What Causes Cleft Lip & Palate

cleft lip and palate

Cleft lip & cleft palate is the fourth most common congenital disability in the US, occurring in about one out of every 700 to 800 live births annually. Although these conditions may not seem severe, they can cause discomfort and complications if not corrected early in life.

As part of National Cleft & Craniofacial Awareness & Prevention Month, we will highlight what causes this condition and what can be done to prevent and treat it. Read this article to learn more. 

 

Cleft Lip and Palate: An Overview 

Cleft lip palate is a congenital birth disability, meaning it is present at birth. It occurs when the top lip and/or the roof of the mouth do not fuse properly during fetal development. This causes a split down the lip’s middle or the mouth’s top. In some cases, it may only affect a portion of the lip, gum, and palate or involve all these structures. The condition can also affect different areas of the face, including the nose and upper jaw.

 

To distinguish, a cleft lip is a separation of the two sides of the upper lip. On the other hand, the cleft palate is a split in the roof of the mouth (palate). The two conditions can occur separately, but they often occur together. There are various cleft lip and palate types, including bilateral and unilateral. Unilateral means that only one side has a cleft. Bilateral means that both sides have a cleft. The severity depends on where it occurs in the upper lip and how much tissue was not connected during development.

Many children with this condition can have long-term consequences, including various physical and cosmetic complications. Some of the adverse effects of lip and cleft palate include:

  • Breathing problems
  • Difficulty with eating, which can lead to malnutrition
  • Tongue thrusting (when a person pushes their tongue forward while eating)
  • Speech difficulties such as lisping, nasal, speech or difficulty saying certain sounds
  • Skin problems, such as eczema and psoriasis
  • Behavioral, emotional, or social problems
  • Ear infections, hearing difficulties, or total hearing loss
  • Teeth that don’t come in correctly (crowded teeth)
  • Failure to thrive in infancy
  • May predispose babies to respiratory problems later in life, such as chronic lung disease or cystic fibrosis (CF).

 

What Causes a Cleft Lip and Palate?

It is possible for a child to be born with cleft lip and cleft palate if:

  • The tissues in their lip don’t fuse together at the appropriate time during fetal development.
  • Certain medications or toxins damage the tissues in their lip while they’re still in the womb.
  • Cleft lips may also be present at birth due to genetic issues, environmental factors, or trauma during pregnancy.

Although cleft palate cause can be associated with genetic factors, many factors make it more likely that your baby will have a cleft lip and/or palate.

 

  • Having a family member with cleft lip and palate increases your risk of having an infant with an oral cleft. The risk of having a child with a cleft is higher if one or both parents have had previous children with these defects (known as recurrence).
  • exposure to certain medications while pregnant, such as prescription painkillers or anti-seizure drugs
  • smoking during pregnancy
  • becoming exposed to German measles (Rubella) or other infections
  • having diabetes during your pregnancy
  • smoking or drinking alcohol while pregnant
  • being obese while pregnant
  • exposure to radiation (for example, x-rays) during pregnancy

 

How Is Cleft Lip and Palate Diagnosed?

The condition can be diagnosed during pregnancy through prenatal ultrasound and postnatal radiographic imaging. But generally, a physical examination of the baby soon after birth will reveal a cleft lip or palate. The doctor may be able to tell which side the problem is on, but only an X-ray can confirm whether there’s a cleft in the roof of the mouth, too. 

A team of specialists usually diagnoses cleft and lip palate during the first year of life. The team might include a pediatrician, geneticist, ENT specialist, plastic surgeon, orthodontist, and speech therapist. They may use imaging tests such as ultrasound, CT scan, MRI, or x-rays to look for other problems associated with cleft lip and palate.

In addition, blood tests will be performed to determine genetic markers that could have led to the condition. The doctor may also check for other problems, such as heart defects.

 

Treatment of Oral Clefts

A mild cleft may not require treatment if it does not interfere with everyday activities and does not cause pain or discomfort to the child. However, some children with a more severe cleft may need surgery to correct their condition at an early age. Some may even require multiple surgeries for years to fix them completely.

 

Children with cleft lip and palate have a better chance of curing the condition if treated early, before six months of age. The sooner plastic surgery is performed on these babies, the better their chances for success will be down the road in treating any other complications that may arise. The surgery aims to correct appearance, speech problems, feeding issues, and other complications.

 

A plastic surgeon or a team that includes plastic surgeons, dentists, and ear-nose-throat specialists performs reconstructive surgery. After that, another team of specialists will work on speech therapy and dental care.

 

Can It Be Prevented?

If you have a family history of cleft palate, please talk with your doctor about ways to prevent it. Although there’s no known way to prevent oral clefts, there are ways to reduce the risk. These include:

 

Take Folic Acid

Women who take prenatal supplements such as folic acid before becoming pregnant have been shown to have a 60% decrease in the risk of having a child with any neural tube defect, including cleft lip and palate. And if you take folic acid during the first trimester, your chance of preventing neural tube defects increases even more!

 

Have a Healthy Lifestyle

The best way to prevent cleft and lip palate is to avoid alcohol, drugs, and smoking during pregnancy. These substances can contribute to serious congenital disabilities. Smoking reduces oxygen flow to the fetus, which can cause birth defects.

 

Manage Insulin Levels

Controlling diabetes during pregnancy by managing blood sugar levels carefully — especially in the first trimester — because high blood sugar levels increase the risk for babies born with facial problems like cleft lip or palate.

 

Takeaway

We hope this article provides a better understanding of congenital defects of cleft lip and palate. Please feel free to contact CMCFresno if you have any further questions. You can call (559) 455-1500 or book an appointment online for a consultation.

For more informative articles and parenting tips, please visit the CMCFresno blog.