About Cleft Lip/Palate

A cleft lip is a condition that creates an opening in the upper lip between the mouth and nose. It looks as though there is a split in the lip. It can range from a slight notch in the colored portion of the lip to complete separation in one or both sides of the lip extending up and into the nose. A cleft on one side is called a unilateral cleft. If a cleft occurs on both sides it is called a bilateral cleft.

A cleft is most commonly caused by a combination of several factors. There may be a number of environmental factors as well. A cleft happens in one in every 700 births. It happens all over the world. It is the fourth most common birth defect.

A cleft is formed by the 4th - 8th weeks of pregnancy. Many women do not even know they are pregnant before the cleft has been formed. A cleft happens when the tissues of the face fail to fuse during gestation. It is a repairable birth defect.

One child in 33 is born with some sort of birth defect. One in 700 is born with a cleft-related birth defect. Most cleft-affected babies are boys, however, it is not uncommon for a girl to be born with a cleft. If a person (male or female) is born with a cleft, the chances of that person having a child with a cleft, given no other obvious factor, rises to seven in one hundred. Some clefts are related to identifiable syndromes. Of those, some are autosomal dominant. A person with an autosomal dominant gene has a 50% probability of passing the gene to an offspring. Many clefts run in families, even though there does not seem to be any identifiable syndrome present. Clefting seems to be at least in part related to ethnicity, occurring most often among Asians, Latinos and Native Americans (1:500), next most often among persons of European ethnicity (1:700) and least often among persons of African ethnicity (1:1,000). After that critical period of the 4-8 weeks of pregnancy, nothing the mother does can cause a cleft, and nothing a mother does can avoid the cleft. Sometimes it is determined even before the mother is aware that she is pregnant.

The timing for repairing clept varies with the doctor and with the child. However, most of the time a cleft lip is repaired at around 10 weeks of age, if the baby weighs at least 10 pounds at that time. The cleft in the palate is repaired at about age 9 - 12 months. There will likely be a bone graft at around age 9. There is no guarantee that those will be the only surgeries your child will have to repair the cleft. Many cleft-affected children have revision work done as they grow. Rhinoplasty is also common. There may or may not be some speech-related surgeries or palate-lengthening surgery. Your plastic surgeon can give you a better idea as to what you might expect for your child. Just remember that it IS repairable, and that each surgery will only improve upon what is already there


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