Cleft palate and cleft lip: differences, causes, treatments

Collectively known as orofacial clefts, cleft palate, and cleft lip are types of congenital disabilities. They occur when the mouth or lip of the fetus does not form properly during pregnancy.

A baby can be born with a cleft lip or a cleft palate. They can also be born with both. The cause of most splits is unknown.

Read on to learn more about cleft palate and cleft lip. This guide includes information on possible causes, risk factors and treatments.

What is the difference between a cleft palate and a cleft lip?

Margaret Vincent/Stocksy United

Cleft palate and cleft lip are both orofacial clefts. A cleft lip affects one or both sides of the lip. A cleft palate, however, refers to an opening in the roof of the mouth.

A cleft lip is due to the fact that the lip tissue does not come together completely before birth. The opening in the upper lip may appear as a slit or notch, or it may be a larger opening. In some cases, it can extend to the nose.

A cleft lip can affect one or both sides of the lip. In Rare casesit can also affect the middle of the lip.

Types of cleft lip include:

  • Cleft lip form-rough: This is a much more subtle type of cleft lip, which appears as a slight indentation
  • Incomplete unilateral cleft lip: In this type, the cleft lip is on one side of the lip and does not extend to the nose.
  • Full unilateral cleft lip: In this type, the cleft lip is on one side of the lip and extends to the nose.
  • Incomplete bilateral cleft lip: In this type, there are openings on either side of the lip. However, they do not extend to the nose.
  • Full bilateral cleft lip: In this type, there are openings on each side of the lip and they extend to the nose.

A cleft palate occurs when the tissues of the palate, or the roof of the mouth, do not come together completely during pregnancy. A cleft palate may only affect part of the palate, or both the front and back parts of the palate may be open.

Types of cleft palate include:

  • Incomplete cleft palate: With this type, the opening occurs at the soft palate at the back of the mouth.
  • Full cleft palate: With this type, the openings occur at the soft palate at the back of the mouth and the hard palate at the front of the mouth.
  • Submucosal cleft palate: With this type, the muscles of the soft palate are separated, but the skin or mucous membrane remains closed. The uvula may appear split in two, called the bifid uvula or cleft uvula.

What does a cleft palate and cleft lip look like?

See the slideshow below for cleft palate and cleft lip photos.

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Bronwynn Wessels/EyeEm/Getty Images

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This shows a complete unilateral cleft lip.

Angela Meier/Shutterstock

Baby with a cleft before and after surgery

This shows a complete unilateral cleft lip before and after surgery.

Can a cleft lip and a cleft palate occur at the same time?

A baby can be born with both a cleft palate and a cleft lip. Around 1 in 1,600 babies in the United States was born with both a cleft lip and a cleft palate.

This compares to 1 in 2,800 babies born with a cleft lip without a cleft palate.

About 1 in 1,700 babies are born with a cleft palate.

What causes cleft lip and cleft palate?

The cause of cleft lip and palate is generally unknown.

Some babies may be born with an orofacial cleft due to changes in their genes.

A cleft palate or lip can occur if the baby has a condition that causes other congenital disabilities. This includes Pierre Robin sequence and 22q11 deletion syndrome, also known as DiGeorge or velocardiofacial syndrome.

Research into the causes of orofacial clefts is In progress.

Can a doctor diagnose a cleft palate or lip during pregnancy?

A doctor can usually diagnose a cleft lip with an ultrasound during pregnancy. This includes cleft lip with and without cleft palate.

They can also diagnose cleft lip and cleft palate once the baby is born. However, the diagnosis of submucosal cleft palate may not be possible until later in life.

The doctor may also perform amniocentesis during pregnancy to see if the orofacial cleft is the result of a genetic condition. During this procedure, they will insert a long needle through your abdomen and into the amniotic sac. They can then collect amniotic fluid for lab tests.

Contact your doctor if they have diagnosed a cleft palate or lip and you want to discuss amniocentesis.

How are cleft palates and lips treated?

Surgery to repair a cleft lip typically occurs in the first months of an infant’s life. Medical professionals recommend repairing a cleft lip within the first 12 months of a baby’s life. For a cleft palate, experts recommend fixing it within the first 18 months.

Additional surgery may also be needed once the child grows.

In addition to repairing the appearance of the congenital disability, orofacial cleft surgery can also improve:

  • breathing
  • audience
  • speech and language development

Specially designed bottles can help with food before surgery.

Depending on the severity of the cleft and the effectiveness of the surgery, a child can benefit speech therapy as they grow. Therapy can also help with self-esteem issues resulting from any visible signs of the disease.

Learn more about:

Will I have another child with an orofacial cleft?

If you have a baby with a cleft lip or cleft palate, you might be concerned about other children you are carrying developing a similar condition.

However, the likelihood of having another child with an orofacial cleft increases only slightly, unless the condition is due to genetics.

If one of the baby’s parents has a genetic condition such as 22q11 deletion syndrome, there is a 50% chance that it will affect the baby as well.

What are the complications of a cleft palate and lip?

Various complications can arise due to a cleft palate or cleft lip, especially before surgery.

Possible complications include:

  • Feeding difficulties: A cleft lip and palate can make breastfeeding and bottle-feeding difficult, especially if the baby cannot form a seal with their mouth.
  • Breathing difficulties: A cleft lip can cause breathing difficulties, especially if they lead to a deviated septum. A septoplasty can help rectify this by straightening the septum.
  • Ear infections: Having a cleft palate can make a baby more susceptible to ear infections. Fluid buildup can also lead to conditions like glued ear, which can impact their ability to hear clearly.
  • Dental problems: Teeth may not develop properly if a baby has an orofacial cleft. It can also increase their risk of tooth decay.
  • Speech problems: A child may have speech problems if they do not receive treatment or surgery for a cleft palate.
  • Jaw offset: A child’s upper and lower jaw can grow at different rates if they have an orofacial cleft. This discrepancy can lead to complications with chewing food, early arthritis of the jaw joint, and misalignment of the teeth.

What are the risk factors for cleft palate and lip?

The causes of orofacial clefts are generally unknown. However, certain risk factors make a baby more likely to develop cleft lip or cleft palate.

Possible risk factors for orofacial clefts include:

  • smoking during pregnancy
  • have diabetes
  • taking certain medicines for epilepsy during the first trimester, including:

Contact your doctor if you have concerns about the risk factors for cleft palate and lip.

What is the outlook for a baby born with a cleft lip or palate?

Following surgery, most children born with a cleft lip or cleft palate will lead an ordinary life without experiencing serious related medical problems.

The surgery will help improve the child’s ability to feed. Speech problems usually go away, although some children may benefit from speech therapy.

The surgery may leave a small scar above the lips. It’s not a permanent scar. It should fade over time, although it may not always completely disappear.

Is it possible to prevent a cleft palate and lip?

Healthcare professionals are often unaware of the cause of lips and cleft palate. Therefore, it may not be possible to prevent orofacial clefts.

However, there are steps you can take to help reduce the likelihood. These steps include:

  • take a folic acid supplement on the advice of your doctor
  • quit smoking during pregnancy
  • avoid drinking alcohol during pregnancy
  • have a health checkup if you plan to start a family
  • maintain a healthy weight as determined between you and your doctor

Smoking and drinking alcohol during pregnancy can also harm a baby in other ways. Contact your doctor for advice on making changes to your diet and lifestyle. Your doctor will also be able to give you information about the medicines you are taking and the effects they may have on the fetus.

Cleft lip and cleft palate are two types of orofacial clefts. These conditions occur when the tissues of the lip or mouth do not form properly during pregnancy. Surgery can help correct a cleft, which usually occurs in the first few months of an infant’s life.

Cleft palate and lip can cause difficulty with eating, breathing, and speech development. Surgery, special bottles, and speech therapy can all help a child with a cleft palate or lip.

Contact your doctor if you are pregnant and have concerns about orofacial clefts. It is possible to diagnose a cleft during an ultrasound.

Christine E. Phillips