Craniofacial Awareness Month: Understanding Cleft Lip and Cleft Palate

Posted on July 18, 2016 by Gerry

Cleft lip and palate is a congenital condition that happens in the first three months of pregnancy affects the upper lip and the hard and soft palate of the mouth. It is one of the most common birth anomalies in the world. Approximately one in every 700 babies is born with a cleft in North America, so it is possible that you may know someone who has this condition. Despite extensive research about cleft lip and palate, its’ causes are still unknown.

Children born with cleft lip and palate need the help of a multidisciplinary medical team to treat problems associated with clefts that may develop. The condition affects a child’s appearance, speech, teeth, eating, hearing and ability to develop socially.

In the developed world, the vast majority of children born with cleft lip and palate are treated successfully and lead normal lives. But millions of children and adults in developing countries suffer with un-repaired clefts. Many are abandoned shortly after birth or kept hidden away from society. Most find it difficult to attend school, communicate easily, find jobs or get married.

The good news is that cleft lip and palate can be successfully treated by a combination of surgery and rehabilitation.

As you might imagine, cleft lip and cleft palate can affect many actions of the mouth and face. Children born with cleft lip or cleft palate might have issues related to their feeding, hearing, teeth, and speech.

Feeding Problems

Babies with just a cleft lip don’t usually have feeding problems. But when the palate is involved, feeding can be a bigger challenge.

Normally, the palate prevents food and liquids from entering the nose. A cleft palate causes babies to swallow a lot of air and regurgitate food into the nose. It also makes it harder for babies to latch on and suck during breastfeeding or bottle feeding. As a result, a baby with a cleft palate may need a special nipple and bottle to receive pumped breast milk or formula. Breastfeeding moms might want to talk with a lactation consultant, who can offer more guidance and suggestions.

Babies with feeding issues should be seen regularly by a doctor to make sure that they’re gaining weight well.

Middle Ear Fluid Buildup and Hearing Loss

Many children with cleft palate are at risk for fluid buildup in the middle ear. This fluid can’t pass through the Eustachian (yoo-STAY-shun) tube as it should, which can lead to ear infections and even hearing loss. So kids with cleft palate usually need ear tubes placed in their eardrums to help drain the fluid and improve hearing.

Kids with cleft palate should have their ears and hearing checked once or twice a year, or more if they are having hearing problems.

Dental Problems

Children with a cleft lip and palate often have dental problems. These can include small teeth, missing teeth, extra teeth (called supernumerary), or teeth that are out of position. They may have a defect in the gums or alveolar ridge (the bone that supports the teeth). Ridge defects can displace, tip, or rotate permanent teeth or prevent permanent teeth from coming in properly.

Regular visits with a pediatric dentist who specializes in cleft lip and palate are important. The dentist will check a child’s mouth growth and development, identify any problems, and make treatments when needed.

Speech Problems

Kids with cleft lip have fewer speech problems than those with cleft palate. About 1 in 5 kids with cleft palate have speech problems after surgical repair. Most often, this means that a child’s voice is hypernasal (sounding like the child is talking through the nose). This happens because the palate doesn’t move well enough to prevent air from leaking out of the nose.

Children with clefts also can have other types of speech problems that aren’t to the cleft; for example, age-related errors such as saying “wed” instead of “red.” Sometimes, the dental problems associated with the cleft will distort some sounds, particularly “s,” “sh,” “ch,” and “j.”

A speech-language pathologist can check a child’s speech and language skills and recommend treatment if needed.

Not knowing any real cause for the occurrence of cleft lip or palate can make prevention difficult. Since it is common, caring for and repairing the issue can often be done successfully.

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