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Cleft lip and cleft palate

Cleft lips and cleft palates are splits or gaps on the upper lip or the roof of the mouth. These problems develop in the womb when areas of the face don’t join together as they should.

Cleft lip and cleft palate is relatively common, affecting around 1 in every 700 babies in the UK.

Unless treated with an operation, clefts can cause problems with feeding, speech, hearing, ear infections, tooth decay, jaw problems and emotional issues.

What causes a cleft lip and cleft palate?

Doctors don't know why some children have a cleft lip or cleft palate while others don't. However, known risk factors include genes, and during pregnancy smoking, use of alcohol, being obese, not having enough folic acid, and taking some medications.

Diagnosis

A cleft lip or cleft palate is diagnosed from its physical appearance.

This may be spotted after the baby is born, or may be picked up during an antenatal ultrasound after week 20 of pregnancy.

How does cleft lip or cleft palate affect a child?

Left untreated, these conditions can cause:

  • Problems eating and drinking. In some cases, food and drink can pass from the mouth back through the nose. Special baby bottles and teats are available to help direct fluid downwards to the stomach. An artificial palate may help until the problems can be corrected with an operation.
  • Ear infections. Fluid is more likely to build up in the middle ear of children with a cleft palate. This can make infections and hearing loss more likely.
  • Speech problems. A cleft lip or cleft palate can affect a child's speech. Speech and language therapy may be recommended.
  • Dental Problems. Problems with cavities and having teeth missing, extra teeth, malformed or displaced teeth are more common.

Cleft lip or palate specialists

In the UK, children born with a cleft are referred to a specialist cleft clinic. A number of specialised healthcare professionals work at these clinics. Members of a cleft lip and palate team typically include:

  • A surgeon to evaluate and perform necessary surgical procedures on the lip and/or palate
  • An audiologist (to assess and treat hearing conditions)
  • An orthodontist (a dentist who will be able to reconstruct teeth)
  • A speech and language therapist to assess speech and feeding problems
  • A specialist cleft nurse, who will be the main point of contact between you and the rest of the team
  • A psychologist to support the family and assess any adjustment problems
  • A paediatrician who specialises in treating children

The health care team works together to develop a plan of care to meet the individual needs of each patient. Treatment usually begins in infancy and often continues through early adulthood.

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