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Cleft Lip In Babies

5 min read

Most of the babies born in this world are healthy. But out of 100 children born, 3 infants will be born with congenital (existing at or before birth regardless of cause) or hereditary birth defects. Cleft lip is considered as the fourth most common birth defect found among infants. One out of 700 babies born annually is found to born with cleft lip with or without cleft palate.
Cleft lip
Giving birth to a child with a cleft lip can cause a psychological impact on the parents especially the mother.

What Is A Cleft Lip (CL)?

Cleft lip is facial malformation found in newly born infants. An infant with a cleft lip will have the upper lip physically separated into two with a narrow opening. Sometimes, this separation is often found to extend beyond the base of the nose. In most of the cases, upper jaw and upper gum are also found to separate.
Cleft lip can occur as unilateral (one-sided) or bilateral (two sided)

What Is Cleft Palate (CP)?

The roof of the mouth is called palate. When the roof of the mouth possesses a split or opening, cleft palate is said to occur. It is another malformation found among newborns.

Do Cleft Lip And Cleft Palate Always Occur Together In Babies?

The development of the lip and palate are not connected. So, it is not necessary that a cleft lip (CL) is accompanied by a cleft palate (CP) and vice versa. But both the cleft palate and cleft lip together (CLP) are also found in many cases.

How Does Cleft Lip Occur In Babies?

The structure of the mouth and face starts to take shape during the first trimester of pregnancy. The lips start to develop between the 4th and 7th weeks of pregnancy. The development of the lips starts from both side of the face and then fuses at the center. When the tissues that form the lips are not properly joint together, cleft lip occurs.

What Causes Cleft Lips In Babies?

The exact cause of cleft lips in babies is still unknown. Some scientists think that the interaction of both environmental and genetic factors are behind the formation of cleft lips. Some of the reasons believed to be behind cleft lips are:

  • Genetic reasons: The chances of the child getting the CL increases if a sibling, parent, or relative has had the problem
  • Medication: Some medicines that the mother may have taken during her pregnancy can results in cleft lip in the child. Some of the drugs that can increase the risk of CL are:
    • Some of the anti-seizure medicines used for treating epilepsy
    • Acne medicines which contain ‘Accutane’
    • Methotrexate belongs to a class of drugs known as antimetabolites and is used in treating some kind of cancer, arthritis, and psoriasis. If the mother used to take this drug for any of the reason mentioned the chances of cleft lip in the newborn increases
  • Smoking: The women who smoke during their pregnancy period are found to have a higher risk to have a baby with a cleft lip than the women who don’t smoke.
  • Exposure: The chances of having a baby with cleft lip increases when the mother is exposed to some chemicals or viruses during pregnancy
  • Diabetes: When a mother is diagnosed with diabetes before conceiving, she develops an increased risk of having a child with a cleft lip, compared to women who did not have diabetes

What Problems Are Associated With The Cleft Lip In Babies?

Several difficulties are associated with cleft lip that affects the baby by hindering a normal life. The difficulties increase with the severity of the cleft lip. A split in the lip that can vary from a small notch in the lip to large extension that starts from the lip, passing through the upper gum and palate and getting into the bottom of the nose.
One of the main issue the baby faces is the trouble to breast feed. This depends on the severity of the cleft. The baby with a minor notch won’t face many issues. But when the gum also bears a cleft, then breast feeding may not be an easy task for him.
Some of the issues that the baby has to face in the future due to CL are:

  • The trouble with speaking: Child with cleft lips are often found to develop issues with speech. It will be difficult for them to produce certain sounds and the issues with the speech increases with the severity and the speech becomes more unclear putting the child in a difficult situation
  • The trouble with teething: Child with cleft lips often found to have dental problems. These problems include missing teeth, extra teeth, crooked teeth and smaller teeth. They often need to visit the dentist to clean the teeth, put the braces to make sure the teeth are growing straight

Cleft lip

How Is Cleft Lips Diagnosed In Babies?

Distinctive physical changes are caused due to cleft lip. A prenatal ultrasound scan can some time disclose the presence of a cleft lip in an unborn child. If diagnosis of cleft lip is missed during an ultra sound scan (which occurs very rarely), CL is easily diagnosed during the first look at the baby after the birth.

How Is Cleft Lip In Infants Treated?

An infant with a cleft lip needs several surgeries to correct the abnormality. Managing the cleft lip is equally important as the treatment. Because of several oral and medical issues that usually accompany the cleft lip, there will be a team of specialists to assist the child and to meet the individual needs of the child while undergoing treatment. The typical panel includes:

  • An oral surgeon to repair the cleft in the gum
  • A speech pathologist to take care of the speech and feeding problems
  • A plastic surgeon to achieve a normal facial appearance
  • An otolaryngologist (an ENT doctor) to analyze the hearing problems and think about the treatment options

As the child grows, cleft lip treatment may involve the following:

  • An orthodontist to straightening and re-positioning the teeth
  • A speech therapist to improve the speech of the child
  • Monitoring by a pediatric dentist for the development of the tooth and the oral health
  • A prosthodontist for making the artificial teeth and dental appliances to revamp the looks and to persuade the functional requirements for eating and speaking
  • A psychologist to support the family and the child and to solve the adjustment issues

Surgery to repair the cleft lip is done within three to six months after the baby is born. The first stage of the surgery includes:

  • Existing muscles and tissues of the child’s lip are stitched together to give a normal lip appearance. Initial nasal repair, if needed, is also done at the same time. The child will stay in the hospital after surgery for around two days
  • Additional surgeries are done depending upon the severity of damages to improve the appearance of the mouth and nose
  • Some children need to have another procedure on their lips and nose before they begin school, or when they enter adolescence while others need bone craft when they are about eight years old. This is done to fill the gap in the upper gum area. This surgery is significant for the upper gum to hold the permanent teeth better and steadying the upper jaw. Some children with minor lip cleft don’t require the further follow-up surgeries at all

The Surgery will improve not only your child’s appearance but also his quality of life, and his capability to eat, breathe and talk normally.
When you give birth to a baby with a cleft lip, you can be in a boundless torment. But now you understand that the cleft lip and cleft palate can be successfully corrected with a minimal scarring. So now go ahead with the treatment with an optimistic mind and help and encourage your child to lead a normal healthy life.

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