Tilt your head back a bit and look in the mirror. Do you see the
way your nose connects to your upper lip?
Now open your mouth. Do you see the seam on the roof of your
mouth? Sometimes you can feel it with your finger or your tongue.
That's where your
grew together in the middle. You can see that the palate goes from
behind your front teeth all the way to the back of your mouth.
How Does a Kid Get Cleft Lip or Cleft Palate?
means a gap or split between two things. A
is a split in the upper lip. This can happen on one or two sides of
the lip, creating a wider opening into the nose. A
is a split in the roof of the mouth. This leaves a hole between the
nose and the mouth. Sometimes a cleft lip and cleft palate occur
together in the same person. Cleft lip and cleft palate are very
common and occur in about 1 or 2 of every 1,000 babies born in the
United States each year.
Cleft lip and cleft palate are
, which means they happen while a baby is developing inside his or
her mother. Normally, the mouth and nose of a baby develop between
the first 6 and 12 weeks of growth. In some babies, parts of the
lips and roof of the mouth don't grow together. Because the
lips and the palate develop separately, it's possible to have
cleft lip, cleft palate, or both.
We don't always know why a particular baby has cleft lip or
cleft palate. Sometimes the condition runs in families. This means
that a person with cleft lip or cleft palate may have a relative
with the same thing. Other times, cleft palate is part of a
syndrome, meaning there are birth defects in other body parts, too.
Sometimes a cleft may be related to what happened during a
mother's pregnancy, like a
she may have taken, a lack of certain vitamins, or exposure to
cigarette smoke. Most of the time, however, the cause of the cleft
is unknown and could not be prevented.
What Happens to a Kid With Cleft Lip or Cleft Palate?
A baby with cleft lip or cleft palate may have problems eating.
This can be a big problem, especially for a newborn baby. Normally,
the palate prevents food and liquids from going up your nose. When
you swallow, the tongue presses up against the palate and pushes
the chewed food to the back of your throat. Try swallowing slowly
and you can feel your tongue touch your palate.
Have you ever laughed so hard while drinking milk that it came
out of your nose? Because there is a hole between the nose and
mouth in babies with a cleft palate, they have the same problem,
but it can happen every time they drink and not just when they
laugh. Fortunately, there are feeding specialists and special baby
bottles that can help.
Kids with cleft palate can have
. This may be caused by fluid in the middle
. Therefore, children with cleft palate should have their ears and
hearing checked about once or twice a year. They usually need very
small special tubes placed in their eardrums to help them hear
Dental problems involving the upper gum or palate often happen
with clefts. These problems can include small
, missing teeth, extra teeth, or crooked teeth. All kids need to
see the dentist regularly and keep their teeth clean. A kid with
clefts might need to go to the orthodontist for
, too, to make sure his or her teeth grow in straight.
Kids with cleft lip or cleft palate may also have problems with
speech. When you talk, the muscles of your soft palate help to keep
air from blowing out of your nose instead of your mouth. Kids with
cleft palate find their soft palate sometimes does not move well
and lets too much air leak out the nose while speaking. That gives
them problems with certain sounds and it makes them sound like they
are speaking partly through their nose.
What Do Doctors Do?
Treating cleft lip or cleft palate takes a team of different
types of specialists (in this case, people who are experts in
helping kids with clefts). This team includes a plastic surgeon, a
, an otolaryngologist (a doctor trained in ear, nose, and throat
problems - say
-lo-jist), an oral surgeon, a dentist, a geneticist, a social
worker, a psychologist, an audiologist, and other health care
specialists. Because there are so many different people for a kid
to see, the team has a coordinator who works with the parents to
help organize everything.
is usually repaired by the time a baby is 3 to 6 months old.
on the cleft lip, the doctor closes the gap in the lip and
corrects the nostril. A person who has cleft lip repaired as an
infant will have a scar on the lip under the nose.
is usually repaired at age 9 to 12 months. During surgery on
cleft palate, doctors close the hole between the roof of the
mouth and the nose and reconnect the muscles in the soft
After surgery, a kid will get regular hearing tests to check for
hearing problems caused by fluid building up in the ears. Because
of this fluid build-up, some kids get special tubes put in their
ears to help them hear better. Kids may also need speech therapy
when they start talking. Some kids with cleft palate might even
need another operation on their palate to improve their speech.
Lots of kids, including those with cleft lip or palate, need
orthodontics or braces after their permanent teeth grow in. Braces
can straighten crooked teeth. Kids with cleft lip and cleft palate
may also need a
when they're about 8 years old. In a bone graft, a surgeon
takes some bone, usually from the person's hip, and uses it to
fill in the gap in the upper gum area. This allows the upper gum
area to hold the permanent teeth better and keep the upper jaw
As kids with cleft lip or cleft palate grow older and become
teenagers, some may want to have their scars made less noticeable,
their jaws aligned, or their noses straightened. Operations to do
these can improve a person's bite, speech and breathing, and
Living With Cleft Lip or Cleft Palate
Some kids with severe cleft lip or cleft palate have a flattened
nose or small jaw. Other kids with just cleft palate may look just
like everyone else. Either way, kids with cleft lip or cleft palate
want to be treated like everyone else. A person might have cleft
lip, but also have beautiful eyes, a great sense of humor, or a
If you have cleft lip or cleft palate, there may be some things
about your face you can't change and some that you can. Doctors
can do amazing things to make you feel good about the way you look
on the outside, and you can do things to make yourself feel good
about the way you are on the inside.
Even with the many successful operations and treatment for cleft
lip and palate, some kids have a hard time growing up with this
condition. They may have classmates who tease or
them or who are just curious and want to know more about it. In
either case, kids with clefts can get help handling these
situations by speaking with their parents, teachers, or counselors,
and of course, any member of their cleft palate team. The good news
is that most kids with cleft lip or cleft palate grow up to be
healthy, happy adults!
Joseph A. Napoli, MD, DDS, and Linda Vallino, PhD, MS,
Date reviewed: February 2007
Note: All information is for educational purposes only. For specific medical advice,
diagnoses, and treatment, consult your doctor.
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