Cleft lip and palate are among the most common birth defects. These conditions occur when the tissues that form the lips and roof of the mouth do not fully come together during pregnancy, which typically occurs between the 6th and 11th weeks of development. The result is a cleft, or opening, in the upper lip, the palate, or both.
A cleft may appear as a small notch or a larger gap that can extend into the nose. It can affect one side of the lip, both side, or occur in the center. A cleft palate can involve the front, or back, or both parts of the palate. Some babies are born with only a cleft lip or a cleft palate, while others have both.
Depending on the severity of their condition, children with a cleft lip or a cleft palate may experience:
- Feeding problems
- Breathing problems
- Speech and language delays
- Frequent ear infections and possible hearing loss
- Dental problems
Causes of Cleft Lip and Palate
While the exact cause is not always known, the following factors may contribute to the development of cleft lip and cleft palate:
- Genetics: A gene passed down from one or both parents may interfere with the normal development of the lips and mouth.
- Genetic syndromes: Cleft lip or palate are found in hundreds of syndromes, including Waardenburg, Pierre Robin, and Down syndromes. Because cleft lip and palate are so often part of genetic syndromes, a thorough medical evaluation and genetic counseling may be recommended to help families understand the condition and assess the risk for future children.
- Maternal health and environment: Smoking, alcohol use, poor maternal health, and some medications (such as anti-epileptic medications) during pregnancy may increase the risk.
Diagnosing Cleft Lip and Palate
Cleft lip can often be detected during routine prenatal ultrasounds. After birth, cleft lip or palate is typically identified during the baby’s first physical exam. However, some types of cleft palate aren’t easily visible and might not be diagnosed until later in life.
Treatment and Support
Treatment for children with cleft lip or palate depends on the size of the cleft, the child’s age and overall health, and whether the condition is associated with a genetic syndrome. Children are usually cared for by a multidisciplinary care team that may include:
- Otolaryngologist (ear, nose, and throat doctor, or ENT)
- Plastic surgeon
- Oral surgeon
- Speech pathologist
- Pediatric dentist
- Orthodontist
- Audiologist
- Pediatrician
- Nutritionist
- Psychologist/social worker
Surgery is often used to repair the cleft. Cleft lip surgery typically occurs before a child’s first birthday, while cleft palate surgery is usually performed before 18 months. Children may require additional surgeries, dental and orthodontic care, and speech therapy as they grow.
With treatment, most children with cleft lip or palate go on to lead healthy lives.
Helpful Tips for Families
- Feeding support: Feeding challenges are common in infants with cleft lip or palate. Ask your child’s care team on ways to overcome feeding challenges.
- Ask questions: Talk to your child’s care team and ask them any questions you understand your child’s. condition and treatment plan.
- Seek support: Connect with other parents of children with cleft lip and palate, and lean on friends and family during this journey.