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 (CDC).
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 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.
The cause of cleft palate and lip is not 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 more likely.
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 acid
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.
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 a 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 a child has problems with ear infections and their Eustachian tubes do not drain properly, hearing loss can result.
A 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.
It’s possible for cleft palate and lip to be diagnosed while the 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, he may want to remove some of the amniotic fluid that surrounds your baby to have it tested for other genetic abnormalities, like Van der Woude syndrome.
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 he or she is 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.
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.