Cleft lip and cleft palate are one of the many oral malformations happen when the baby is still developing in the womb.It happens when the lip or the palate are not formed properly due to lack of tissue or when the tissues in the mouth or lip don’t join together properly. The birth defect is said to occur between the 4th and 9th week of pregnancy, which is when the lips and palate begin to take form and shape in the fetus. Cleft is considered as the 4th most common birth defect in the USA affecting 700 babies each year.
These defects are referred to as orofacial clefts and can be diagnosed in the baby through an ultrasound before the birth.
During pregnancy, when the baby’s facial features are still developing, the cells and tissues from both sides of the head grow inward, towards the center. The cells fuse together to give rise to features like mouth, lips, and chin. If the tissues forming the lips, doesn’t fuse together or in a proper way, it leaves a gap or separation in the upper lip. It could be a slit or a gap that extends till the nose, including the upper jaw or upper gums.
When the palate forms between the 6th and 9th week of pregnancy, the tissues in the roof of the mouth fuse together. The malformation occurs in a similar way, when the cells don’t fuse together completely, leaving a gap in the roof of the mouth. It could either be in the hard palate (the front portion of the roof of the mouth) or the soft palate (the back portion of the roof of the mouth).
The formation of the lip and palate occurs separately in the fetus. Even if a child doesn’t have a visible cleft lip, they may have a cleft palate and vice versa. Both can also occur together.
Why Cleft Condition Occurs?
The reason behind the malformation has not been known very well. However, certain known factors have been associated with the case, based on the study of various instances. Clefts have been considered as a genetic abnormality combined with environmental factors in which the mother had stayed and what she ate and drank during pregnancy.
Some factors that come to light during from the study results are:
2. Diabetes: Women suffering from diabetes before conceiving are also at a higher risk of giving birth to babies with cleft lip and cleft palate.3
What Are The Problems Related To Cleft?
A baby with a cleft can have difficulty in breastfeeding, which can lead to malnutrition. Children can also develop speech issues and dental problems. Recurring ear infections are also an outcome, which may lead to hearing loss in worst cases.
Many children also have to face social stigma, while some deal with personal issues like low-self esteem and problems in social interaction.6
What Are The Possible Treatments?
Surgery is one straight answer to correcting the defect. However, it depends on how severe the condition is. Usually, surgery to correct the cleft lip is recommended within first 12 months after birth, while a cleft palate is often repaired well before 18 months. Subsequent surgeries might follow to correct the appearance and to improve the breathing, hearing or speech as the child grows.
Children might also need dental care or speech therapy thereafter—which varies with the severity. The American Cleft Palate – Craniofacial Association (ACPA), a nonprofit society consisting of a team of professionals who specialize in the treatment of orofacial cleft, provide various services and treatment options for children dealing with this condition—there services are spread across the US.
Children with cleft have a healthy life ahead once the treatment is completed. Since many of them have to deal with bullying and starring which can make them self-aware and cripple their confidence levels, parents of children with the condition must constantly support them. Parent support groups and organizations like ACPA can together help cope with the condition that affects 4,437 babies every year according to The Center for Disease Control.7
|↑1||Little J, Cardy A, Munger RG. Tobacco smoking and oral clefts: a meta-analysis. Bull World Health Organ. 2004;82:213-18.|
|↑2||Honein MA, Rasmussen SA, Reefhuis J, Romitti P, Lammer EJ, Sun L, Correa A. Maternal smoking, environmental tobacco smoke, and the risk of oral clefts. Epidemiology 2007;18:226–33.|
|↑3||Correa A, Gilboa SM, Besser LM, Botto LD, Moore CA, Hobbs CA, Cleves MA, Riehle-Colarusso TJ, Waller DK, Reece EA. Diabetes mellitus and birth defects. American Journal of Obstetrics and Gynecology 2008;199:237.e1-9.|
|↑4||Margulis AV, Mitchell AA, Gilboa SM, Werler MM, Glynn RJ, Hernandez-Diaz S, National Birth Defects Prevention Study. Use of topiramate in pregnancy and risk of oral clefts. American Journal of Obstetrics and Gynecology 2012;207:405.e1-e7.|
|↑5||Werler MM, Ahrens KA, Bosco JL, Michell AA, Anderka MT, Gilboa SM, Holmes LB, National Birth Defects Prevention Study. Use of antiepileptic medications in pregnancy in relation to risks of birth defects. Annals of Epidemiology 2011;21:842-50.|
|↑6||De Sousa, Avinash, Shibani Devare, and Jyoti Ghanshani. “Psychological issues in cleft lip and cleft palate.” Journal of Indian Association of Pediatric Surgeons 14, no. 2 (2009): 55.|
|↑7||Facts About Cleft Lip & Cleft Palate.MIAMOO|