Understanding Cleft Lip and Cleft Palate

July is National Cleft and Craniofacial Awareness and Prevention Month. Cleft lip and cleft palate, known together as orofacial clefts, are one of the most common birth defects in the United States. According to the Centers for Disease Control (CDC), more than 2,600 babies are born with a cleft palate and more than 4,400 babies are born with a cleft lip (with or without a cleft palate) each year. Children born with this condition can face a variety of challenges including feeding and speech difficulties.

What is a cleft lip and palate?
Cleft lip and cleft palate are birth defects that usually form during the fourth and seventh week of pregnancy. A cleft lip occurs when the tissue that forms the lip does not join completely before birth resulting in an opening in the upper lip. Children with a cleft lip can also have a cleft palate, which happens when the tissue that forms the roof of the mouth does not join together completely during pregnancy.
 
What causes cleft lip and palate?
The causes of orofacial clefts among most infants are unknown according to the CDC, but some factors which may increase the likelihood of a baby developing either one or both of these defects include:

• Family history: Parents who have had a family history of cleft lip or cleft palate are at a higher risk of having a baby with a cleft.
• Race: In the United States, cleft lip and palate are reportedly most common in Native Americans and least common in African-Americans.
• Sex: Males are twice as likely to have a cleft lip with or without cleft palate. Cleft palate without cleft lip is more common in females.
• Exposure to certain substances during pregnancy: Cleft lip and cleft palate may be more likely to occur in pregnant women who smoke cigarettes, drink alcohol or take certain medications.
• Having diabetes: There is some evidence that women diagnosed with diabetes before pregnancy may have an increased risk of having a baby with a cleft lip with or without a cleft palate.
• Being obese during pregnancy: There is some evidence that babies born to obese women may have an increased risk of cleft lip and palate.

How is cleft lip and palate treated?

Babies and children with a cleft lip with or without a cleft palate face a variety of challenges – depending on the type and severity of the cleft. Those affected can often have ear infections, hearing loss, difficulty feeding, dental problems, speech difficulties, and coping challenges. Treatment for these conditions often requires the expertise of a team that includes: a surgeon, dentist, audiologist and speech-language pathologist.  In general, a surgeon will close the cleft, a dentist or orthodontist will help straighten the child’s teeth and jaw and an audiologist will test for hearing impairment.

Speech-language pathologists (SLP) provide therapy to treat the feeding, swallowing and speech difficulties that can occur in children with orofacial clefts. For example, some children may have trouble pronouncing certain sounds or consonants. The Speech-Language Institute (SLI) offers assessments and individualized treatment plans that can help children overcome these obstacles and improve their communication. For more information on SLI’s services or to schedule an appointment, call 215.780.3150.