A cleft lip occurs when there is a split
or opening in the lip. This opening can be small or large enough to connect the
upper lip and nose. A cleft palate occurs when the roof of the mouth does not
close properly during a baby’s early development inside the womb. The palate is
made up of two parts, either of which can be cleft – the hard palate and the
soft palate. The hard palate is a bony portion in
the front of the roof of your mouth. The
soft palate is located at the back of the mouth and is made up of soft tissue.
Cleft palate and cleft lip, also
referred to as orofacial defects, are birth defects that affect more than 7,000
babies in the United States every year, according to the Centers for Disease Control and Prevention.
Symptoms of Cleft Palate and Lip
In most cases, the split in the lip
that is characteristic of a cleft is the most noticeable sign of the defect.
Milk may come out of your baby’s nose while feeding because the barrier between
the mouth and nose is abnormal. It’s also possible for children with a cleft to
have dental problems, such as missing teeth or having extra teeth.
A cleft palate can also trigger
frequent middle ear infections and problems with your child’s Eustachian tubes.
These tubes help to drain fluid out of the ears and are responsible for making
sure that the amount of pressure is equal on both sides of your eardrum. If
your child has problems with ear infections and their Eustachian tubes don’t
drain properly, hearing loss can result.
Your child may also have problems with
speech. This is more common in cases of cleft palate than in cases of cleft
lip. Speech problems caused by a cleft are usually characterized by a nasal
quality in the voice.
Causes of Cleft Palate and Lip
The cause of cleft palate and lip
isn’t known, but doctors believe that the defects occur because of both genetic
and environmental factors. Genetics can play a role in the development of
clefts if one or both parents pass down a gene that makes a cleft palate or lip
What you do during your pregnancy can
also increase the likelihood that your child will have a cleft palate or lip.
Factors that scientists believe may cause a cleft to develop include:
- cigarette smoking
- drinking alcohol
- taking illegal drugs
- being diabetic
- not getting enough prenatal vitamins, like folic
A cleft can occur as an isolated birth
defect or as part of a larger genetic syndrome, such as van der Woude syndrome
or velocardiofacial syndrome, which are both genetic malformation disorders.
Diagnosis of Cleft Palate and Lip
It’s possible for cleft palate and lip
to be diagnosed while your baby is still in the womb through the use of an ultrasound.
An ultrasound uses high frequency sound waves to create an image of your baby
inside your abdomen.
If your doctor discovers that your
baby has a cleft palate or lip while in the womb, they may want to remove some
of the amniotic fluid that surrounds your baby to have it tested for other
genetic abnormalities, such as van der Woude syndrome.
Treatment of Cleft Palate and Lip
The treatment for your child’s cleft
palate or lip will depend on the severity of the condition. Treatment often
involves several surgeries to close the opening and reconstruct the face.
A team of specialists may work with
you and your child. For example, if your child has problems with speech because
of their cleft, they might work with a speech pathologist. Your child’s team
may also include a plastic surgeon, an oral surgeon, and/or an orthodontist.
Surgery to repair a cleft palate or
lip is ideally performed in your child’s first year. However, additional
reconstructive surgeries may be required well into your child’s teenage years.
It’s recommended that you get your
baby’s cleft lip repaired when they’re between 10 weeks and 1 year old. If your
child has a particularly wide cleft, your child’s doctor may want to do a lip
adhesion that involves sewing the cleft together temporarily until a surgeon
performs the repair. During surgery, your child will be put under anesthesia
and a surgeon will use tissue and skin from both sides of the cleft lip to make
the lip wider and close the gap.
Doctors usually perform surgery to
repair a cleft palate when a child is between 6 and 18 months old. During
surgery, the muscles and tissue on the two sides of the palate are connected
together to close the cleft.
Coping with Your Child’s Birth Defect
Ask your child’s treatment team about
support groups in your area for families of children with birth defects.
Communicate openly with your child and help to build their self-esteem by
letting them know that they are not defined by their defect.