Ask an expert: My unborn baby has a cleft lip – why does it happen and what is the treatment?

I just had my 18 week scan and it showed my baby had a cleft. Why does this happen, how will it affect my child and can it be treated?

Craniofacial expert Dr Peter Mossey, member of the Medical Advisory Board of children’s lunge charity Smile Train (smiletrain.org.uk), says: “During facial development in the womb, the Upper lip formation occurs in three parts. In most cases, these pieces will meet from the nose down. If this sequence is interrupted, however, the baby may be born with a cleft lip.

“A cleft lip may be accompanied by a cleft palate, which is a gap in the roof of the mouth due to a developmental defect in which the two sides of the palate do not fuse at the midline. Cleft lip is much easier to detect on an 18 week CT scan than a cleft palate.

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“Cleft lips can range from a small space on the upper lip to a wide space that reaches the nose. A cleft palate ranges from a small space in the uvula – the small protrusion that hangs down from the end of the soft palate – to a space that goes from the uvula to the front of the baby’s gum line.

“If left untreated, a cleft lip and/or palate can cause problems eating, speaking, hearing and breathing, so it’s important that babies born with a cleft are treated as soon as possible.

“Fortunately, babies born with a cleft lip and/or palate in the UK have access to NHS treatment and will be referred to a multidisciplinary cleft team as soon as the cleft is diagnosed, whether on ultrasound or birth. This team will work closely with new parents, providing them with information and support.

“Surgery to repair a cleft lip usually takes place when the baby is between three and six months old. A cleft palate is repaired between nine and 12 months. However, the child may face further surgeries throughout childhood due to complications.

“All aspects of cleft care – including diet, surgery, speech therapy, hearing check-ups, dental care and orthodontics (braces) if needed, as well as genetic, pediatric and psychosocial care – are available free of charge.

“Thanks to this care, most children treated for cleft lip and cleft palate live perfectly normal lives. However, the surgery can leave a scar on the upper lip, which some children may find difficult to accept during their childhood and adolescence, affecting their self-esteem and making them aware of their appearance.

Christine E. Phillips