Cleft Lip and Palate – General Information
What Is a Cleft Lip and/or Palate
A cleft lip is a separation of the two sides of the lip. The separation may also include the upper gum line, the nose, and the bones of the upper jaw. The degree of involvement of the lip and of the nose varies. The cleft can be very minor in a condition called a microform cleft lip, can involve a portion of the lip (an incomplete cleft lip), or the entire upper lip (a complete cleft lip). The cleft may involve one side of the lip (unilateral) or both sides of the lip (bilateral).
A cleft palate is an opening in the roof of the mouth. This happens when the two sides of the palate do not join together when the unborn baby is developing in the womb. Cleft lip and palate can involve one side (unilateral cleft lip and/or palate) or both sides (bilateral cleft lip and/or palate). Because the lip and palate develop separately, it is possible for the child to have a cleft lip, cleft palate, or both a cleft lip and palate.
How Common Is It?
Cleft lip and cleft palate are the most common birth defects in the United States. It is estimated that approximately 1 out of every 600 newborns is affected with cleft lip and cleft palate. The formation of a cleft lip and a cleft palate occurs early in the pregnancy during the first trimester. The cause of most clefts are the result of a combination of genetic and environmental factors. The risk of recurrence of a cleft condition depends on a number of factors, including the number of affected persons in the family, the relation of the affected relative, the race and sex of the affected person, and the severity of the cleft.
What Should I Expect?
There are a number of member of the cleft team, who may take care of your child. Some of these specialists include the plastic/craniofacial surgeon, otolaryngologist (ear, nose, and throat doctor), dentist/orthodontist, speech pathologist, audiologist (hearing specialist), nurses, mid-level practioners, and social workers. When the palate is involved, this can affect speech, feeding, dental development, ear health, and hearing. Therefore, a number of disciplines work together to oversee all of these aspects that are involved in cleft care.
When Are Cleft Lip and Cleft Palate Repaired?
There are multiple factors that may affect the timing of the lip and palate repair. In general, a cleft lip is usually repaired at around 3 months of age and the palate is repaired between 9 and 12 months of age. In some children with a cleft lip and palate, a NAM (nasoaleolar molding) device will be used prior to the lip repair. This device, designed by the orthodontist on the team, helps to align the gumline, lip, and nose prior to the cleft lip repair. To get the full effect of this molding, the lip repair is sometimes delayed for a month or two in some children that are undergoing NAM treatment. The overall health of the child is also taken into account in the timing of the cleft repair. Factors such as prematurity, low weight, airway concerns, and other congenital conditions (such as congenital heart defects) are considered in the timing as well. These factors are discussed among the members of the cleft team and in coordination with your child’s primary physician.
We are committed to partnering with you and your family to ensure the very best care for your child. We are here for you, and we welcome any additional questions that you may have. If you are expecting a child with a cleft, we do offer pre-natal consults. If you are new to our clinic, we look forward to establishing a relationship with your family.