Dayton Children’s Hospital

Cleft Lip and Palate

What is cleft lip/cleft palate?

A cleft lip/cleft palate is one of the most common birth defects. It happens in one of every 700 births.

Here’s what it means:

  • cleftlip- CDCCleft lip. This is a small opening in the lip that extends up to the nose. A cleft lip is caused when the lip doesn’t join together properly as the fetus develops during the early stages of pregnancy.

 

 

 

 

 

 

  • cleft_palate - CDCCleft palate. A cleft palate is an opening in the roof of the mouth. This happens when the sides of the palate don’t join completely as the fetus develops. It also happens in early stages of pregnancy.

 

 

 

The exact reason cleft lip/cleft palate happens is often a mystery, however it can run in families. Sometimes, a cleft lip/cleft palate occurs in conjunction with other birth defects. A baby can have a cleft lip, a cleft palate or both. Children with a cleft lip or a cleft palate often have problems with feeding and talking. They also might have ear infections, hearing loss and problems with their teeth.

Clefts may happen on just one side of the lip or palate. This is called a unilateral cleft. Sometimes clefts can involve both sides of the lip and palate. This is called a bilateral cleft. Rarely, a cleft can occur right down the middle of the lip or palate. This is called a midline cleft.

How is the condition diagnosed?

Most babies with cleft lip/cleft palate can be diagnosed by an ultrasound during your pregnancy. But this doesn’t always happen. Sometimes, you find out about the cleft lip/cleft palate after the baby is born.

How is cleft lip/cleft palate treated?

No treatment can be provided until after your baby is born. If it’s detected that your baby has a cleft lip/cleft palate during your ultrasound, further evaluation for other physical anomalies and genetic conditions is required. If the baby is found to have an isolated cleft lip/cleft palate, then your pregnancy will be monitored closely with ultrasounds at least every four weeks. If the baby is found or suspected to have other anomalies or a genetic condition, then additional testing such as an amniocentesis may be done.

Normally, there is no need for early delivery and no indication that a cesarean birth is necessary just because your baby has a cleft lip or palate. A cleft lip/cleft palate can interfere with feeding, including breastfeeding. You and our team will come up with a feeding plan that works best for you and your baby. Before you go home with your baby, we will teach you special feeding techniques to make sure your baby will be able to get enough nutrition. Our nurse navigator can arrange for you to meet with neonatologists, lactation consultants, and speech/swallowing specialists before your baby is born if such a consultation would be helpful in your specific case.

Ultimately, treatment for cleft lip/cleft palate is surgery to close the opening. Cleft palate
surgery helps the baby avoid any abnormal speech problems, eat properly and look “normal.”

How will cleft lip/cleft palate affect my baby during and after surgery?

Babies with clefts will need surgery to fix the clefts in the lip and/or the palate. The timing of the surgery varies from baby to baby and depends on the kind of cleft, its severity and your baby’s overall health. Most clefts of the lip are repaired at 3 to 6 months of age. The palate is not repaired until later, usually around the child’s first birthday (9 to 18 months). Recovery from surgery usually takes about four weeks.

Your child might need special dental and speech therapy as he or she gets older. Dayton Children’s Cleft Lip/Cleft Palate Clinic provides a comprehensive, multidisciplinary team approach to the care of children with cleft lip/cleft palate. This approach allows our team members to follow your child through age 21 if necessary, ensuring that all patient and family needs are met at every step.