by Kathy Stemke

Created on: June 07, 2008   Last Updated: June 09, 2008

When a tiny fetus is developing in the womb, the right and left sides of the lip and the roof of the mouth fuse together. However, one out of 800 babies in America are born with a birth defect in which the tissues of the lip and palate don't form properly. The opening or gap of these tissues is called a cleft lip or a cleft palate. Since the lip and palate develop separately, a baby can have one or both of these defects.

Fortunately, both of these birth defects are treatable with reconstructive surgery. Usually clefts are detected through prenatal ultrasound. Teams of medical professionals have joined together to treat the physical, psychological and educational needs of these children and their families.

WHAT CAUSES ORAL CLEFTING?

The general belief is that a combination of genetics and environmental factors contribute to these abnormalities. Either mothers or fathers can pass on genes that cause cleft palate or cleft lip. Certain drugs, diseases and the consumption of alcohol or tobacco during pregnancy can also contribute to the babies risk of developing these defects.

CLEFT LIP SURGERY

Clefts occurring on one or both sides of the upper lip can range from a small opening to a complete separation of the lip extending to the nose. When the baby is just a few weeks old, the surgeon will make an incision on either side of the cleft and pull the muscle and skin of the lip together closing the separation. The child is medicated for any discomfort and restraints are put on the elbows to prevent the baby from rubbing the stitched area. Special nipples are used to make feeding easier.

CLEFT PALATE SURGERY

Because cleft palate surgery is more extensive, this operation is done when the child is between 9-18 months old. The doctor will make an incision on either side of the separation and pull the tissue to the center of the roof of the mouth. This procedure rebuilds the palate, which enables the child to eat and learn to speak. During recovery an intravenous line may be used for feeding and restraints are applied to prevent the baby from disturbing the repaired area.

COMPLICATIONS WITH CLEFTS

1. Plastic surgery is needed to restore facial features.
2. These children tend to have more colds, hearing loss, and speech defects.
3. Drainage tubes are often placed in the ear to prevent ear infections.
4. Bone grafting and teeth replacement is sometimes needed.
5. Orthodontic procedures help straighten teeth.
6. Speech therapists evaluate and assigns exercises needed to restore speech.
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