Cleft Lip & Palate
Overview
One in every 700 births results in a cleft lip and/or palate. Many of these 
congenital deformities occur in families that have no history of clefts. While it is known how cleft deformities occur, it is seldom known why.
Cleft defects develop very early in pregnancy. They result from an abnormality in the genes (units of heredity) or chromosomes (packets of genes). These elements contain the program that determines how the child will be formed. Why and how abnormalities in the genes and chromosomes develop is largely unknown. An individualized genetic assessment may be helpful in identifying the cause of the malformation.
A person with a cleft who has no family history of this deformity has only a four percent chance of having a child with a cleft. If there is a family history of clefts, the chances are somewhat higher. In most children born with cleft lip and/or palate, this is the only congenital abnormality. However, approximately fifteen percent of all children with a cleft have multiple congenital abnormalities.
The condition of cleft lip and palate generally develops during the sixth to eleventh weeks of a pregnancy when the normal joining of these parts of the face and skull does not occur for some unknown reason. The development of a cleft lip and palate is often attributed to genetics if other members in the child’s family also have the condition, and some cleft lip and palate cases are linked to various health problems. Because cleft lip and palate occurs very early in a pregnancy, it is difficult for cleft lip surgeons to identify a direct cause-and-effect relationship between the environment and the condition.
There are several things to keep in mind when dealing with cleft lip and palate:
- Cleft lip and palate is the most common birth defect. It occurs in 1 out of every 700 babies.
- Cleft lip and palate has no link to race.
- Cleft lip and palate occur more frequently in boys than girls.
- If parents have one child with the condition of cleft lip and palate, there is a two percent to five percent chance that they will have another child with this same condition.
Treatment offered by Cleft Lip Surgeons
Because babies with cleft lip and palate have problems with feeding, they should be assessed by a feeding specialist and a cleft lip surgeon as soon as possible after their birth. A cleft lip surgeon will almost always operate on a child with a cleft during its first year of life. To correct a cleft lip, surgeons usually perform a corrective procedure when the child is between three and four months old. Cleft lip surgeons will then operate to repair the palate when the child reaches the age of nine to 12 months.
The actual timing of any surgical procedure depends on the child’s actual growth and on the particular treatment plan developed by the cleft lip surgeon. If necessary, a secondary repair operation may be performed by a cleft lip surgeon later on, perhaps when a child is four to six years old. If the cleft lip surgeon decides that additional treatment is necessary, an alveolar bone graft may be performed to fill the gap in the gum where a child’s teeth come in – generally, between the ages of eight and ten. Any cleft lip surgeon selected to perform these operations should be a specialist in reconstructive surgery on patients with a cleft lip and palate.
