Cleft lip and cleft palate are openings or split in the upper lift, the roof of the mouth i.e. palate, or both.

Both of these develop when facial structures that are developing in your baby do not close completely.

It is important to note that both of these are some of the most common birth defects.

Moreover, they commonly occur as isolated birth defects, however, may also be associated with different inherited genetic conditions or syndromes.

Thus, if you have a baby born with a cleft lip, it can be upsetting, however, you can always consult your doctor.

They can correct this condition and with a series of surgeries, they can restore it to a normal function,

Additionally, it helps to restore a normal function and achieve a more normal appearance with minimal scarring.

Keep on reading to learn more about it in detail.

Understanding a Cleft

A cleft is a fissure or a gap and it can be small, or partial.

It looks like an indentation on the lip of your child and can also completely extend to the nose.

A unilateral cleft occurs when the two parts of your child’s skull that form the hard palate do not fuse together.

The soft palate, on the other hand, has a gap or cleft.

Moreover, if your child has a complete cleft palate, they may also have a gap in their jaw.

While an incomplete cleft palate looks like a hole in the roof of the mouth.

cleft palate 1

According to the Centers for Disease Control and Prevention, CDC, in the United States alone, about 2650 infants are born with a cleft palate every year.

About 4,400 babies develop this each year and might occur with or without a cleft palate.

With the help of modern surgery, your doctor can help your child correct this condition with minimal scarring.

However, if you do not get the treatment it may cause dental problems, ear infections leading to hearing loss, feeding difficulties, low self-esteem, and speech problems.

A team consisting of your family physician, to a speech therapist will work together to help your child as it can cause a range of developmental issues.

Causes of Cleft Palate

While you are conceiving, during the first 12 weeks, the skull of the fetus begins to develop.

Two separate plates of the bone and tissue form and gradually move towards each other.

At this point, the join or fuse, at the mouth and nose to form the skull of your baby.

However, if this procedure does not complete or if there is incomplete fusion, it will result in a cleft.

Moreover, researchers are of the view that most cases of cleft palate and cleft lip are due to an interaction of both genetic and environmental factors.

You or your spouse can pass on the genes to your child causing clefting.

This can be either alone or as a part of a genetic syndrome that includes this condition as one of the signs.

But in some cases, your child may inherit a gene that makes them more likely to develop it, and then certain environmental factors may trigger its development to occur.

Risk Factors of Cleft Palate

There are different factors that can increase the likelihood of your baby developing a cleft lip and cleft palate.

These are as follows:

Family History: If you or your spouse have a family history of cleft lip or cleft palate, there are higher chances of having a child with a cleft.

Exposure to Certain Substances: It is important to note that exposure to certain chemicals like smoking, drinking alcohol, or using certain medications during pregnancy can also cause its development.

Diabetes: Some evidence suggests that females who have diabetes before pregnancy can have increased chances of having a baby with cleft lip, with or without cleft palate.

Obesity: Some evidence suggests that babies born to obese women also have an increased risk of this condition.

It is important to note that men or boys are more likely to have cleft lips with or without cleft palate.

However, cleft palate without cleft lip is more common in girls.

According to research, both these conditions are most common in Native Americans and least common in African Americans.

Symptoms of Cleft Palate

This condition is immediately identifiable at the time of birth and may appear as:

  • a split in the lip and roof of the mouth or palate that affects either or both sides of the face
  • a split in the roof of the mouth that does not affect the appearance of the face
  • split in the lip that appears as only a notch or gap in the lip or extend from the lip through the upper gum and palate into the bottom of the nose

On the other hand, a cleft occurs only in the soft palate or submucous cleft palate which is rare.

This is present at the back of the mouth and is covered by the lining of the mouth.

This type is often not identifiable at the time of birth and may not even be diagnosed until late when your child develops certain signs.

Signs and Symptoms of such a condition are:

Difficulty feeding, and swallowing nasal speaking voice, and chronic ear infections.

Diagnosis of Cleft Palate

In most cases, your doctor can identify the cause of the cleft palate at the time of birth and does not need special tests for its diagnosis.

Moreover, before your baby is born, your doctor can also diagnose this condition with the help of an ultrasound.

Additionally, a prenatal ultrasound that uses sound waves to create pictures of the developing fetus can help.

While analyzing, your doctor can detect a difference in the facial structure of your child.

surgical options

Your doctor can identify this condition around the 13th week of pregnancy.

As the fetus is still developing, it is often easy to diagnose a cleft lip.

However, a cleft palate that occurs alone is more difficult to diagnose in an ultrasound.

If during an ultrasound, your doctor diagnoses a cleft, they may offer a procedure to take a sample of amniotic fluid.

This test can help indicate that the fetus has inherited a genetic syndrome that may also cause other birth defects.

In most cases, however, the causes of this condition are unknown.

Treatment of Cleft Palate

The goals of the treatment are to help your child and improve their ability to speak, eat and hear normally.

Moreover, it helps them to achieve a normal facial appearance.

This often involves a number of doctors like surgeons, oral surgeons, ENT specialists, pediatric dentists, orthodontists, hearing specialists, speech therapists, psychologists, etc.

The treatment involves surgery to repair the defect and therapies to improve any related conditions.

Surgery

Depending on the condition of your child, surgery can help to correct the cleft lip and palate.

Following the initial repair, your doctor will recommend following-up surgeries to improve speech and appearance of the lip and nose.

Your doctor will perform the surgeries in the following order:

Cleft Lip Repair: within 3 to 6 months of the age

Cleft Palate Repair: by the age of 12 months. In some cases earlier is possible

Follow-up Surgeries: between the age of 2 and late teens.

Let’s learn about it in detail.

Surgical Treatment

The surgery for both cleft lip and cleft palate takes place in the hospital.

Your doctor or surgeon will administer general anesthesia so that your child does not feel pain.

Different surgical techniques and procedures help to repair cleft lip and palate, reconstruct it, and prevent any related complications.

The procedure includes:

Cleft Lip Repair

This helps to close the separation in the lip. The surgeon will make incisions on both sides and create flaps of tissues.

They will then stitch together, including the muscles, and create a more normal lip appearance, structure, and function.

Initial nasal repair is also done during this repair.

Cleft Palate Repair

With the help of different procedures, your child’s surgeon will close the separation and rebuild the roof of the mouth.

results

During this, they will make incisions on both sides and reposition the tissue and muscles and then stitch them.

Ear Tube Surgery

For your child, ear tubes may also be placed to reduce the risk of chronic ear fluid, which can lead to hearing loss.

During this surgery, they will pace tiny bobbin-shaped tubes in the eardrum to create an opening to prevent fluid buildup.

Reconstruction Surgery

Additional surgeries can help to improve the appearance of your child’s mouth, lip, and nose.

Surgeries can help improve the appearance, quality of life, and ability to eat, breathe, and talk.

However, possible risks are bleeding, infection, poor healing, widening or elevation of scars, and temporary or permanent damage to the nerves, blood vessels, or other structures.

Treatment for Complications

Your doctor can recommend other treatments for complications due to this condition.

These includes:

Feeding strategies like using a special bottle nipple or feeder, speech therapy to correct speech difficulties, and orthodontic adjustments to the teeth and bite like using braces.

cleft palate complications

Moreover, your pediatric dentist will monitor tooth development and oral health, ENT specialist will monitor ear infections, and may also recommend assistive devices or hearing aid.

Therapy with a psychologist can also help your child cope with the stress of repeated medical treatments and other concerns.

Complications of Untreated Cleft Palate

Certain complications that can occur due to a cleft palate or an untreated cleft palate are:

One of the immediate concerns right after birth is feeding your child, and cleft palate can make it difficult to feed.

Moreover, your child is at an increased risk of developing middle ear fluid and hearing loss.

If the cleft palate extends to the upper gum, it can affect the tooth development of your child.

Additionally, it can cause speech difficulties and it may sound nasal.

Your child may also face social, emotional, and behavioral problems due to differences in appearance and the stress of intensive medical care.

Final Thoughts

If your child has a cleft lip and cleft palate, you may be concerned about the possibility of having another child with the same condition. While most cases cannot be prevented, you can consider genetic counseling, taking prenatal vitamins, and avoiding using tobacco and alcohol while conceiving.