Cleft Lip & Cleft Palate: Everything A Parent Needs To Know!

Cleft lip & cleft palate are common birth defects where a baby is born with a cleft/gap or split in the lip and/or roof of the mouth (palate). This malformation occurs when the baby is developing inside the mother’s womb, where the tissue doesn’t fuse together. These conditions can either occur solely or could occur as part of a syndrome. Cleft lip and cleft palate can either occur on one or both sides of the mouth. It is possible to have a cleft lip without a palate or vice versa or both cleft lip and palate as the lip & roof of the mouth develop separately. It has been found, that twice as many boys are born with a cleft lip, both with and without a cleft palate, and twice as many girls are born with a cleft palate without a cleft lip. Keep reading to learn more about the causes, signs & symptoms & treatment!

Most of the time, the causes for a cleft lip & cleft palate are unknown and cannot be prevented. However, genetic and environmental factors may play a role. It is known that there is a greater chance of a baby to be born with one or both of these facial defects if their sibling or parent has the same. Some medications such as anti-seizure drugs, acne medications containing Accutane, methotrexate if consumed by the mother during pregnancy can lead to the afore-named facial malformations. Exposure to certain viruses or chemicals during the fetal developmental stages could also play a role.

Once a baby is born, a paediatrician can easily spot the diagnosis either due to the obvious physical changes or during a routine physical examination of the newborn’s mouth, nose & palate. A physician may also be able to pick the malformation(s) during a prenatal ultrasound examination. If this is a part of a syndrome, then other tests may be conducted to check for other abnormalities.

Difficulty Eating/Feeding – A gap or opening in the palate can allow foods/liquids to pass from the mouth back through the nose. Since the surgical correction can’t happen until a certain age, the baby will have to be fed using specially designed bottles to help the food/liquids enter the stomach. Other options could include wearing an artificial palate.

Ear Related Issues – There‘s an increased risk for ear infections with cleft palate, due to the build up of fluid in the middle ear. If left untreated this can lead to hearing loss, for this reason a special tube is placed in the ears to help prevent fluid collection.

Dental Issues – There is an increased chance of having dental related issues such as missing teeth, extra teeth, malformed or displaced teeth along with increase in cavities and other teeth-related issues which would require orthodontic treatments including oral surgeries to fix the issues.

Speech Related Issues – Difficulty speaking can be a problem with kids with cleft lip or cleft palate. However, a speech pathologist can help resolve speech-related issues.

Treatment plan depends on the defect and the extent of the defect. A cleft lip, for example, may need 1 or 2 surgical corrections. The first correctional surgery performed at 3 months of age. A cleft palate on the other hand, requires more surgeries over the course of 18 years, the first surgery performed between 6 & 12 months of age which is performed to simply create a functional palate to reduce risks of ear infections and allow for the teeth & facial bones to develop as normally as possible. A bone graft can be needed at 8 years of age to help stabilize the jaw and support the permanent teeth. Depending on the extent of the defect, further surgical interventions may be needed to help improve speech, improve the appearance of lip, nose, removal or minimization of scars, for example. The treatment plan may involve a multidisciplinary approach such as involvement of plastic surgeons, audiologists, orthodontist, oral surgeon, otolaryngologist among others. The good news is, if it is an isolated oral/facial defect, then most children can live a normal life by achieving normal appearance, speech & eating. However, if this is part of a syndrome, the outcome will depend on the presence of other malformations/defects.