Cleft Palate Treatment

About Cleft Lip and Palate

Cleft lip and cleft palate comprise the most common birth defect in the United States. One of every 600 newborns is affected by cleft lip and/or cleft palate.

A cleft lip is a separation of the two sides of the lip. The separation often includes the bones of the upper jaw and/or upper gum. A cleft palate is an opening in the roof of the mouth in which the two sides of the palate did not fuse, or join together, as the unborn baby was developing. Cleft lip and cleft palate can occur on one side (unilateral cleft lip and/or palate), or on both sides (bilateral cleft lip and/or palate). Because the lip and the palate develop separately, it is possible for the child to have a cleft lip, a cleft palate, or both cleft lip and cleft palate.

Cleft lip and cleft palate are congenital defects, or birth defects, which occur very early in pregnancy. The majority of clefts appear to be due to a combination of genetics and environmental factors. The risks of recurrence of a cleft condition are dependent upon many factors, including the number of affected persons in the family, the closeness of affected relatives, the race and sex of all affected persons, and the severity of the clefts.

A child born with a cleft frequently requires several different types of services, e.g., surgery, dental/orthodontic care, and speech therapy, all of which need to be provided in a coordinated manner over a period of years. This coordinated care is provided by interdisciplinary cleft palate/craniofacial teams comprised of professionals from a variety of health care disciplines who work together on the child’s total rehabilitation.

Frequently Asked Questions

A to Z: What’s first?
If there’s a baby in your world, congratulations! If the baby is affected by cleft issues, there are a few things to think about, a few things to do, and a few pieces of information that may be helpful to you as you and baby begin your life together: 

What is cleft lip and cleft palate?

A cleft lip is an opening in the lip. A cleft palate is an opening in the roof of the mouth. Clefts result from incomplete development of the lip or palate while the baby is forming before birth. Babies’ lips and palates develop separately during the first three months of pregnancy. In most cases, the left and right parts of the lip come together, or “fuse,” creating the two vertical lines on the normal upper lip. In a similar way, the left and right parts of the palate come together to create a normal palate. The front-to-back line that can usually be seen along the roof of a normal mouth indicates where “fusion” occurred.

Why didn’t our baby’s mouth fully develop?
We don’t know the answer to this question, but it was not because you did something wrong. Sometimes clefts run in families, and in many cases, they rely on genetic predisposition. Some clefts occur in combination with other problems and are associated with a syndrome. It was not your fault. Scientists have learned that there are many possible causes for clefts. Research is under way to discover more about these causes.

How many babies are born with clefts?
Cleft lip and/or palate make up the most common birth defect in the United States. Approximately one out of every 594 newborns, or over 6,800 children, per year in the U.S. is affected by cleft lip and/or palate.

What can be done to help our baby?
A cleft lip can usually be repaired in the first few months of life. A cleft palate can usually be repaired some months later. The exact timing of these repairs depends on the baby’s health and considerations of his or her future development, as determined by the doctor who performs the surgery.

Can our baby be fed properly?
Some babies with clefts have very few or no problems feeding, while others have more difficulty. Use of special bottles and careful positioning of the baby are sometimes helpful modifications. Your pediatrician will give you proper guidance.

Will our baby’s teeth grow properly?
If the cleft affects only the lip, the teeth will probably not be affected. If the cleft affects the gums where the teeth grow, your baby will probably need the care of dental specialists.

Will our baby have trouble learning to talk?
If the cleft affects only the lip, speech problems are unlikely. However, many children with cleft palate need the help of a speech pathologist, and some may need an additional operation to improve their speech. The goal is to help the child develop normal speech as soon as possible.

Will our baby be mentally retarded?
There is no relationship between mental retardation and cleft lip and palate. However, if the cleft is part of a cluster of other problems (a syndrome), learning ability is sometimes affected.

How can we pay for the treatment our baby will need?
Health insurance may pay for all or part of the necessary care. Additional financial assistance may be available from an agency in your state which is supported by your tax dollars. 

How do other parents feel when their child is born with a cleft?
It is natural for parents to feel upset at this time. Feelings of concern, anxiety, and grief are not unusual. Your family physician and the hospital staff members will guide you to a team of specialists who can provide you and your baby with the help you will need.

How can we tell our relatives and friends about the baby’s cleft?
Most new parents feel that this is a difficult task. Although you may feel uncomfortable, it is important that you tell relatives and friends as soon as possible. Try to be as direct and honest as you can. Your baby is much more than his or her cleft, and everyone needs to remember that. If the people closest to you can visit while the mother and baby are still in the hospital, this is often helpful. 

I’ve read the word hare lip what does it mean?
The word “hare” refers to a rabbit, which has a natural indentation in the center of its lip. The term is rarely used by professionals, because it is inaccurate and insensitive. “Cleft lip” is the correct description of the condition.

How can I get more information?
The Cleft Palate Foundation (CPF) has a number of publications for parents of children with clefts, including booklets on infant feeding, on the child from birth to four years, on the school- aged child, and on genetics. Modern care of a child born with a cleft lip or cleft palate is best managed by a team of medical, dental, speech, and other specialists. Dr. Coaklely works with several “cleft palate team” in our community, state, and country.

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