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Cleft Palate: Medical Information on Causes, Diagnosis, Symptoms and Treatment

cleft-palate-complicationsQuick Answers about Cleft Palate

  • Cleft Palate Overview
  • Cleft Palate Causes
  • Cleft Palate Symptoms
  • Diagnosing Cleft Defects
  • Treatment and Managing the Defect
  • Prognosis (Outlook)
  • Coping and Support

Cleft Palate

Cleft Palate Overview

Orofacial Cleft Birth Defects including cleft palate and cleft lip develop during pregnancy when the mouth or lip are not properly formed. During the sixth and ninth weeks of pregnancy, the palate (the roof of the mouth) forms. In some fetuses, this area does not completely join causing an opening of the palate in the front and back, or at only one location in the palate. A cleft palate can cause serious problems, making it difficult for the child to eat or speak clearly. Other times, children experience severe ear infections, hearing problems and difficulties with their teeth.

Statistics maintained by the CDC (Centers for Disease Control and Prevention) reveal that more than 2600 infants are born every year with a cleft palate, which is approximately one out of babies born annually. This includes isolated orofacial clefts and single birth defect involving only a cleft palate. Children of Native Americans, Latinos, and those of Asian heritage have an increased rate of cleft palates and cleft lips. Boys tend to be twice as likely of developing a cleft lip as girls. However, girls are twice as likely to develop a cleft palate without a cleft lip.

The experience of birthing an infant born with a cleft palate can be traumatic on the parents. However, cleft palate and cleft lips can be corrected. Repairing the birth defect usually requires a series of surgeries by a competent surgeon who can restore the baby’s normal facial functioning and reconstruct the appearance of the child’s face with minimal scarring.

Cleft Palate Causes

Doctors, researchers, and scientists have yet to discover the exact cause of cleft palate and cleft lip defects. To date, these conditions are not preventable. Many scientists believe that this condition is the result of a combination of environmental factors and genetics. Statistics reveal there is an increased potential of the infant being born with clefting if a relative, parent or sibling was also born with the defect.

Medications taken by the mother during her pregnancy might be a potential cause of the defect. There might be a direct correlation between cause and effect with some prescription drugs including:

  • Anti-compulsive/anti-seizure drugs
  • Acne medications that contain methotrexate or Accutane used to treat psoriasis, arthritis, and cancer.
  • Epilepsy treatment medication including valproic acid and topiramate in the first three months (first trimester) of pregnancy.

Exposing the fetus to chemicals and viruses while the baby is developing in the womb might also increase the potential rate of developing cleft palates and cleft lips. Finally, clefting may be the result of other medical conditions.

Scientists have discovered a correlation between smoking during pregnancy and infants born with orofacial clefts compared to non-smoking women. Additionally, there seems to be a correlation between women who were diagnosed with diabetes before becoming pregnant and the increased risk of birthing a child with a cleft palate or cleft lip.

Cleft Palate Symptoms

Most children with a cleft palate or cleft lip will also have the presence of other birth defects. Some children’s cleft problems are small and almost unnoticeable. Others have a complete split of their lip that travels to the base of the nose. Cleft palate can develop on one or each side of the roof of the mouth and extend to the back of the palate. The most common types of symptoms of cleft defects and the associated problems include:

  • A significant change in the shape of the nose
  • Poorly aligned teeth
  • Difficulty in eating
  • A failure to gain weight
  • Poor growth
  • Language and speech difficulties
  • Recurrent ear infections
  • The flow of liquids through the nasal passageways during feeding

Diagnosing Cleft Defects

Most cleft palate and cleft lips in newborns are easy to diagnose because of their obvious physical characteristics. However, determining if an unborn child has a cleft palate or cleft lip usually requires a prenatal ultrasound.

Less conspicuous “clefting” defects after the baby’s birth usually require an extensive physical exam of the palate, nose, and mouth to verify the presence of the cleft. A pediatrician might conduct extensive diagnostic testing to detect or rule out other defects and abnormalities. Some forms of cleft palates and cleft lips including bifid uvula and submucous cleft palate are not diagnosed until many years after the child’s birth.

Treatment and Managing the Defect

The available options for treating a cleft lip or cleft palate will depend on the severity of the defect, the presence of other birth defects and associated syndromes, and the child’s needs and age.

Surgical options are nearly always available to repair a cleft lip. This procedure usually happens in the first few months after the child is born and no later than the child’s first birthday. Repairing a cleft palate through surgical procedures as recommended within the first 18 months after birth or earlier when possible. While surgeries are highly successful, many children require additional procedures throughout their developing years.

In addition to closing the cleft to maximize hearing, breathing, speech and language development, the surgeon will also work to improve the child’s facial appearance. In many cases, the child will need additional services including speech therapy, specialized dental care, and orthodontics. The complete reconstruction usually requires craniofacial and cleft teams that work in a coordinated effort to maximize the child’s outcome.

With treatment, most children will likely lead a normal and healthy life. However, severe defects often leave some children with self-esteem issues throughout their life. Support groups are available for children with birth defects and their parents.

Prognosis (Outlook)

Most newborns suffering from a cleft defect will heal without any issues. The appearance of the child as they grow older usually depends on the location and severity of the defect. In many cases, the child will require additional surgery to fix scarred tissue left over by corrective surgery.

Parents can expect their child to have repeated visits to the dentist and/or orthodontist to correct misaligned teeth and problems associated with eating. Additionally, children often experience hearing issues and will require ongoing hearing tests beginning at an early age and repeated throughout adulthood.

Even with speech and language therapy, the child may still have issues with talking clearly after their surgery. This is often the result of muscle challenges in the palate. However, ongoing speech therapy can help the child overcome these muscle issues in time. It is crucial to follow the recommendations of the healthcare provider and get follow-up care.

Coping and Support

No parent whatever expects their child will be born with a birth defect. Discovering that your newborn has a cleft palate or cleft lip can cause emotional stress for the entire family. However, there are coping mechanisms and support groups to help parents, family members and the child in dealing with the problem and its repair/recovery.

Parents should avoid blaming themselves and find support in the local community that provides education and financial options. It is crucial that parents help their child build confidence, discover their positive qualities and maintain open communication and dialogue with family members and friends.

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