Cleft Palate and Cleft Lip: Causes and Treatment

A cleft refers to a gap or a split in the upper lip and/or roof of the mouth (palate). Cleft palate and cleft lip are birth defects that occur to a baby’s mouth or lip due to incomplete fusion of parts of the mouth during early pregnancy. A baby can have a cleft lip, a cleft palate, or both (orofacial clefts).

Cleft palate occurs when the tissue that makes up the roof of the mouth (palate) does not join together completely during pregnancy. This can result in an opening in the hard palate (the bony front portion of the roof of the mouth) and/or the soft palate (the soft back portion of the roof of the mouth). 

Cleft lip isan incomplete formation of the lip during foetal development. It can range from mild (notching of the lip) to severe (large opening from the lip up to the nose). A cleft lip can be unilateral (one side of the lip) or bilateral (both sides of the lip).

Risk factors

The causes of cleft palate and cleft lip are not fully understood, but they are believed to result from a combination of genetic and environmental factors. Here are some potential risk factors:

• Family history of cleft palate/lip.
• Folic acid deficiency.
• Smoking during pregnancy.
• Substance abuse during pregnancy (alcohol, illicit drugs).
• Certain types of medications taken during pregnancy (anti-seizure medications, cancer drugs).
• Diagnosed with diabetes before pregnancy.
• Obesity during pregnancy.

Diagnosis

A cleft lip can often be identified during a routine prenatal ultrasound. It is typically noticeable during a newborn’s initial examination. However, certain types of cleft palate may not be as easily detected and might go undiagnosed until later in life.

Potential complications

Babies can have trouble breastfeeding because they cannot form a good seal around the nipple. Solid food and liquids may pass from the mouth back through the nose. 

Children with cleft palate are also more likely to have fluid buildup in the middle ear, leading to ear infections and hearing loss if left untreated or occurs repeatedly.

Children with cleft palate/lip tend to experience speech and language issues including sounding nasal, difficulty in articulating words, and ultimately, difficulty being understood. They are also prone to missing, malformed, or displaced teeth and cavities. They may experience defects of the alveolar ridge (bony upper gum that surrounds the teeth) which could prevent permanent teeth from appearing and premature loss of canine/incisor teeth.

If left untreated, these complications will negatively impact the growth and development of the affected children.

Treatment options

Services and treatments for children with orofacial clefts can vary based on the severity of the cleft, the child’s age and specific needs, and the presence of associated syndromes or other birth defects.

Book an appointment at Gleneagles Hospitals

Parents may initially feel overwhelmed by a cleft palate or cleft lip diagnosis. However, consulting an experienced healthcare professional can offer reassurance, assist with treatment planning, and help ensure the child leads a normal childhood.

If you are concerned regarding cleft palate or cleft lip, get in touch with us to find out more about our Paediatric services at your nearest Gleneagles Hospital.