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What is Cleft Lip and Cleft Palate?

A cleft lip or cleft palate happens when your baby’s upper lip and mouth doesn’t form completely. This results in an opening and is present at birth. Oral clefts (or orofacial clefts) occur in about 1 in 1,000 babies in the United States, meaning it’s a relatively common birth defect. It often happens early in pregnancy, or between 4 and 9 weeks of gestation, and male babies are more likely to have a cleft lip (with or without a cleft palate) than female babies, but female babies are more likely to have a cleft palate without a cleft lip.

Oral clefts can range from mild to severe. In the case of a cleft lip, it can occur as a small notch above the upper lip. Other times, it can occur as a large opening or hole between the upper lip and nose. It most often occurs on one or both sides of the lip. On the other hand, cleft palates can affect either the soft palate (the soft tissue at the back of the mouth) or hard palate (the bony part in the front of the mouth).

What causes oral clefts?

It’s not well understood what causes oral clefts, although there are some things that seem to increase the risk. This usually includes genetic and environmental factors. These include:

• A family history of oral clefts. Oral clefts can be more common in families of Asian, Hispanic, and Native American descent
• Substance use during pregnancy
• Nutrient deficiency, specifically of folic acid
• Having diabetes before pregnancy
• Use of certain anti-seizure medications
• Obesity during pregnancy
• Certain infections like rubella

During gestation, fetuses develop the skull and face from either side, meeting in the middle eventually. When this process is interrupted at any stage,  the face might not fully “close” around the new tissues. As mentioned, this can affect the lip, hard palate, and soft palate based on multiple factors.

What an Oral Cleft Means For Your Baby

Having a cleft palate or lip can result in complications beyond the physical appearance, including:

• Ear infections
• Difficulty with hearing
• Difficulty with speech
• Difficulty feeding
• Dental issues

These wide-ranging consequences require a diverse team of experts who specialize in treating babies born with a cleft palate.

How are oral clefts diagnosed and treated?

Oral clefts can be easily diagnosed after birth and they often can be diagnosed prenatally with ultrasound, but not always. After birth, it’s usually recommended to have corrective surgery performed within one year. This allows for normal growth and development, as well as the prevention of difficulties with breathing, speech, and feeding. It’s possible that your child might need additional surgeries for oral clefts as they grow, so it’s important to partner with a team of dentists, facial surgeons, and speech therapists who can ensure your child develops normally throughout life.

How can I prevent oral clefts?

Although oral clefts are typically not preventable, it makes sense to take folic acid starting prior to conception (at least 400 micrograms per day) and try to avoid alcohol and smoking in pregnancy. Achieving a healthy weight prior to pregnancy can have numerous benefits.

How to Cope With A Birth Defect

Because cleft palate and lip can affect anyone, it often causes significant distress to new parents when they discover their baby has a birth defect they couldn’t prevent. Even though there are treatment options available to correct this condition, that doesn’t mean that it’s not upsetting to get this news, whether during pregnancy or after birth.

When you find out about your baby’s birth defect, perhaps the most important thing to keep in mind is that it’s not your fault. This condition can happen regardless of the choices you make, even if you’ve followed your doctors’ every word of advice. The next step to take is finding support from friends and loved ones, reaching out for support.

When it comes to caring for your baby, focus on their personhood. Get them the treatment they need to prevent future complications, and if a long-term side effect stays with them until they’re older, make sure to instill confidence in their appearance and encourage behaviors like smiling and carrying themselves with dignity. It’s also good to keep communication open and non-judgmental so your child will always feel safe coming to you to talk about issues related to their condition in the long run.

Schedule an Appointment

Although oral clefts are not often severe, they can prevent challenges to your child early on. To partner with our expert team and begin taking the right steps for prevention and management of oral clefts, contact our New York City office by calling or filling out our online form.

Carnegie Imaging for Women blogs are intended for educational purposes only and do not replace certified professional care. Medical conditions vary and change frequently. Please ask your doctor any questions you may have regarding your condition to receive a proper diagnosis or risk analysis. Thank you!