Cleft lips and cleft palates are openings in the face, lips, and mouth or palate of newborn babies. They are two of the most common congenital abnormalities, occurring in approximately one in every 700 newborns.

Babies can be born with a cleft lip or a cleft palate or with both conditions.

Cleft lips and palates can cause difficulties, including eating and speaking problems, and they also may look scary to new parents. But cleft lips and palates are treatable.

What Are Cleft Lips?

A cleft lip is an opening in one or both sides of the upper lip. If the condition affects one side of the upper lip, it’s known as a unilateral cleft lip. If it affects both sides of the upper lip, it’s known as a bilateral cleft lip.

Cleft lips also can extend up into the nose and involve the ridge of a child’s gums and palate. If the cleft lip does not extend into the nose, it is known as an incomplete cleft lip. If the cleft lip does extend into the nose, it’s known as a complete cleft lip.

About 4,500 babies each year are born with cleft lips.

What Are Cleft Palates?

Cleft palates are openings in the roof of the mouth. The openings can occur in both the back of the mouth (the soft palate) and the front of the mouth (the hard palate).

If the openings only occur in the soft palate, it’s an incomplete cleft palate. When they’re present in both the hard and soft palate, it’s a complete cleft palate.

About 2,500 babies are born with cleft palates each year.

What Causes Cleft Lips and Palates?

Babies’ lips and mouths form early in pregnancy. Cleft lips and cleft palates occur when the lips and mouths don’t form properly.

The exact cause of cleft lips and palates is unknown. Factors that can increase the risk of cleft lips and palates include:

  • Family history.
  • Genetic changes in the baby.
  • Lack of folic acid.
  • Certain health conditions in the mother, like diabetes or obesity.
  • The use of some medicines, such as epilepsy medicines.
  • Smoking or alcohol use by the mother during pregnancy.

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Cleft Lips and Cleft Palates Diagnosis

Doctors often can diagnose cleft lips and cleft palates with an ultrasound during the mother’s pregnancy. They also can diagnose the condition at birth.

Symptoms of Cleft Lips and Cleft Palates

Children born with cleft lips and/or cleft palates frequently have eating problems. Babies require suction to extract milk from the breast or a bottle. A cleft palate or a cleft lip and palate can make it difficult for the baby to suck or swallow normally.

Other complications that children with cleft lips and palates may face include:

  • Hearing problems and ear infections.
  • Speech problems.
  • Teeth formation and other teething issues.
  • Social difficulties.

Children born with cleft conditions face multiple challenges and treatment needs from a variety of specialists. This begins at birth with feeding and continues until they are young adults. They need treatment from multiple specialists to grow up well-adjusted and to succeed in all aspects of life. Our goal in treating cleft-affected individuals is to achieve the best outcomes. That often requires multiple treatments until the child reaches young adulthood.

Cleft Lip and Palate Treatment

Babies born with cleft lips and cleft palates need ongoing treatment throughout childhood to manage the complications of their condition.

After birth, babies may need special bottles or potentially a feeding tube to manage feeding problems and help them get the proper nutrition.

Surgery to repair a cleft lip usually happens when the baby is between 3 and 6 months old. Surgery to fix a cleft palate happens later, when the baby is between 9 and 18 months old. Surgeons also may put tubes in the baby’s ears to prevent ear infections.

From there, a child will have regular follow-up appointments and surgical procedures to treat other symptoms of their condition. These procedures occur at certain points of the child’s growth and development.

At the Cleft-Craniofacial Center at UPMC Children’s Hospital of Pittsburgh, a multidisciplinary team of experts treats patients with congenital facial conditions like cleft lips and cleft palates. The team may include:

  • Plastic surgeons.
  • Oral and maxillofacial surgeons.
  • Pediatric dentists.
  • Orthodontists.
  • Ear, nose, and throat (ENT) surgeons.
  • Speech pathologists.
  • Hearing specialists/audiologists.
  • Psychologists.
  • Social workers.
  • Geneticists.

Children with cleft conditions need these specialists to achieve the best possible outcomes. Their involvement in treatment is critical at various points of growth and development. Having a dedicated, multidisciplinary cleft treatment team is essential to meet all the needs of an individual with a cleft.

Children with cleft lips and palates need regular follow-ups. But proper treatment can help them obtain normal development and appearance and reduce or eliminate other complications.

Can Cleft Lips and Palates Be Prevented?

It’s not always possible to prevent cleft lips and cleft palates. But here are steps you can take during pregnancy to lower your baby’s risk:

  • Take prenatal vitamins.
  • Have regular prenatal care.
  • Avoid tobacco and alcohol use.
  • Discuss medicine use with your doctor.
  • Manage any health conditions you have before and during pregnancy.

The Cleft-Craniofacial Center at UPMC Children’s provides world-class, team-based care for a variety of congenital and pediatric facial conditions. The Cleft-Craniofacial Center is an accredited treatment center, as it maintains or exceeds all standards set by the American Cleft Palate Craniofacial Association. For more information or to schedule an appointment, call 412-692-8650.

Sources

Centers for Disease Control and Prevention, Facts About Cleft Lip and Cleft Palate. Link

March of Dimes, Cleft Lip and Cleft Palate. Link

U.S. National Library of Medicine, Cleft Lip and Palate. Link

About Pediatrics

From nutrition to illnesses, from athletics to school, children will face many challenges growing up. Parents often will make important health care decisions for them. We hope to help guide both of you in that journey. UPMC Children’s Hospital of Pittsburgh ranks consistently on U.S. News & World Report’s Best Children’s Hospitals Honor Roll. UPMC Magee-Womens Hospital is a longtime national leader for women and their newborns. We aim to provide the best care for your children, from birth to adulthood and beyond.