Cleft lip and palate is one of the most common birth defects in the United States. Parents of infants who have a cleft defect at birth may face uncertainty and confusion. What is cleft lip and palate? What caused them? Can they be fixed?
The Centers for Disease Control and Prevention (CDC) estimates that more than 4,400 babies in the United States are born with an isolated cleft lip and more than 2,600 babies are born with a cleft palate every year. Together, these defects are called “orofacial clefts.”
A cleft palate is an opening or split in the roof (the “palate”) of your baby’s mouth. Clefts occur while the baby grows in utero, when the tissue that forms the roof of the mouth does not fuse together correctly. Clefts can affect the hard, front section of the roof of the mouth, or the soft tissue in the rear section. Some babies are born with only one section open, while some are born with both open. A cleft lip occurs when the tissue that makes up the lip does not close in utero, but does not involve the palate. A cleft lip and palate can coexist or can occur separately. Orofacial clefts can be identified during a routine ultrasound, but some are not diagnosed until birth.
Babies born with a cleft lip and/or palate may have difficulty feeding and swallowing. They may also have frequent ear infections and dental problems, and speech development may be affected.
The good news is that cleft lips and palates can be repaired. Surgery may be recommended for your baby anywhere between 8-12 months old. Of course, the timing to repair the split also depends on the exact nature of the cleft, as well as on your child’s general health. Some children have complications in addition to a cleft palate and may need future surgeries or speech therapy.
Researchers have found that both genetics and environmental factors can play a role in the development of orofacial clefts. A parent can pass down the gene that causes clefts, or a factor in the baby’s environment triggers the cleft. Clefts can result from influences like a mother’s diet, medication use, or the baby’s exposure to cigarettes, alcohol, or other drugs. Some research shows that mothers who take multivitamins containing folic acid before pregnancy and during the first trimester can reduce the risk for cleft palates. In some babies, a cause for the cleft is never determined.
Reviewed by Dr. Sara Connolly, December 2018