About 4,800 babies are born each year in the United States with clefts and no other birth defects, according to the March of Dimes. Most of these children are born with cleft lips along with cleft palates. Children with cleft palates without cleft lips are rare- only about 2,600 babies are born each year in the U.S. with this condition. Clefts can cause a variety of problems for babies, including difficulty nursing, improper development of bones in the face and ear, nose and throat problems. Clefts may cause speech impairments as well as breathing problems and prevent proper drainage of sinus cavities and ears. Appearances are a concern as well; even if a cleft does not affect eating or cause medical concerns, the emotional impact of a cleft lip or palate can be devastating to a young person.
Anatomy
A cleft lip is the incomplete formation of the skin between the upper lip and the nose. A cleft palate is a gap between the roof of the mouth and the nasal cavity.
Clefts
Cleft lips can be as minor as an indentation in the lip, or the separation may continue all the way to one nostril. Cleft lips can be unilateral, with just one cleft, or bilateral with two clefts, one leading to each nostril. Cleft palates can affect both the front and rear palates, or a child may have a partial cleft.
Sex
More boys are born with a cleft lip and more girls have a cleft palate without a cleft lip, according to KidsHealth, a medical information site sponsored by the Nemours Foundation.
Feeding
A baby with a cleft lip may have trouble sucking on a nipple because the cleft prevents their lips from getting a good seal around the skin or bottle. A cleft palate may allow milk or formula to enter the nasal cavity. A cleft lip is also called a harelip, according to MayoClinic.com.
Surgery
Surgery can repair cleft lips and palates. Cleft lip is usually performed within the first three to six months of a child's life. A unilateral cleft lip can be repaired in a single surgery, while two operations, staged about a month apart, may be needed to fix each side of a bilateral cleft. The procedure usually involves removing a strip of skin on each side of the cleft and suturing the lip together. A short hospital stay is required.
Cleft palates usually necessitate several reconstructive surgeries. The first surgery, usually performed between the ages of nine and 14 months, creates a functional palate. This allows the bones of the child's face to develop correctly, promote drainage of the sinuses and ears, as well as allowing the child to eat and drink. Additional surgeries may be necessary to improve the appearance of the lips and nose, close openings between the mouth and nose, clear any airway obstructions and address any speech impairments associated with cleft palate. These surgeries are more complex, and require several nights in a hospital, possibly with a stay in the intensive care unit.
Alveolar Ridge Defect
Children with a cleft palate may have a defect in the alveolar ridge, which is the bony gum where the upper teeth grow. The defect may prevent teeth from coming in or cause teeth to be displaced or crooked. Surgery involves implanting bone matter into the alveolar ridge, then correct the placement of teeth through the use of braces.
