Cleft Lip and Palate

Cleft lip and palate are birth defects that occur when a baby's lip or mouth does not form properly during pregnancy. They are among the most common birth defects, affecting about 1 in every 700 births.

Types of Clefts

• Cleft Lip: A cleft lip is an opening in the upper lip that can extend into the nose. It can occur on one or both sides of the lip and can be complete (extending into the nose) or incomplete (only affecting the lip).
• Cleft Palate: A cleft palate is an opening in the roof of the mouth, which can affect the hard palate (the bony part of the roof of the mouth) and/or the soft palate (the soft tissue at the back of the roof of the mouth).
• Cleft Lip and Palate: Some babies have both a cleft lip and a cleft palate, which can occur on one or both sides of the face.

Causes and Risk Factors

The exact cause of cleft lip and palate is not known, but it is believed to be a combination of genetic and environmental factors. Some risk factors include:

• Family history: Having a family member with a cleft lip or palate increases the risk.
• Genetic syndromes: Certain genetic syndromes, such as van der Woude syndrome, can increase the risk of cleft lip and palate.
• Pregnancy complications: Women who have diabetes, smoke, or take certain medications during pregnancy may be at higher risk of having a baby with a cleft lip or palate.

Symptoms

The symptoms of cleft lip and palate can vary depending on the severity of the condition. Some common symptoms include:

• Visible opening in the upper lip (cleft lip)
• Opening in the roof of the mouth (cleft palate)
• Difficulty feeding: Babies with cleft lip and palate may have trouble latching onto a breast or bottle, which can lead to feeding difficulties.
• Hearing problems: Children with cleft palate are at higher risk for ear infections and hearing loss.
• Speech difficulties: Cleft lip and palate can affect the development of speech and language skills.

Treatment

Treatment for cleft lip and palate typically involves a team of healthcare professionals, including plastic surgeons, orthodontists, and speech therapists. The goal of treatment is to repair the cleft lip and palate, improve appearance, and restore function.

• Surgery: Surgery is usually performed in stages, starting with repair of the cleft lip at around 3-6 months of age, followed by repair of the cleft palate at around 9-12 months of age.
• Orthodontic treatment: Orthodontic treatment may be necessary to improve the alignment of teeth and bite.
• Speech therapy: Speech therapy can help children with cleft lip and palate develop proper speech and language skills.

Complications

Children with cleft lip and palate are at higher risk for certain complications, including:

• Ear infections: Children with cleft palate are at higher risk for ear infections, which can lead to hearing loss if left untreated.
• Hearing loss: Children with cleft palate may experience hearing loss due to recurrent ear infections or other factors.
• Dental problems: Children with cleft lip and palate may be at higher risk for dental problems, such as tooth decay and gum disease.

Prognosis

The prognosis for children with cleft lip and palate is generally good, especially with early treatment and intervention. With proper care and management, most children with cleft lip and palate can lead normal, healthy lives.