Cleft Lip and Palate

During the fifth or sixth week of prenatal development, your baby’s lip starts to grow together. Three to seven weeks later, the palate at the top of your baby’s mouth starts to grow together, too. However, if something interrupts this growth, your baby may experience a condition known as cleft lip and/or cleft palate. These conditions are treatable and require a treatment team to be successful. Here’s what you need to know about cleft lip and cleft palate.

Causes of Cleft Lip and Palate

Cleft lip and palate can stem from a number of causes, some preventable and others genetics-related. Leading a healthy lifestyle during pregnancy is important. Abusing alcohol or illegal drugs or smoking while pregnant could contribute to cleft lip and palate. Radiation exposure or taking certain medications while you are pregnant also can increase the risk cleft lip and palate will occur.

One cleft lip and palate cause you cannot prevent is having a family history of the condition. If you have a family history of cleft lip and palate, ask your physician about the possibility of talking to a genetic counselor who can help you identify the risks your child will experience cleft lip and palate.

Cleft Lip and Palate Diagnosis

Cleft lip and palate can vary in severity and location. Your physician may identify your child’s cleft lip and palate by its location. An “incomplete” cleft lip does not extend into the nose while a cleft lip that involves both sides of the lip and up into the nose is known as a bilateral complete cleft lip and palate.

By contrast, cleft palate is not as visible to the eye and results when the top of your baby’s mouth does not completely meet. In the severest instances, the opening can go up and into the nasal cavity.

Cleft Lip and Palate Intervention

In some instances, your physician may be able to diagnose cleft lip and palate as early as 14 to 16 weeks into your pregnancy. Fetal ultrasound technology enables your physician to visualize your baby’s face, potentially diagnosing the condition.

While a cleft lip and palate does not hurt your baby, it can affect his breathing and ability to feed. You may wish to speak with a nurse or physician who specializes in feeding techniques for babies with cleft lip and palate. For this reason, surgical repair often is recommended to treat the cause and is typically performed within the first 12 to 18 months of life.

The Care Team

When your child has cleft lip and palate, a number of medical specialists will be a part of your child’s care team. This includes a plastic or craniofacial surgeon who is responsible for correcting the cleft lip and palate. Your child’s pediatrician also will coordinate necessary treatments and evaluate your child’s progress. Other key specialists that may be involved include an orthodontist, pediatric dentist, speech and language specialist, otolaryngologist, audiologist, social worker and genetic counselor, if needed.

Surgical Intervention for Cleft Lip and Palate

Surgery to repair the cleft lip and palate focuses on repairing the split portion of the lip and palate. Surgery to repair the cleft palate tends to be more complicated than cleft lip surgery and may require repeat operations to fully close the cleft palate.

Caring for a child post-surgery can be difficult because the cleft lip and palate affects how your child breathes and eats. Because your child is so small, it may be difficult for her to understand what is happening. Because your child will have some stitches, feeding may be performed intravenously to provide your child nutrition without disturbing the physical site. Swelling, nasal congestion and mild pain are typical side effects post-surgery that your physician may recommend treating with prescription pain medication and antibiotics. However, you should never give your child aspirin pain medications as they can contribute to Reye’s syndrome, a harmful medical condition.

Your child may have some activity restrictions following surgery, such as avoiding rough play or toys that may be chewed on. These restrictions may continue for one to two weeks post-surgery until your child’s stitches have dissolved and mouth healed.

Thanks to minimally invasive surgical techniques, recovery time and visible scars can be minimized so your child can get back to being a child. Children with cleft lip and palate can live happy, productive lives with only slight scars to show for the surgical repairs.