Cleft lip and palate

Definition

Cleft lip and palate are birth defects that affect the upper lip and the roof of the mouth.

Causes, incidence, and risk factors

There are many causes for of cleft lip and palate. Problems with genes passed down from one or both parents, drugs, viruses, or other toxins can all cause such birth defects. Cleft lip and palate may occur along with other syndromes or birth defects.

A cleft lip and palate can affect the appearance of one's face, and may lead to problems with feeding and speech, as well as ear infections. Problems may range from a small notch in the lip to a complete groove that runs into the roof of the mouth and nose. These features may occur separately or together.

Risk factors include a family history of cleft lip or palate and other birth defect. About 1 out of 2,500 people have a cleft palate.

Symptoms

• Separation of the lip alone
• Separation of the palate
• Separation of the lip and palate
• Varying amounts of nasal distortion
• Recurrent ear infections
• Failure to gain weight
• Nasal regurgitations during bottle feeding
• Growth retardation
• Misaligned teeth
• Poor speech
• Feeding problems

Signs and tests

A physical examination of the mouth, nose, and palate confirms a cleft lip or cleft palate. Medical tests may be done to rule out other possible health conditions.

Treatment

Surgery to close the cleft lip is usually done at 3 - 9 months of age. Surgery may be needed later in life the problem severely affects the nose area.

A cleft palate is usually closed within the first year of life so that the child's speech normally develops. Until surgery can be done, a prosthetic device is often fitted over the palate for feeding.

Continued follow-up may be needed with speech therapists and orthodontists.

Support Groups

For additional resources and information, see cleft palate support group.

Expectations (prognosis)

Although treatment may continue for several years and require several surgeries, most children with a cleft lip and palate can achieve normal appearance, speech, and eating. However, some people may have continued speech problems.

Complications

• Recurrent ear infections
• Hearing loss
• Dental cavities
• Displaced teeth
• Poor speech
• Lip deformities
• Nasal deformities

Calling your health care provider

Cleft lip and palate is usually diagnosed at birth. Follow the health care provider's recommendations for follow-up visits. Call if problems arise between visits.