Cleft Lip and Cleft Palate

Cleft lip and cleft palate are abnormal facial and oral formation that causes openings or splits in the upper lip, palate, or both. This malformation makes the facial structures of the baby not completely close. This malformation occurs in pregnancy. Isolated birth defects and inherited genetic conditions or syndromes are common factors of this condition. However, cleft lip and cleft palate can be corrected and restored to their normal function.

Symptoms

An opening or a split in the lip or palate can be identified at birth. They may appear as:

• A cleft in the lip or palate affecting one or both sides of the face
• A cleft in the lip or palate appearing as a small notch in the lip or spreading through the upper gum or the bottom of the nose
• A cleft not affecting the appearance of the face

Another kind of cleft palate called submucous cleft palate is unnoticeable at birth but as its signs and symptoms develop. The signs and symptoms of submucous cleft palate may include:

• Feeding problems
• Swallowing problems, such as liquids or food coming out from the nose
• Voice of nasal speaking
• Chronic infections in the ear

When to see a doctor

The doctor usually coordinates care for cleft lip and cleft palate at birth after noticing the condition. However, if you notice any sign or symptom of submucous cleft palate, you are advised to take your baby to the doctor.

What Causes Cleft lip and cleft palate?

Cleft lip and cleft palate occur when there is a lack of tissue in the mouth and lip area to completely fuse. This condition normally happens during the first two to three months of the pregnancy. Genetic and environmental factors are considered the main factors of this condition.

Risk factors

Several factors increase the risk of cleft lip and cleft palate including:

• Family history of cleft lip or cleft palate
• Pregnant women who smoke, drink alcohol, or take some medications
• Pregnant women who have been diagnosed with diabetes before the pregnancy
• Obesity during pregnancy

Complication

Complications of cleft lip and cleft palate vary varied to the type and severity of the condition. The complications may include:

• Feeding problems
• Loss of hearing
• Ear infections
• Dental problems
• Speech problems
• Tendency to be involved with other medical conditions, such as social, emotional, and behavioral problems.

Diagnosis

Cleft lip and cleft palate can be diagnosed immediately at birth. However, they can be also seen on ultrasound before birth.

Treatment

The purposes of the treatment for cleft lip and cleft palate are to achieve a normal facial appearance and to improve the ability to eat, speak, and hear normally. The treatments may include:

Surgery

To correct cleft lip and palate, the doctor usually considers the conditions of each baby to determine an appropriate time for the surgery and the type of surgery. The kinds of surgery for cleft lip and palate are as follows:

• Cleft lip repair
• Cleft palate repair
• Ear tube surgery
• Appearance reconstructive surgery

Suggested ranges of age for each kind of surgery

• Within the first 3 to 6 months of age - cleft lip repair
• 12 months or earlier - Cleft palate repair
• Between the age of 2 and late teen years - Follow-up surgeries

Preparing for an appointment

Before your appointment, you are advised to be aware of restrictions prior the appointment and you may prepare some information including:

• Your baby’s symptoms
• Questions that you want to ask the doctor

During the consulting, the doctor may ask some questions including information such as:

• The history of your family member who has been involved with cleft lip and palate
• The problems while feeding
• The symptoms of the baby that worry you
• Whether anything improves or worsens your baby’s symptoms