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Cleft Lip / Cleft Palate

What are cleft lip and cleft palate?

Cleft lip and cleft palate are birth abnormalities of the mouth and lip. These abnormalities affect about one in every 700 births and are more common among Asians and certain groups of American Indians than among Caucasians. They occur less frequently among African Americans. Cleft lip and cleft palate occur early in pregnancy when the sides of the lip and the roof of the mouth do not fuse together as they should. A child can have cleft lip, cleft palate, or both. Cleft lip and cleft palate together are more common in boys. It is also important to know that most babies born with a cleft are otherwise healthy with no other birth abnormalities.

Illustration of a unilateral incomplete cleft lip
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Illustration of a unilateral complete cleft lip
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Illustration of a bilateral complete cleft lip
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Cleft lip and cleft palate may occur together in an infant, or separately. The degree of the abnormality of both cleft lip and cleft palate can vary greatly. The most common early problem associated with these abnormalities is feeding your baby.

What causes cleft lip and cleft palate?

The exact cause of cleft lip and cleft palate is not completely understood. Cleft lip and/or cleft palate are caused by multiple genes inherited from both parents, as well as environmental factors that scientists do not yet fully understand. When a combination of genes and environmental factors cause a condition, the inheritance is called "multifactorial" (many factors contribute to the cause). Because genes are involved, the chance for a cleft lip and/or cleft palate to happen again in a family is increased, depending on how many people in the family have a cleft lip and/or cleft palate. If parents without clefts have a baby with a cleft, the chance for them to have another baby with a cleft ranges from 2 to 8 percent. If a parent has a cleft, but no children have a cleft, the chance to have a baby with a cleft is 4 to 6 percent. If a parent and a child have a cleft, the chance is even greater for a future child to be born with a cleft. Genetic consultation is suggested.

What are the symptoms of cleft lip and cleft palate?

The symptoms of these abnormalities are visible during the first examination by your infant's physician. Although the degree of the abnormality can vary, upon inspection of the mouth and lips, the abnormality can be noted, as there is an incomplete closure of either the lip, roof of the mouth, or both.

What are the complications associated with cleft lip and cleft palate?

Beyond the cosmetic abnormality, there are other possible complications that may be associated with cleft lip and cleft palate, including the following:

Feeding my baby with cleft palate:

The most immediate concern for a baby with cleft palate is good nutrition. Sucking for children with a cleft palate is difficult because of the poorly formed roof of the mouth. Children with just a cleft lip (without a cleft palate) do not routinely have feeding difficulties. The following are suggestions to help aid in the feeding of your infant:

The team approach for managing and correcting cleft abnormalities:

There may be many people involved in management of a cleft abnormality for your child, because the skills of many different areas are needed to help with the problems that can occur with cleft abnormalities. The following are some of the members of the team:

Treatment for cleft lip and cleft palate:

Treatment for these abnormalities includes surgery and a complete team approach to help with the multiple complications that can occur. Specific treatment will be determined by your child's physician based on:

For most infants with cleft lip alone, the abnormality can be repaired within the first several months of life (usually when the baby is 10 to 12 pounds). This will be decided by your child's surgeon. The goal of this surgery is to fix the separation of the lip. Sometimes, a second operation is needed.

Cleft palate repairs are usually done between the ages of 9 to 18 months, but before the age of 2. This is a more complicated surgery and is done when the baby is bigger and better able to tolerate the surgery. The exact timing of the surgery will be decided by your child's physician. The goal of this surgery is to fix the roof of the mouth so that your child can eat and learn to talk normally. Sometimes, a second operation is needed.

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Online Resources of Craniofacial Anomalies


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