Cleft lip and palate are common birth defects that affect the development of the lip or roof of the mouth (palate). Cleft lip occurs when the lip does not completely form and leaves a cleft or split in the upper lip on either side of the nose (unilateral cleft lip) or both sides (bilateral cleft lip). Cleft palate is when the palate does not completely close leaving a gap in the roof of the mouth inside. It is possible to have either cleft palate or cleft lip alone, or both cleft lip and palate. Cleft lip and palate are noted at birth and can sometimes be seen on ultrasound during pregnancy. Clefts occur very early in pregnancy, typically before most women even know they are pregnant (between 4-6 weeks).
The cause of both types of clefting is considered multifactorial meaning that risk factors include both genetic and environmental influences. These risk factors may include but are not limited to family history, race (most common in Indian and Asian backgrounds), gender (cleft lip more common in boys, cleft palate more common in girls), certain medications during pregnancy, chemical or drug exposures during pregnancy, viruses and genetic factors as well. Risks to have a child with a cleft lip and/or palate increase when other family members have been born with clefts. In families with no family history who have had a child born with a cleft lip or palate have a 2-6% risk for a second child to be born with a cleft. Even within families, the type and severity of clefts can vary greatly.
Babies born with clefts may have difficulty feeding, more frequent ear infections, sometimes hearing loss and dental problems. Surgery to correct a cleft lip is usually done by 12 months and 18 months for a cleft palate closure. Although many children born with clefts require dental and orthodontic care or other surgeries later, they typically lead a normal life after treatment.