Cleft Palate – Symptoms and Causes

Overview

Cleft lip and cleft palate rank among the most common birth defects worldwide. These conditions occur when a baby’s face develops in the womb. The upper lip or roof of the mouth (palate) fail to close completely.

The defects can appear separately or together.

In many cases, doctors cannot identify the exact cause of these conditions. Sometimes they result from genetic syndromes, but often they happen without a clear reason.

The diagnosis may be concerning for parents, but modern treatments offer excellent solutions. Treatment typically involves several surgeries performed at different ages. These procedures aim to:

• Repair the physical opening
• Improve appearance
• Restore normal function for eating and speaking

After treatment, children usually have minimal scarring and can develop normal speech and eating abilities. The comprehensive care approach helps ensure the best possible outcomes for affected children.

Signs and Symptoms

Cleft lip and palate are visible birth differences that affect the mouth and face. These conditions can be identified at birth or sometimes during pregnancy through ultrasound imaging. The appearance varies depending on the type and severity.

A cleft might show up as:

• A split affecting one or both sides of the lip and palate
• A small notch in the lip or a more extensive opening that runs from the lip through the upper gum and into the nose
• A separation in the roof of the mouth that doesn’t change facial appearance

Some babies have a submucous cleft palate, which is hidden beneath the mouth’s lining. This less obvious type might not be noticed until certain problems develop:

• Feeding difficulties
• Nasal-sounding speech
• Frequent ear infections
• In rare cases, swallowing problems with liquids or food coming out through the nose

When Medical Care Is Needed

If your baby is born with a visible cleft or one is detected during pregnancy, healthcare providers will begin coordinating treatment right away.

For hidden submucous clefts that aren’t immediately obvious, it’s important to schedule an appointment with your child’s doctor if you notice any of the symptoms mentioned above. Early evaluation helps ensure proper treatment and better outcomes.

Healthcare professionals can guide you through the treatment process, which often involves a team of specialists working together to address different aspects of your child’s care.

Causes

Cleft lip and cleft palate develop when facial tissues fail to properly join during early pregnancy. Normally, these tissues fuse within the first few weeks after conception.

When this process doesn’t complete correctly, an opening remains in the lip or palate.

The origins of these conditions stem from multiple factors. Genetics play a significant role. Either parent may pass down genes that directly cause clefting or contribute to syndromes where cleft lip or palate appears as one symptom.

Some babies inherit a genetic predisposition that makes them vulnerable to clefting. Environmental factors then interact with these genes to trigger the condition. This combination of genetic and environmental influences explains many cases.

However, doctors cannot identify a specific cause for many affected babies. Despite medical advances, the exact reasons remain unknown in numerous situations.

Some risk factors include:

• Family history of clefting
• Certain medications taken during pregnancy
• Smoking or alcohol use during pregnancy
• Nutritional deficiencies during pregnancy

Risk Factors

Several factors may increase the chances of a baby developing a cleft lip and cleft palate:

Family History

• Children whose parents or relatives have had cleft conditions face higher risks
• Genetic factors play a significant role in these birth defects

Pregnancy Exposures

• Tobacco use during pregnancy
• Alcohol consumption while pregnant
• Certain medications taken during pregnancy

Nutritional Factors

• Low folate levels in the first three months of pregnancy
• Inadequate vitamin intake during early pregnancy

Demographic Patterns

• Boys are more likely to have cleft lip (with or without cleft palate)
• Girls more commonly develop cleft palate without cleft lip
• Higher rates occur in Native American and Asian populations
• Lower rates appear in African American communities

Complications

Children born with cleft lip or palate often struggle with feeding issues. Babies with cleft palate particularly find sucking difficult, which can complicate breastfeeding.

Ear problems are common concerns. These children have a higher risk of middle ear fluid buildup, which can lead to frequent infections and possible hearing loss if not properly treated.

Dental development may be affected when clefts extend through the upper gum. This can result in missing, misaligned, or poorly formed teeth.

Speech development faces significant challenges. The palate plays a crucial role in forming sounds, so children with cleft palate often develop speech difficulties. Their speech may sound nasal or unclear.

The emotional impact cannot be overlooked. Children with clefts may experience:

• Social difficulties due to visible differences
• Behavioral problems
• Emotional stress from ongoing medical treatments
• Self-esteem issues

Prevention

Having a baby with a cleft lip or palate might raise questions about future pregnancies. Many cases cannot be prevented. However, there are several steps that may help reduce the risk.

Consider Genetic Counseling

Families with a history of cleft conditions should speak with a healthcare provider before planning a pregnancy. A genetic counselor can assess potential risks and provide personalized guidance.

Take Prenatal Vitamins

Women planning to become pregnant should ask their doctor about starting prenatal vitamins. These supplements contain essential nutrients that support healthy development during pregnancy.

Avoid Tobacco and Alcohol

Both tobacco and alcohol use during pregnancy significantly increase the risk of birth defects, including cleft conditions. Avoiding these substances is an important preventive measure.

Other Helpful Steps:

• Maintain regular prenatal care
• Follow a balanced, nutritious diet
• Discuss all medications with a doctor
• Manage chronic health conditions properly

Early conversations with healthcare providers can help parents understand and potentially reduce risks for future pregnancies.