Birth defects: cleft lip and palate

Labioschisis can manifest itself in more or less severe forms: from a small split in the skin of the lip to a complete separation of the nasal passages

The cleft can occur on only one side of the infant’s lip (unilateral) or on both (bilateral). Some rarer forms have the cleft in the middle of the upper lip or on the lower lip.

Cleft palate, on the other hand, is a congenital malformation of the palate.

It presents as a cleft in the anterior part of the hard palate; in more severe forms, it also affects the alveolar edge of the palate, the palate, the soft palate and the uvula.

Cleft lip may be accompanied by cleft palate (cleft lip-palate), dental abnormalities, cartilage malformations, or a lack of seal in the jaw and nasal bones.

Causes of cleft lip and palate

In the first weeks of pregnancy, the sides of the face grow individually and then, as a rule, coalesce.

Cleft lip and cleft palate are the result of improperly performed welding.

The causes of cleft lip and cleft palate are not yet known: it is thought that these malformations, which are created in the fetus as early as the third month of pregnancy, can be caused by infections, drugs, smoking or smoking. abuse of alcohol by the mother.

Usually, if there are similar cases in the family, the infant is more likely to develop cleft lip or cleft palate.

Problems associated with cleft lip and palate

The cleft lip leads to feeding problems, because the infant may have difficulty suckling and therefore be properly breastfed: specific bottles and teats are then used.

In addition to aesthetic and psychological problems, the malformation can also lead to defects in the development of the teeth and speech difficulties: it is possible that, even after corrective surgery, the child grows up to have difficulty speaking normally and requires speech therapy.

Cleft palate can also cause additional problems related to bronchopulmonary aspiration infections (such as pneumonia) and inner ear infections caused by fluids (saliva, milk) that can invade the child’s ear canal through the cleft palate.


Treatment for cleft lip involves plastic surgery to be performed as soon as possible (usually within the first two months of life), with subsequent revisions over the years.

The operation usually takes place under general anesthesia and lasts about one to two hours: the surgeon works by reconstructing the skin and muscles of the lip, without having to use tissue taken from other parts of the body.

The most common problem in cleft lip repair surgery is related to cleft asymmetry.

It is not uncommon for more than one operation to be necessary, with the risk of leaving a visible scar on the child’s lip.

In cleft palate correction surgery, incisions are made on both sides of the cleft; the two edges are then brought together and secured with stitches to allow the palate to heal.

After the operation, care must be taken that the child does not touch or rub the lip, in order to avoid the opening of the sutures (if necessary, a new operation would be necessary) and to allow rapid healing.

Feeding will consist of liquid foods or, if the age of the child allows, soft foods (such as pureed fruit or vegetables), to be administered with caution, using a syringe tip rubber or the side of a spoon, taking care not to touch the wound.

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Christine E. Phillips