Cleft palate and cleft lip are facial and oral abnormalities that occur while the child is still developing in the womb. Clefting occurs when there is not sufficient tissue in the mouth or lip, causing the tissue that is there to fail to join together properly.

Frequently Asked Questions About Cleft Lip and Palate

1. What do a cleft lip and cleft palate look like?
   A cleft lip is a split between the two sides of the upper lip. It appears as a narrow gap in the skin. The separation sometimes extends beyond the base of the nose and involves the bones of the upper jaw or gum. A cleft palate is an opening in the roof of the mouth. It can include the hard palate and/or the soft palate. Because the lip and palate develop separately from one another, a child can be born with a cleft lip but not a cleft palate or vice versa.
2. Who develops cleft palate and cleft lip?
   The Centers for Disease Control estimate that in the United States each year about 2,650 babies are born with a cleft palate and 4,440 babies are born with a cleft lip with or without a cleft palate. Cleft lip is the fourth most common birth defect in the U.S. and occurs more often in children of Latino, Asian, or Native American descent.
3. What causes a cleft lip and cleft palate?
   Ultimately, the cause of clefting is unknown and at this time they cannot be prevented. Many scientists believe that clefts are a result of a combination of environmental and genetic factors. Some say that certain medications taken during pregnancy may be related to clefting, including anti-seizure drugs and any medication containing Accutane or methotrexate.
4. What problems are associated with cleft lip and cleft palate?
   • Problems eating: The separation or opening in the palate can cause food and liquids to pass from the mouth through the nose. However, specially designed baby bottles are available to keep fluids flowing downward toward the stomach. Some children wear an artificial palate to help them eat properly.
   • Ear infections and hearing loss: Cleft palate can increase the risk of ear infections because these children are more prone to fluid build-up. To prevent hearing loss as a result of ear infections, some children need special tubes to be inserted in the eardrums to help with fluid drainage.
   • Speech impediments: Some children with cleft lip or cleft palate have trouble speaking. Often their voices do not carry well, they may be difficult to understand, or they suffer from hypernasal speech.
5. How is cleft lip and cleft palate repaired?
   Cleft lip often requires either one or two surgeries. Surgery is recommended within the first few months of a child?s life, usually performed around three months of age. Surgery for cleft palate requires multiple surgeries over a period of 18 years, the first of which should occur between six and 12 months of age.

If you have any questions regarding cleft lip or cleft palate, feel free to post in the comments section below.

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Children often experience many health issues related to the ear, nose and throat areas. Some of the illnesses or problems are the result of bacterial infections or viral infections that may occur after exposure to others who have that virus. Some illnesses are the result of a simple cold that turns into an infection, possibly because the ear, nasal and throat passages are small or blocked. This can be due to congenital abnormalities of the ear, enlarged tonsils, adenoiditis and adenoid hypertrophy, chronic ear problems or other ear, nose and throat problems.

One other issue that can be the result of genetics, in addition to congenital abnormalities of the ear, would be enlarged tonsils. Children with enlarged tonsils experience difficulty breathing, especially at night and often have sleep apnea. Sometimes these children will develop snoring while some, about one to three per cent will show signs of Sleep Disordered Breathing in addition to snoring. The child may experience symptoms of sleep disordered breathing, which is 3.7 times more likely in children with enlarged tonsils. Some children snore on a regular basis, approximately 10% of children will have this tendency while a smaller number may actually have Obstructive Sleep Apnea, or OSA, which is prevalent in about two to four percent of children who snore. This symptom is a consideration in whether or not the child should have their tonsils removed. About 80% of tonsillectomies now are done due to obstructive sleep problems, or OSA while 20% of tonsillectomies are performed due to recurring infections. Formerly, about 30 years ago for instance, the number of tonsillectomies due to infection in children was the reason approximately 90% of the time.

While it is unknown if genetics play a role in enlarged tonsils, the congenital abnormalities of the ear in children is directly related to genetics. Over half of children with hearing loss can have that hearing loss traced back to the genes of the parent or parents. While only a small number of newborns experience hearing loss, which is reported in about one in every 1,000 newborns, every newborn is tested for hearing within a short time of birth.

Other problems with the ear, nose and throat may develop even if the child does not have congenital abnormalities of the ear. Ear infections are a common illness that may or may not be the result of congenital abnormalities of the ear or other ear formation issues. Another issue that can cause hearing loss in newborns would be infections in the mother during the pregnancy or other environmental causes which are not related to congenital abnormalities of the ear. Some children exhibit many more ear infections than others. Visit a recommended Ear, Nose and Throat doctor to find out more and have your child checked for ear nose and throat problems in children and adolescents.

Another area of expertise for ENT doctors is the cleft lip or cleft palate. There has been significant improvement in the treatment of these conditions. Surgery is required to repair cleft lip or cleft palate and is recommended early in life before 12 to 18 months of age for the child.

The doctors for children who specialize in the ear, nose and throat area can help to acquire a diagnosis, whether it is congenital abnormalities of the ear, enlarged tonsils, ear canal formation, cleft lip, sinus passage infections or any similar issue involving the upper respiratory system. Those doctors will provide information and options so you can understand the situation facing your child and make educated decisions on the best action to take for good results and hopefully good health in the future for your child.

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