Cleft lip and cleft palate: causes

We don’t know exactly what causes cleft lip and cleft palate. Genetic influences are believed to be largely responsible, although often there’s no family history of the condition.

For people with cleft lip or cleft palate, the lip or the roof of the mouth doesn’t close over properly during development of the fetus. This forms a cleft, or open space.

Cleft lip and cleft palate can happen separately, but they often happen together, sometimes in association with other problems. Usually, only soft tissues are affected. Occasionally bone can be involved, causing deformity of the nose as well.

Cleft lip alone is more common, occurring in about 1 in every 1000 births. Cleft palate occurs in about 1 in every 2500 births. Overall, approximately 1 in 800 births will be affected by cleft lip and/or cleft palate.

Symptoms of cleft lip and cleft palate

Cleft lips and/or cleft palates vary in severity. They can range from a small notch in the upper lip, to a gaping defect of the lip and palate, and sometimes the nose. With a cleft palate, the hole in the roof of the mouth means there’s a connection between the mouth and the nose.

Aside from the obvious appearance of the lips and mouth, babies with cleft lip and/or cleft palate might have significant trouble feeding. This is because they find it difficult or impossible to suck, even though they have no problems swallowing.

Treatment for cleft lip and cleft palate

Treatment for cleft lips and/or cleft palates depends on their severity.

Initially a baby will be fed with a special spout, or elongated teat, which delivers milk to the back of the throat.

Surgery is always necessary, and the type, extent and number of operations depend on the degree of the cleft lip or cleft palate. A cleft lip is usually repaired at 3-6 months of age, and a cleft palate at around 9-12 months of age, before the child starts to speak. Occasionally minor corrections are made before the child starts school.

The cosmetic results with cleft lips alone are usually excellent. Speech therapy can help enormously in correcting nasal-sounding speech in the case of a cleft palate.

Children who have a cleft lip or cleft palate need to have regular follow-up visits with a doctor, because these children are more prone to ear infections and subsequent problems.

Specialised dental care might also be necessary, because many children born with a cleft lip and/or cleft palate will have missing or malformed teeth.

Prevention of cleft lip and cleft palate

Cleft lip and/or cleft palate can’t be prevented. Current research shows that what parents do during pregnancy has no effect on whether a child will be born with these conditions.