Cleft Palate/Cleft Lip
What is it?
A cleft is a birth defect that occurs when the
tissues of a fetus's lip and/or palate do not
properly fuse very early in pregnancy. A cleft
palate is a condition in which the roof of the
mouth abnormally opens into the floor of the nose.
A cleft lip is an elongated opening between the
upper lip and the nose. It may involve one or both
sides of the lip and may occur with or without a
cleft palate.
Who gets it?
Cleft palate and cleft lip are conditions
present at birth. Cleft palate occurs
approximately once in every 2,500 live births and
affects females more than males. However, twice as
many boys as girls are afflicted with a cleft lip,
both with and without a cleft palate. Clefting
occurs most often in Asians, Latinos, and Native
Americans (1 of 500 births) and least often in
people of African descent (1 of 1000 births).
What causes it?
Cleft palate and cleft lip can be caused by
either genetic or environmental factors. The genes
that cause clefting may be passed from either
parent. Environmental factors include the mother's
diet, use of drugs or tobacco, and the rubella
virus.
What are the symptoms?
Babies born with cleft lips or cleft palates
may have trouble breathing, as well as swallowing.
They cannot adequately suck, so they cannot nurse
and must be fed with a special bottle or a bulbar
syringe. Later, when their teeth erupt, the upper
and lower teeth and jaws are often misaligned,
resulting in difficulty chewing. A cleft palate
also affects a child's speech since the palate is
necessary for speech formation. Children with
clefts are also vulnerable to frequent ear
infections. Their Eustachian tubes do not
effectively drain fluid from the middle ear to the
mouth, so fluid accumulates, pressure builds, and
infection sets in.
How is it diagnosed?
Clefting is apparent upon examination
immediately after birth.
What is the treatment?
Cleft lip defects may be repaired shortly after
birth, but many doctors prefer to operate on
infants according to the "rule of 10"-
when the child is at least 10 weeks old and weighs
at least 10 pounds. While repair of the cleft lip
is usually successful in one operation, a second
operation may be performed later to refine the
scar. Cleft palates are repaired after the first
or second year of life with a series of
operations. If the defect lies primarily in the
forward, bony portion of the palate (called the
"hard palate"), doctors may wait to
operate until the child is between five and seven
years old and has more bone growth. One option for
nonsurgical treatment is a prosthetic appliance
worn as an artificial palate. Later, the child
will need orthodontic treatment to realign the
structures of the mouth for proper function.
Children with frequent ear infections may need to
have drainage tubes inserted into their ears to
prevent hearing loss.
Reconstructive surgery, orthodontic treatment,
and speech therapy can minimize the effects of
clefting. Breathing, eating, and speech are also
greatly improved with treatment, so a child born
with a cleft lip and/or palate may lead a normal
life.
This information has been designed as a comprehensive and quick reference
guide written by our health care reviewers. The health information written
by our authors is intended to be a supplement to the care provided by your
physician. It is not intended nor implied to be a substitute for
professional medical advice.
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