Another equipment commonly used for gravity feeding is a customized bottle with a combination of nipples and bottle inserts. A large hole, crosscut, or slit in the nipple, a protruding nipple and rhythmically squeezing the bottle insert can result in controllable flow to the infant without the stigma caused by specialized equipment. Individuals with cleft also face many middle ear infections which may eventually lead to hearing loss. The Eustachian tubes and external ear canals may be angled or tortuous, leading to food or other contamination of a part of the body that is normally self-cleaning. Hearing is related to learning to speak. Babies with palatal clefts may have compromised hearing and therefore, if the baby cannot hear, it cannot try to mimic the sounds of speech. Thus, even before expressive language acquisition, the baby with the cleft palate is at risk for receptive language acquisition. Because the lips and palate are both used in pronunciation, individuals with cleft usually need the aid of a speech therapist. Tentative evidence has found that those with clefts perform less well at language. Psychosocial issues
There is research dedicated to the psychosocial development of individuals with cleft palate. A cleft palate/lip may impact an individuals self-esteem, social skills and behavior. Self-concept may be adversely affected by the presence of a cleft lip or cleft palate, particularly among girls. Negative outcomes can also be associated with the long durations of hospitalization.
Two faces on one head
Where twinning of the head itself is only partial, it can result in the condition known as diprosopus—one head with two faces. Earliest known occurrence
The February 22, 2007, issue of the journal Biology Letters detailed the discovery of a 122 million-year-old fossil of a two-headed Hyphalosaurus lingyuanensis, marking the earliest known occurrence of axial bifurcation. List of notable occurrences
Humans
Dicephalic conjoined twins (dicephalus parapagus dipus)
Lycosthenes described a pair of adult female twins who had separate necks but one body. Both heads ate, drank, slept, and spoke. They had to beg from door to door, "everie one giveing (sic) to her freely". They were banished to Bavaria due to fears pregnant women who saw them would give birth to similar children; nothing else is known of them. In 1990 Abigail and Brittany Hensel were born in Minnesota, United States. In 2000 Ayse and Sema Tanrikulu were born in Kahramanmaraş, Turkey
In June 2000 Carmen and Lupita Andrade were born in Veracruz, Mexico. They later moved to the United States for healthcare with their parents. In 2003 Sohna and Mohna were born in India
On June 13, 2003, twin girls named Huda and Manal Abdel Nasser Mohammed Mahmoud, were born in Asyut, Egypt
In 2006 Syafitri was born in Indonesia
In 2007 Mary Grace and Mary Divine Asis were born in the Philippines with only one heart. They died on April 30, 2008. On August 25, 2008, a baby boy named Kiron was born with two heads in south-western Bangladesh.