Cleft Lip and Palate in Children
Overview
Cleft lip and palate are openings or splits in the upper lip or roof of the mouth (palate). A child can be born with a cleft lip, cleft palate, or both. Cleft lip and palate may be the only birth defects, or they may happen with other defects.
A cleft lip may be as mild as a notch of the lip. Or it may be as severe as a large opening from the lip to the nose.
A cleft palate may leave an opening that goes into the nasal cavity. Cleft palate is not as noticeable as cleft lip because it is inside the mouth. The cleft may:
- Affect one or both sides of the palate
- Go from the front of the mouth or hard palate to the throat or soft palate
- Include the lip
Causes
Cleft lip and cleft palate happen when a baby develops in the mother's uterus. Researchers don't know the exact cause of cleft lip and palate. It can be caused by genes passed on from parents, as well as environmental factors. Environmental factors include taking certain medicines during pregnancy, smoking or drinking alcohol during pregnancy, infections, and getting too little vitamin B and folic acid during pregnancy. Parents who have cleft lip, cleft palate, or both, or who have other kids with the problem are at an increased risk of having babies with the defect.
Symptoms
The symptoms of these problems can be seen during the first exam by your baby's healthcare provider. How much the lip or palate differs from normal can vary. The symptoms can include:
- Lip doesn't close fully
- Roof of the mouth doesn't close fully
- Neither the lip nor the roof of the mouth closes fully
Diagnosis
A cleft lip and cleft palate can be diagnosed during pregnancy during a routine ultrasound exam. Or they may be seen during the first exam by your baby's healthcare provider.
Treatment
Both cleft lip and cleft palate can be fixed with surgery.
- Cleft lip. The first surgery for cleft lip is often done before a baby is 1 year old, but as early as possible.
- Cleft palate. The first surgery for cleft palate is often done in the first 18 months after birth, but again as early as possible. Some children may need more than one surgery.
Complications
Beyond the appearance of a cleft lip, other possible complications include:
- Feeding trouble. Feeding trouble happens more with cleft palate defects. Your baby may not be able to suck correctly because the roof of the mouth is not formed completely. Most babies with cleft palate aren't able to breastfeed. But they can be fed breastmilk with special nipples and bottles.
- Ear infections and hearing loss. Ear infections are often caused by problems with the tubes that connect the middle ear to the throat (eustachian tubes). Infections that come back again and again can then lead to hearing loss.
- Speech and language delay. Muscles involved with speech may not work well. This can lead to a delay in speech or odd speech. Talk with your child's healthcare provider about seeing a speech therapist.