Three-year-old Logan Hatfield doesn’t simply ask to watch “The Lion King.” He lets out a loud roar and follows with a soft “king.”
It’s one of the many cherished memories he has created for his parents, Jenna and Brad, and his two older siblings. It’s also a welcomed contrast to the months before and after his birth, when his parents worried how a cleft lip and palate would affect his development.
Logan, to their delight, now not only roars but also wrestles his brother and lets his sister dress him. He’s just like any other kid, Jenna says, thanks to the treatment he received at Boston Children’s Hospital. “It’s really remarkable, especially thinking back on how anxious I was,” she says.
He will have a second surgery in several years, after his facial features and bone structure change. For now, 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. Just as importantly, he can also display what his mom calls “his very big personality.”
Finding a support system
Logan, a resident of New Hampshire, had a wide bilateral cleft lip and palate. With openings on both sides of his lip running into his nose, it was, according to Jenna, challenging for Logan to feed and for her to manage.
But Jenna and Brad had been preparing for those challenges before Logan was born. It started when an ultrasound suggested he might have a genetic syndrome. To learn more, Jenna’s doctor recommended Boston Children’s, where an MRI ruled out any syndrome but confirmed that he would be born with a cleft lip. While the identification of a cleft lip wasn’t necessarily good news, it seemed less jarring than the possibility of more serious medical conditions. Plus, after meeting with Boston Children’s clinicians, she had “only good feelings” about the care he would eventually receive — an understanding that her family wouldn’t be alone during what they recognized would be a long journey with many highs and lows.
Overcoming early hurdles
Logan was first treated at Boston Children’s days after his birth. Because of his cleft lip and palate, he could not generate suction and had trouble feeding from a bottle. He was given a bottle with a one-way valve that lets milk flow without suction and makes feeding easier — a temporary solution until the next step of his treatment three months later.
To move his gums and palate closer together, Dr. Elizabeth Ross, a Boston Children’s dentist, temporarily attached an orthodontic appliance known as a Latham-type device to bone in Logan’s mouth. This pre-surgery step required Jenna to occasionally turn a screw in the device for it to pull together his gums and palate. “It was pretty difficult,” Jenna recalls. “I had to feed him with a syringe for a month after that because he had to learn to eat all over again.”
But Jenna stayed mindful that this challenging step was one of several that would lead to improvements in Logan’s condition. It also gave her a sense of accomplishment that she had helped his recovery.
Another surgery down the road
More progress came later in 2019 with the first of two transforming operations. Dr. Carolyn Rogers-Vizena, a plastic surgeon in the Cleft Lip and Palate Program, repaired Logan’s lip by repositioning and uniting the skin, muscle, 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 gets past the first stage of surgical repair — typically in infancy, as Logan has — their quality of life improves and parents see progress is possible.
Life the way it should be
For Logan and his family, life is now how it should be: mostly worry-free. He loves being the younger brother of 6-year-old Jackson and 5-year-old Adalyn, and he has charmed his preschool teacher.
And with Logan far along in 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 nonprofit that sends care packages to young patients.
Jenna remembers when Logan finally turned a corner. Progress was evident in the form of a seemingly ordinary activity: A few months after his first surgery, Logan reached past his mother, held her drink — and finally took a few sips through a straw.
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