Cleft lip and cleft palate
DEFINITION
Cleft lip and cleft palate are openings or splits in the upper lip, the roof of the mouth (palate) or both. Cleft lip and cleft palate result when developing facial structures in an unborn baby don’t close completely.
Cleft lip and cleft palate are among the most common birth defects. Cleft lip and cleft palate most commonly occur as isolated birth defects but are also associated with many inherited genetic conditions or syndromes.
Having a baby born with a cleft can be upsetting, but cleft lip and cleft palate can be corrected. In most babies, a series of surgeries can restore normal function and achieve a more normal appearance with minimal scarring.
CAUSES
Cleft lip and cleft palate occur when tissues in the baby’s face and mouth don’t form properly. Normally, the tissues that make up the lip and palate fuse together in the second and third months of pregnancy. But in babies with cleft lip and cleft palate, the fusion never takes place or occurs only partially, leaving an opening (cleft).
Researchers believe that most cases of cleft lip and cleft palate are caused by an interaction of genetic and environmental factors. In many babies, a definite cause isn’t discovered.
Genes inherited from the parents. Either the mother or the father can pass on genes that cause clefting, either as an isolated defect or as part of a syndrome that includes clefting as one of its signs. In some cases, babies inherit a gene that makes them more likely to develop a cleft, and then an environmental trigger actually causes the cleft to occur.
Exposure to certain substances during pregnancy. Cleft lip and cleft palate may be more likely to occur in pregnant women who smoke cigarettes, drink alcohol and take certain medications
SYMPTOMS
Usually, a cleft — or split — in the lip or palate is immediately identifiable at birth. Cleft lip and cleft palate may appear as:
- A split in the lip and roof of the mouth (palate) that can affect one or both sides of the face
- A split in the lip that can appear as only a small notch in the lip or can extend from the lip through the upper gum and palate into the bottom of the nose
- A split in the roof of the mouth (palate) that doesn’t affect the appearance of the face
Less commonly, a cleft occurs only in the muscles of the soft palate (submucous cleft palate), which are at the back of the mouth and covered by the mouth’s lining. This type of cleft often goes unnoticed at birth and may not be diagnosed until later when signs develop. Signs and symptoms of submucous cleft palate may include:
- Difficulty swallowing
- Nasal speaking voice
- Recurring ear infections
When to see a doctor
A cleft lip and cleft palate are usually apparent at birth, and your doctor may start coordinating care at that time. If your baby has signs and symptoms of a submucous cleft palate, such as difficulty with feedings, make an appointment with your child’s doctor.
