the process, holding graduation ceremonies for little ones finishing their first phase of treatment.

Sarah Franzen still chokes up when she talks about her 20-week ultrasound. That's when she and her husband, Ben Turnquist, learned the child she was carrying would be born with a cleft lip and cleft palate.

"At first, it was upsetting," Sarah says. "You hope for the best, and it's hard to learn that there's something wrong with your baby. It was really scary."

The fear lessened once Sarah and Ben met Uldis Bite, M.D., a facial plastic surgeon, and Chad Rasmussen, D.D.S., an orthodontist.

"They gave us reassurance that we weren't alone," Sarah says. "Dr. Bite told us that this wasn't a big deal, that this type of surgery is his specialty. He and Dr. Rasmussen came up with a game plan, which was helpful for me because I'm a planner."

That game plan began soon after Sarah and Ben's son Walker was born, when staff from Orthodontics visited the newborn to make molds of his mouth. The molds were used to create a nasoalveolar molding device, or NAM, which would help narrow the gap created by the cleft.

"The device went in his mouth like a retainer, and we taped it to his cheeks to keep it in 24/7," Sarah says. "It wasn't fun for him or me."

Each week for 12 weeks, Walker had an appointment with Dr. Rasmussen to have the device adjusted, slowly narrowing the cleft.

"It's a lot of work for families up front," Dr. Rasmussen says. "But this treatment hopefully reduces the number of surgeries a child will need going forward."

Dr. Rasmussen and his team recognize the burden treatment places on families.

"We adjust the device, but mom and dad do the real work," Dr. Rasmussen says.

Not long ago, Dr. Rasmussen decided to do something special to recognize that work. He created a graduation ceremony that's held on the last day of a child's NAM treatment, complete with a certificate of completion.

Families are also given a onesie, made by an Orthodontics team member, that reads, "Every smile has a story."

"We get attached to the families, and this is a way to say thanks and congratulations," Dr. Rasmussen says.

Sarah says that same care and concern was shown by every member of Walker's care team.

"Everyone rallied around us," Sarah says. "He was receiving care from different teams, but they were all working together to look out for Walker's best interests. They all had the attitude, 'We've got this,' which was comforting to us as parents."

When he was 13 weeks old, Walker had his first surgery.

"Handing him over for surgery was the hardest part of all of this," Sarah says. Afterward, she was handed back "a completely different baby."

"It is amazing to see the transformation," Sarah says. "We took family photos before surgery and to look at those and then see him now is incredible."

And definitely something to smile about.


Tags: Cleft lip and cleft palate, Dr. Chad Rasmussen, Dr. Uldis Bite, Patient Stories

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