Understanding Cleft Lip and Palate

A cleft lip occurs when the parts of the upper lip do not grow together during development of the baby before it is born. A cleft palate occurs when the parts of the roof of the mouth do not grow together during development before birth. The result is a separation in the upper lip or an opening in the roof of the mouth. Cleft lip and palate are the most common birth defects, occurring in 1 out of every 700 children born alive in the United States. These problems are completely correctable. If untreated the child will have obvious facial deformities, severe speech and language impairments, chronic dental disease, hearing loss because of ear disease, malnutrition and low self-esteem.

What Causes Cleft Lip or Cleft Palate?

At this time, the cause of cleft lip and palate cannot usually be identified. Clefts occur very early in pregnancy and may be the result of a combination of the baby’s genetic information and the environment in which the baby is developing.

Diagnosis of Cleft Lip and Palate

Cleft lip may be seen on an ultrasound as early as the 16th week of pregnancy. A cleft palate usually can not be seen on an ultrasound, but will only be diagnosed after the baby is born. A referral to the Craniofacial/Cleft Palate program can be made before the baby is born to meet the team and find out more about the treatment ahead. After the baby is born the diagnosis of cleft lip and palate is confirmed by a complete physical exam in the newborn nursery. Children who are born with only a small separation of the back part of the palate may not be diagnosed immediately at birth. The cleft may only be identified if there are difficulties with feeding, chronic ear infections or abnormal speech.

Treating a Baby Cleft Lip and Palate

Treatment for Cleft Lip and Palate begins in the newborn nursery. The family is taught how to feed the baby using a special bottle and nipple. When the baby goes home from the nursery they are seen weekly to follow their weight gain. When the baby is about one month old they are seen by the entire team for the first time.

Repair of the cleft lip is usually done when the baby weighs 10 pounds, at 6-12 weeks of age. The Palate is repaired when the baby is about 10 months old. The baby has regular team visits every 6 months until they reach the age of 3 years.

During these visits their hearing is checked, their speech development is evaluated and the surgical repairs examined. They may also be seen by a geneticist, psychologist and other team members as needed. Dental exams and treatment as needed begin at 1 year of age.

The visits with the team orthodontist begin about age 6 years in preparation for the surgical repair of the cleft in the gum between 8-10 years. The team visits continue annually until growth is complete and treatment is finished.

Surgical procedures are carried out as needed for problems with speech and the dental bite. A final surgical adjustment of the lip and nose is usually done just prior to completion of treatment. New problems may occur in adults with cleft lip and palate after treatment has been completed.

The Craniofacial/Cleft Palate Program at LuskinOIC is unique in offering treatment to Adult patients with Cleft Lip and Palate.