Cleft lip and cleft palate are considered as birth defects that occur when the baby’s lip and mouth do not form properly during pregnancy.
Dr. Ali Hassan Al-Qattan
Bachelor of Medicine, Surgery, Gynecology and Obstetrics
The Royal College of Surgeons in Ireland
Cleft lip and cleft palate are considered as birth defects that occur when the baby’s lip and mouth do not form properly during pregnancy, which can affect the baby’s feeding, speech and facial appearance. In addition, they are associated with recurrent ear infections, hearing problems, teeth development and psychological problems.
The lip forms between the fourth and seventh week of pregnancy. As the baby develops during pregnancy, facial tissues and special embryonic (baby) cells from each side of the head grow toward the center of the face and join together to make the face. A cleft lip happens if these growing embryonic (baby) tissues that make up the lip do not join correctly and completely before birth. This results in an opening in the upper lip. This opening can be a small slit in the lip or it can be a large opening that goes through the lip into the nose. Cleft lip can happen on one or both sides of the lip or in the middle of the lip. Children with cleft lip can also have a cleft palate.
The roof of the mouth (palate) is formed between the sixth and ninth week of pregnancy. A cleft palate happens if the embryonic (baby) tissues that make up the roof of the mouth do not join together correctly and completely during pregnancy, leaving an opening in the roof of the mouth (palate). For some babies, both the front and back parts of the palate are open. For other babies, only part of the palate is open.
Children with a cleft lip, who may or may not have a cleft palate too, or children with only cleft palates, usually have problems with speaking clearly, feeding, hearing and teeth development.
(Number of Babies born with Cleft lip / Cleft Palate):
There are many causes of cleft lip and cleft palate. They can happen due to genetic syndromes and problems in the genes. They can also happen due to the enviromental factors faced by the mother during her pregnancy. In some cases, the causes of cleft lip and cleft palate are unkown. Here are some factors that increase the chance of giving birth to a baby with cleft lip/cleft palate:
All cleft lip /cleft palate cases can be diagnosed by looking at the baby’s face and mouth after delivery without the need of complex imaging and diagnostic tests. However, cleft lip /cleft palate can be diagnosed nowadays during pregnancy and before childbirth due to the advancement in medicine and technology. This can be done by doing an ultrasound during pregnancy (from the beginning of the 13th week of the pregnancy).
The Ultrasound Machine uses ultrasound waves to create images for the embryo (baby) in the mother’s womb and visualize his/her parts. Cleft lip/cleft palate can be diagnosed by looking at these pictures created by the ultrasound machine, if they exist. However, cleft palate can be more challenging to diagnose, as it is hard see it in the ultrasound images.
The doctor can also take a sample of the fluid surrounding the baby in the mother’s womb (Amniotic Fluid) using a special needle under the ultrasound’s guidance. This sample is then sent to the lab for analysis and to check whether there are genetic syndromes or gene problems that may cause the cleft lip /cleft palate.
Cleft lip and cleft palate treatment aims to treat the facial appearance caused by the cleft lip /cleft palate and the complications associated with them such as the feeding, the speech, and the hearing problems.
Treating cleft lip/cleft palate requires a Multi-Disciplinary Team (MDT) that consist of different specialists including: Ear Nose and Throat(ENT) Surgeons, Plastic Surgeons, Ear Nose and Throat(ENT) Doctors; Pediatricians, Pediatric Dentists, Orthodontist, Nurses, Speech and Language Therapists, Medical Geneticists, and Psychologists.
The main treatment is a surgical operation to repair the cleft lip/ cleft palate followed by other operations to fix the appearance of the nose , mouth and lip, and to treat any other complications caused by the cleft lip /cleft palate.
The surgical operations can be done in the following sequence:
No one expects to have a baby with a birth defect. When the excitement of a new life is met with the stress of discovering that your baby has a cleft lip or cleft palate, the experience can be emotionally demanding for the entire family.
When welcoming a baby with cleft lip and cleft palate into your family, keep these coping tips in mind:
You can support your child in many ways: