What Is a Cleft Lip and Cleft Palate?
What Is a Cleft Lip and Cleft Palate?Cleft lip and cleft palate (roof of the mouth) are congenital disabilities of the lip and mouth. All developing fetuses have a split lip and palate early in pregnancy. Normally the gaps in the lip and palate close later in pregnancy. A cleft lip and cleft palate occur when they don’t close properly. Babies can have a cleft lip and cleft palate, only a cleft lip, or only a cleft palate. Cleft lip and/or cleft palates (combined cases) are some of the most common congenital disabilities in the United States.
An environmental or genetic factor causes the majority of cleft lips or cleft palates, although the cause is unknown in some cases. Surgeries can correct a cleft lip and cleft palate so children can have normal mouth function and appearance.
Types of Cleft Lip and Cleft Palate
TypesA cleft lip can appear alone or with a cleft palate, and a cleft palate may occur alone or with a cleft lip. The types of cleft lip and cleft palate are:
Types of cleft lip
- Unilateral cleft lip affects one side of the upper lip and includes:
- Incomplete unilateral cleft lip (the split does not reach the nose)
- Complete unilateral cleft lip (the split reaches the nose)
- Bilateral cleft lip affects both sides of the lip and creates two clefts (splits) including:
- Incomplete bilateral cleft lip (the splits do not reach the nose)
- Complete bilateral cleft lip (the splits reach the nose)
Types of cleft palate
- Incomplete cleft palate is a cleft in the back of the mouth in the soft palate.
- Complete cleft palate is a cleft that affects the hard and soft parts of the palate creating a gap that extends from the front of the palate and to the back.
- Submucous cleft palate is under the mucous membrane and is covered by the soft palate. This type of cleft often goes unnoticed at birth and may be diagnosed only after signs develop.
- Bifid uvula, also known as a cleft uvula, is a condition in which the uvula is split in two. The distance between the two halves of the uvula may be narrow or wide. A bifid uvula may occur alone, or it may be related to a submucous cleft palate.
Signs & Symptoms of a Cleft Lip and Cleft Palate
SymptomsA cleft (split) in the lip and/or palate is usually noticed at birth. Cleft lip and cleft palate may include:
- A split in the lip on one or both sides of the face might look like a small gap in the lip or might be a larger gap from the lip to the bottom of the nose.
- A split in the roof of the mouth (palate) that doesn’t affect the appearance of the face.
- A split in the lip on one or both sides of the face with a split in the roof of the mouth.
What Causes a Cleft Lip and Cleft Palate?
CausesThe majority of cleft lips and/or cleft palates are caused by an environmental or genetic factor, although in some cases, the cause is unknown. Smoking and taking certain medicines during pregnancy may also be factors.
Risk Factors
Risk FactorsGenetic and environmental factors increase the risk of having a baby with a cleft lip and/or cleft palate. These include:
- Genetic factors where a cleft lip and/or cleft palate runs in families. A parent with a cleft lip or cleft palate can pass the condition to a child.
- Sex. Males are more likely to have a cleft lip with or without a cleft palate. Females are more likely to have a cleft palate without a cleft lip.
- Smoking during pregnancy
- Diabetes in the mother before pregnancy increases the risk of having a child with a cleft lip with or without a cleft palate.
- Medicines. The use of certain medicines in the first trimester (the first 3 months) of pregnancy, for example, to treat epilepsy, may increase the risk of having a baby with a cleft lip or a cleft palate.
- Obesity during pregnancy
Complications
ComplicationsPossible complications from a cleft lip and/or cleft palate can include:
- Feeding difficulties for babies. Nutrition is usually the main concern for babies with a cleft palate because it makes sucking from the breast difficult or impossible. Babies with a cleft palate will need to be fed with special bottles. Babies with only a cleft lip don’t usually have feeding difficulties.
- Ear infections. Babies with a cleft palate are more susceptible to ear infections. An ear, nose, and throat specialist can advise on ways to prevent recurring infections, which can also affect hearing.
- Dental problems. The teeth of children with a cleft lip and/or cleft palate may not develop normally, so orthodontic treatment is typically needed.
- Speech issues. A cleft lip and/or cleft palate may cause difficulty and delay in speaking. A speech therapist can help children with speech issues.
Prevention
PreventionThere are currently no known ways to prevent a cleft lip and/or cleft palate. People with a family history of the condition and people with diabetes may want to discuss their risk with a genetic counselor and a doctor before getting pregnant.
Understanding and lowering risk factors include:
- Avoiding smoking during pregnancy can reduce the risk of having a baby with the condition.
- Genetics. Genetic counseling may help people with a family history of the condition understand the risk of the condition to their child and treatment options.
- Diabetes. People with diabetes who consider getting pregnant can discuss the risk to the child with their doctor.
- Medicines. People who are pregnant or considering getting pregnant and are taking certain medicines that can increase the risk for the condition should consider discussing alternative medicines with their doctor.
- Maintaining a healthy weight
Trust NewYork-Presbyterian For Cleft Lip and Cleft Palate Care
At NewYork-Presbyterian pediatric otolaryngologists, specialists are trained to diagnose and treat ear, nose, and throat (ENT) diseases and have expertise in caring for infants and children with different disorders. Our ENT experts work together to care for children with cleft problems such as unilateral cleft lip, bilateral cleft lip, and cleft palate. Contact us to make an appointment for a consultation and treatment.