Cleft Lip and Cleft Palate: What You Should Know

Cleft lip and cleft palate or orofacial clefts are birth defects that affect one in nearly 3,000 babies in the US. During pregnancy, the baby’s lip and/or palate do not form normally. Affected children are born:

  • With cleft lip and cleft palate
  • With cleft lip but normal palate
  • With cleft palate but normal lip

Children born with orofacial clefts frequently develop difficulties speaking clearly and feeding and are prone to ear infections. They may also experience oral and aural problems.

Cleft Lip

A baby’s lip forms sometime between the fourth and seventh weeks in the womb. During pregnancy, specialized cells and body tissue from either side of the head grow toward the facial center, ideally joining together to form the lips and the mouth. A disruption in the joining of these tissues before birth results in a cleft lip, or a crevice in the baby’s upper lip. The crevice that forms may be a small split in the upper lip, or it can be large enough to go through the lip and extend into the nose. It may form on one side, the middle, or both sides of the lip. It is also possible for children born with a cleft lip to likewise have a cleft palate.

Cleft Palate

The baby’s palate (the inner mouth’s roof) forms sometime during the 6th to 9th weeks in the womb. A cleft palate results from the failure of mouth tissue to join together at this time. In some cases, the front and back portions of the mouth’s roof are both open. In others, the palate is only partially open.

Causes of Orofacial Clefts

The actual causes of orofacial clefts in infants remain unknown. For some children, it is possibly genetic or combined with other factors such as the environment, the mother’s diet, or certain medications, especially during the early stages of pregnancy.  

Recent reports from the Centers for Disease Control and Prevention (CDC) included research findings of a number of risk factors for giving birth to a child with an orofacial cleft:

  • Smoking: Smoking during pregnancy increases the likelihood of giving birth to a child with an orofacial cleft.
  • Diabetes: A mother diagnosed with diabetes prior to pregnancy has been linked to an increase in the risk of giving birth to a child with orofacial clefts.
  • Certain medications: Women who took valporic acid or topiramate for the treatment of epilepsy during the early stages of pregnancy, particularly the first trimester, have been found to be at a higher risk of giving birth to a child with orofacial clefts.

Other factors that may increase the likelihood of a child developing an orofacial cleft include:

  • Folic acid deficiency 
  • Substance abuse during pregnancy
  • The exposure to chemicals or viruses during pregnancy.
  • Underlying medical conditions.

Orofacial clefts are highly recognizable physical deformities and, thus, easily diagnosed, sometimes even before a baby is born. Prenatal ultrasound can effectively detect most orofacial clefts, particularly cleft lips. Due to its concealed location, cleft palate is harder to diagnose pre-birth.

Treatment for Cleft Lip/Palate

The treatment for orofacial clefts in children may vary, depending on a number of factors such as severity, age, and other syndromes or defects present at birth.  

Corrective surgery performed by a specialist plastic surgeon is usually recommended at various stages for different children. The repair of a cleft lip is ideally done during the baby’s first 12 months and within the first 18 months for children with cleft palate. Some children may need additional surgery as they age. Surgical procedures for repairing orofacial cleft improve the child’s facial appearance and correct breathing, speech and language development, and hearing. Other children will likewise need additional treatment like orthodontic procedures or speech therapy.  

Children born with orofacial clefts generally have a positive prognosis. Although, for some children, there may be self-esteem issues arising from their difference of appearance relative to children born without orofacial clefts. Various support groups for both parents and children have been established and organizations that provide financial and medical aid for families with children born with orofacial clefts.  

Cleft lip and cleft palate are orofacial clefts—birth defects characterized by the separation or split in the inner and outer mouth of a baby. These develop during pregnancy, found as possibly linked to a mother’s diet, smoking, environment, or medications. In the US, orofacial clefts are known to be the fourth among commonly occurring congenital disabilities. Even though treatment may involve several corrective surgeries or therapy over many years, children with orofacial clefts can grow up leading normal, healthy lives.

Meta title: Orofacial Clefts: Causes and Treatment
meta desc: Cleft lip and cleft palate are orofacial clefts, one of the leading congenital disabilities among children. Find out about their causes and treatment in this article.

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