Ask the Pediatrician: Cleft lip and palate

Q: The birth defects of cleft lip and palate affect children around the world. We have all seen the pictures of children living in poverty that have this disfiguring problem. What can you tell us about this condition?

A: Cleft lip and palate not only affects children living in developing countries, it happens right here at home as well. About 7,000 children in the U.S. are born with either cleft lip, palate, or both, every year.  A cleft palate is when the roof of the mouth does not close before birth, and a cleft lip is when there is a gap between the upper lip and nose.

Q: What causes this to happen?

A: There is not one thing that can go wrong, but several things that can increase your risk. Not having enough of an essential nutrient, folic acid, can increase the risk, and this is one reason why pregnant women, or women trying to get pregnant, are encouraged to take prenatal vitamins.  Certain infections, or genetics, can increase risk, and so can drinking alcohol during pregnancy. However, the biggest risk factor is cigarette smoking. One of the many reasons why it’s a great idea not to smoke.

Q: I understand that right here in Springfield, Shriner’s Hospital cares for children born with cleft lip and palate.

A: Yes, because it is a birth defect that affects a lot of different aspects of a growing child’s life. Not only can feeding be difficult, but if not property corrected, speech development can be a problem, as well as ear and sinus infections. Cleft lips are generally repaired very early in infancy, but cleft palate surgery generally is a little later - around 1 year of age or so, depending on the needs of that child. Some children need a series of operations that can extend throughout childhood. Multiple specialty areas come together to treat these children, including plastic surgeons, orthopedic surgeons, orthodontists and dentists, ear-nose-throat doctors, nutritionists, speech and language pathologists, geneticists, and social workers to name only some of those that provide crucial services to families. Many hospital systems provide care, but here in Springfield, Shriner’s Hospital for Children provides exemplary care.

For more information from the March of Dimes: http://www.marchofdimes.com/baby/birthdefects_cleftpalate.html