Cleft lip (cleft lip)

• Article
• 2021-03-02

In the earliest days of a baby's development in the womb, there is normally a cleft (called a cleft) between the right and left sides of the lip and the roof of the mouth (called the palate). Sometime during the 6 ^th to 11 ^th week of pregnancy, the split comes together to form the lips and the mouth. If the tissue doesn't join, it can cause cleft lip or cleft palate.

The opening in a cleft lip can be a small cleft or a large cleft that extends from the lip to the nose. The slit can be on one side or on both sides of the lip, or in the middle. The opening in a cleft palate can affect the front, back, or both parts of the palate.

A baby can be born with only a cleft lip or cleft palate, but some babies are born with both.

Children with cleft lips or cleft palates may have problems eating and breathing, depending on the size of the openings. As they get older, they can also develop speech and language delays. Children with cleft lip or palate are also more likely to have ear infections, hearing loss and dental problems.

Causes

The most recent research suggests that cleft lip or palate is caused by:

• Genes. A gene defect inherited from one or both parents prevents the lips and mouth from joining during development in the womb.
• Genetic syndromes. A genetic syndrome is a disease that has more than one symptom or defect. It can be caused by a single gene or many genes. Cleft lip or palate are found in more than 400 syndromes, including Waardenburg, Pierre Robin and Down syndromes. About 30 percent of cleft defects are associated with a genetic syndrome.
• Health and environment. A mother's poor health during early pregnancy, or if she drinks alcohol, smokes cigarettes, or is on certain anti-seizure medications, can increase the risk of cleft lip or palate.

Diagnosis

A cleft lip can be diagnosed during pregnancy during a routine ultrasound. It will usually be visible during a baby's initial examination, although some types of cleft palate are not easily visible and may not be diagnosed until later in life.

Therapy

The treatment of children with cleft lip or palate depends on the size of the cleft, the age and needs of the child, and whether there are additional problems associated with a genetic syndrome. A child with a cleft lip or palate is often referred to a team of experts, including an ENT (ear, nose, and throat) physician, plastic surgeon, oral surgeon, speech pathologist, pediatric dentist, orthodontist, audiologist, pediatrician, nutritionist, and psychologist / social worker. Because cleft lip and palate are so often part of genetic syndromes, a thorough medical exam and genetic counseling is recommended for children and their parents to find out if their future children may be affected.

Surgery is often used to close the lip and palate. Cleft lip surgery is usually performed before a baby's first birthday, and surgery on the palate is performed before 18 months. If there are other problems as they get older, a child may need additional surgeries, dental and orthodontic care, and speech therapy. With treatment, most children with cleft lip or palate do well and lead healthy lives.

Helpful Hints

• Ask for advice, especially if your baby is having trouble breastfeeding or drinking from a bottle. There are many ways to overcome nutritional problems.
• Asking questions. Talk to the people treating your baby and ask them to explain what you don't understand.
• Ask for support from family, friends and other ouchildren of children with a cleft lip and palate.

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