A cleft lip and/or cleft palate occurs when a baby’s lip and/or roof of the mouth does not form properly during pregnancy. As a baby develops during pregnancy, tissue and cells from both sides of the head grow together to make the face.
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The lips form between the fourth and seventh weeks of pregnancy. A cleft lip results if the tissues that form the upper lip fail to join completely before birth. This opening can be a small slit, or it can be a large opening that extends through the lip into the nose. A cleft lip can be on one or both sides of the lip or in the middle of the lip, which occurs rarely. Cleft lips can occur in isolation or in conjunction with a cleft palate.
The roof of the mouth, or palate, is formed between the sixth and ninth weeks of pregnancy. A cleft palate occurs when the tissue of the roof of the mouth does not join together completely during pregnancy. In some babies, only the back of the palate is open and for others, the entire palate is open.
Children with a cleft lip and/or palate can have problems feeding and once speech develops, speaking clearly. In children with a cleft palate, ear infections can also be an issue. Children with a cleft palate or a cleft lip that involves the gum line of the upper jaw might have problems with proper development of their teeth.Other problems can include difficulty breathing through their nose and/or abnormal appearance of the nose.
The cause of cleft lips and palates are unknown. It is believed they are caused by a combination of genetics, environmental factors, and possibly certain food and medicines the mother may consume while pregnant. Additionally, if a mother smokes while pregnant or is diabetic, their baby might have a greater chance of developing a cleft lip or palate. The majority of children born with cleft lips and/or palates do not have a syndrome or other identifiable cause.
With prenatal care that includes ultrasounds, cleft lips and cleft palates are often detected during pregnancy. While some clefts may not be seen on ultrasound, the majority can be detected after the baby is born. In very rare cases are cleft lips and/or palates not diagnosed until later in life.
The care of a child with a cleft lip and/or palate involves a team of experts to care for every aspect of the child. This often includes a pediatrician, speech therapist, audiologist, geneticist, dentist or oral surgeon, otolaryngologist and facial plastic surgeon to repair the cleft. Several surgeries may be required, depending on many factors including the type of cleft (lip and/or palate), severity of the cleft, and age and health of the child. Additional surgery to address frequent ear infections, dentition, and the nose may be required. The vast majority of children with cleft lips and/or palates can lead healthy normal lives.