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Cleft Lip and Cleft Palate

By Simeon A. Boyadjiev Boyd, MD, Professor of Pediatrics and Genetics, Section of Genetics, Department of Genetics, University of California, Davis

The most common birth defects of the skull and face are cleft lip and cleft palate, affecting about 1 of every 700 babies.

  • Cleft lip is a separation of the upper lip, usually just below the nose.

  • Cleft palate is a split in the roof of the mouth (palate) resulting in an abnormal passageway into the nose.

Cleft lip and cleft palate often occur together.

Both environmental and genetic factors may be involved in the formation of a cleft lip or cleft palate. The mother's use of tobacco, alcohol, or other drugs while pregnant may increase the risk of having a baby born with a cleft lip or cleft palate. Having one child born with a cleft lip or cleft palate increases the risk of having a second child with this kind of birth defect.

Cleft Lip and Cleft Palate: Defects of the Face

Cleft lip is disfiguring and prevents infants from closing their lips around a nipple. A cleft palate interferes with eating and speech and increases the risk of ear infections. Several options are available to help infants eat better, depending on the deformity. Options include the use of specially designed bottle nipples, a dental device that can temporarily seal the roof of the mouth so infants can suckle better, a feeder that can be squeezed to deliver formula, and an artificial palate that can be molded to the top of the infant's mouth.

Cleft lip and cleft palate can be corrected with surgery. Timing of the surgery depends on the deformity and on the infant. For a cleft palate, a two-stage procedure is often done. The cleft lip, nose, and soft palate (the smooth soft back part of the palate) are repaired at age 3 to 6 months. Then the hard palate (the ridged hard front part of the palate) is repaired at age 15 to 18 months. Dental and orthodontic treatment, speech therapy, and counseling may be needed when the child is older.

The likelihood of cleft lip and cleft palate can be reduced if a woman takes folate (folic acid) before pregnancy and through the 1st trimester of pregnancy.

Because abnormal genes may be involved in the formation of a cleft lip or cleft palate, affected families may benefit from genetic counseling.

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