All of us begin fetal life with undefined facial parts that gradually fit together like a puzzle, creating our own unique appearance. The sections of the puzzle fuse together in the middle of the top lip, creating the seam called the philtrum. If the pieces fail to fuse, a cleft lip or palate occurs.
What is cleft lip?
Cleft lip and palate are deformities of the face, lip and palate that occur early in fetal development. The cleft presents as a separation or split between the two sides of the lip under the nose. The separation is often present inside the mouth also, splitting the upper, hard palate of the mouth and sometimes including the soft palate, or back portion of the oral cavity.
How many children are affected?
Because the lip and palate develop at different times of gestation, a child may have a cleft lip without a cleft palate, or the palate may be cleft and the lip normal. One in 700 babies are born with cleft lip every year. It is the fourth most common birth defect in the United States.
Native American, Latino and Asian children are more often affected than Caucasian children, and boys are twice as likely to be born with cleft lip, with or without the cleft palate. Girls, on the other hand, have twice the cleft palate without cleft lip.
Are children with cleft lip able to feed?
It is difficult for children with cleft lip or palate to suck from a bottle or breast.
Special bottle nipples are provided to assist. One kind of bottle is called a special needs feeder. It does not require suction to work.
What about emotional impact?
It is disturbing to find out that your child has a cleft lip or palate, and it can be very challenging for new parents. Sometimes parents facing such a challenge can become very depressed.
Families facing a cleft lip diagnosis need to be referred to a clinical nurse specialist on cleft lip and palate within 24 hours of diagnosis. The Cleft Lip and Palate Association can provide contact groups and communication with other parents of cleft lip babies, as well as psychological counseling if requested.
What is the prognosis?
Cleft lip and palate repair can be done so well that the child’s appearance and function will be completely normal. However, this surgery can be difficult to obtain and expensive if parents have limited insurance.
Cleft lip and palate hinder proper feeding, make communication difficult, and cause children to be viewed as ‘different’ and socially isolated. Cleft lip and palate surgery changes everything, giving parents a reason to hope and children a reason to smile!