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Cleft Lip and Cleft Palate
By: Ashley Dixon
During the early stages of pregnancy, the upper lip and palate develop
from tissues lying on either side of the tongue. Normally, as the face and
skull are formed, these tissues grow towards each other and join up in the
When the tissues that form the upper lip fail to join up in the middle of
the face, a gap occurs in the lip. Usually, a single gap occurs below one or
other nostril (unilateral cleft lip). Sometimes there are two gaps in the
upper lip, each below a nostril (bilateral cleft lip).
When the palate fails to join up, a gap is left in the roof of the mouth up
into the nose. We don't know why the 'joining up' process fails in this way.
Some evidence suggests there may be a genetic factor, as cleft lip and
palate can run in families.It is thought, however, that certain types of
drugs may increase the risk.
Problems it Creates
• Difficulty feeding
The most immediate problem caused by a cleft lip or palate is likely to be
difficulty with feeding. Many babies with a cleft lip can breastfeed.
However, some have difficulty in forming a vacuum in order to suck
properly. Babies with these problems may need a special teat and
bottle that allow milk to be delivered to the back of the throat where it
can be swallowed. Sometimes, special dental plates can be used to seal
the roof of the mouth to help the baby suckle milk better.
Babies who find it difficult to feed may gain weight slowly at first, but
have usually caught up by the time they are six months old.
Problems it Creates
• Speech and Hearing
Cleft palate can cause problems with speech. The size of the cleft is not an
indicator of how serious such problems are likely to be - even a small cleft can
affect speech quite seriously. Most children go on to speak normally after the
palate is repaired, although some may develop problems such as nasal speech.
Hearing may be affected because the muscles of the palate affect the ear, making
the child more likely to develop "glue ear". This is a condition where thick
sticky fluid accumulates behind the eardrum as a result of an infection of the
middle ear. Doctors call it otitis media with effusion. It can cause temporary
hearing loss but can be treated with antibiotics or, if it is an ongoing problem,
with a minor operation to insert a tiny plastic tube (a grommet) into the
eardrum through which the fluid can drain.
Occasionally, cleft palate may also affect the growth of the jaw and the
development of the teeth
Pictures: Cleft Lip
Pictures: Cleft Palate