All About Cleft Lip and Cleft Palate

02 November, 2020
In order to try to correct a cleft lip and cleft palate, many professionals with knowledge of many different areas are necessary.

Cleft lip and cleft palate are birth defects that occur when a baby’s lip or mouth doesn’t form properly during gestation. Together, these two conditions are often known as “orofacial clefts”.

Children with these abnormalities often have difficulty feeding and speaking clearly. They’re also more likely to suffer from ear infections and experience dental problems and hearing difficulties.

A cleft lip is usually more common in boys than girls. Also, it’s important to know that most babies born with a cleft are healthy and have no other birth defects.

What is a cleft lip?

A child with a cleft palate.

During embryonic development, the formation of the lips takes place between weeks 4 and 7. Both the child’s tissues and a special cell type grow in the direction of the center of the face in order to form the face itself.

The union of these tissues forms facial features such as the lips and mouth. So, a cleft lip occurs when the tissue that forms the lips doesn’t completely join together before birth.

It’s for this reason that an opening appears in the upper lip. This opening can vary in size from one person to another and even go through the lip and into the nose.

In addition, these deformations can occur in different areas of the lip. For example, on one side, both sides, or in the center. This last location is usually the least common.

What is a cleft palate?

Babies born with a cleft lip usually have a deformed palate as well. Unlike the lip, the palate forms between weeks 6 and 9 of gestation. A cleft palate occurs when the tissue that forms this structure doesn’t come together properly during pregnancy.

This deformation can be more or less pronounced. In some babies, the malformation affects both the front and the back of the palate. In contrast, in others, only a part of the palate remains open.

You may also be interested in reading: Respiratory Diseases in Newborns

Causes

Experts aren’t sure of the exact cause of cleft lip and palate. Multiple genes inherited from both parents cause a cleft lip and/or palate. Thus, a combination of genes and environmental factors causes these disorders. In other words, the inheritance is known as “multifactorial”.

Since genes are involved, the chances of a cleft lip or palate occurring again in a family are high. However, the likelihood will depend on the number of family members who have this deformation.

If one parent has a cleft, but none of their children have it, the chances of having a baby with a cleft lip are 5%. However, if one parent and one child have it, the chances of another child being born with it are even greater.

Read also: Preimplantation Genetic Diagnosis

The therapeutic approach to cleft lip and cleft palate

A father holding his newborn son in the hospital.

To try to correct a cleft lip and cleft palate, many professionals are needed. Approaching the issue requires knowledge of many different areas in order to help with the problems that can occur.

Some teams involved in treatment are the following:

  • Plastic/Craniofacial Surgeon: These are surgeons who specialize in the diagnosis and treatment of skeletal abnormalities of the skull, facial bones, and soft tissue. They work closely with orthodontists and other specialists to coordinate a surgical plan.
  • Pediatrician: Will help coordinate the multiple specialists involved and monitor the child as he or she grows.
  • Orthodontist: Coordinates a treatment plan with the surgeon and other specialists.
  • Speech and Language Therapist: Will perform a comprehensive evaluation of your child’s speech to assess communication skills and closely monitor your child through all stages of development.
  • Otolaryngologist: An ear, nose, and throat specialist. He or she will assist in the evaluation and management of ear infections and hearing loss that may be side effects of your child’s anomaly.

Treatment

Treatment of these abnormalities includes surgery and a comprehensive team approach to help with the multiple complications that can occur. After surgery, the doctor may prescribe some drugs to help overcome the problem.

Your child may also need padded elbow pads to prevent rubbing in the area of stitches and surgery.

During surgery and for a short time afterward, your child will have an intravenous catheter to provide fluids until he or she can drink normally by mouth.

  • Gurkowski, M. A., & Bracken, C. A. (2010). Labio leporino y paladar hendido. In Toma de Decisiones en Anestesiología. https://doi.org/10.1016/b978-84-8086-334-6.50171-1
  • Alarcón-Almanza, J. M. (2010). Labio y paladar hendido. Revista Mexicana de Anestesiologia.
  • Serrano P., C. A., Ruiz R., J. M., Quiceno B., L. F., & Rodríguez G., M. J. (2018). LABIO Y/O PALADAR HENDIDO: UNA REVISIÓN. UstaSalud. https://doi.org/10.15332/us.v8i1.1180