Cleft lip is one of the most common birth defects, affecting nearly 5,000 babies born in the United States each year. Cleft lip occurs when the developing facial structures in an unborn baby fail to close completely, resulting in a split or gap in the upper lip. In most cases, a series of surgeries is able to restore normal functioning and appearance.
However, most cases of cleft lip occur together with cleft palate as well. Cleft palate occurs when the tissue in the roof of the mouth doesn’t fuse together completely. While both types of cleft are able to be surgically corrected, it is likely that the clefts will create other problems, such as ear infections, speaking difficulties, and tooth development. After surgery, all of these concerns will need to addressed and treated separately.
Surgery
Surgery to repair a cleft lip is recommended within the first year of life, but it will typically occur within the first few months. Most children will need more than one surgery throughout tives life to keep up with the changes as they grow and develop. These surgical procedures will not only improve the appearance of the face, but it will also be beneficial for breathing, hearing, and speech development.
Sometimes there are pre-surgery techniques that are recommended to help stretch and reshape the tissues of the lip and nose to prepare for the surgery and ensure positive results.
Other Challenges
Depending on the location and severity of the cleft, children who are born with cleft lip, with or without cleft palate, will also face a variety of other challenges. These include:
- Ear Infections – If a cleft lip is accompanied by cleft palate, a child is at a very high risk for developing middle ear infections. This is because an intact palate with normal muscle function is necessary for proper drainage of the middle ear. To treat this, most babies with cleft palate will develop ear infections and require ear tubes to help drain their ears.
- Speech Difficulties – Without a timely repair of clefts, normal speech will be challenging. Even with successful surgery, a child’s speech development may still be affected. Because of this, a speech pathologist may be needed to evaluate the child and provide speech therapy if needed.
- Dental Problems – Some children’s clefts will also affect the growth of the upper jaw, which may require separate surgery to correct. If the cleft extends through the upper gum area, tooth development will also likely be affected as well. If this is the case, a pediatric dentist can be helpful in monitoring oral health and tooth development from an early age.
- Difficulties Eating – The most immediate concern when a baby is born with a cleft is ususally the problem of feeding. Some babies born with cleft lip are able to breast feed. However, if the baby has cleft lip and cleft palate, sucking can be difficult, cause gagging, or even cause breast milk to come out through the nose. Because of these potential problems, there are specific feeding strategies that have been developed for babies with a cleft. For example, there are special bottles and nipples that can be used. In rare cases, feeding tubes are necessary.
- Social, Emotional, and Behavioral Problems – Besides health issues, children with clefts have the potential to deal with other external problems because of their differences in appearance, as well as the stress that can come with long-term, intensive medical care. Psychologists may be necessary to help both the children and their families cope with the pressures.
