MONDAY, Dec. 31 (HealthDay News) -- When Americans hear "cleft
lip" or "cleft palate," they often think of children in developing
countries, but U.S. babies are by no means immune to the birth
Each year about 7,000 American children are born with an oral
cleft defect, according to the U.S. Centers for Disease Control and
Prevention. This means that their lip hasn't formed completely and
isn't closed properly in the case of cleft lip or, in the case of
cleft palate, that there's a hole in the roof of their mouth.
The good news, though, is that the condition is treatable.
"The outcomes for children are excellent," said Dr. Joseph Shin, chief of the division of plastic and reconstructive surgery at Montefiore Medical Center in New York City. "Children do fine with it. It's not the end of the world." Shin has served on humanitarian surgical missions for Operation Smile and other organizations to repair cleft lips and cleft palates in countries in South America, Mexico, Morocco and the Middle East.
Cleft lip and cleft palate aren't just cosmetic concerns,
however. "There's a lot of function in the palate and the lip,"
explained Dr. Laura Swibel Rosenthal, an assistant professor in the
departments of otolaryngology and pediatrics at Loyola University's
Stritch School of Medicine in Chicago. "Babies have to eat and not
have food go up through their nose."
Children born with these conditions can also have problems with
their ears and sinuses because fluids can travel where they
shouldn't. If the defects are not corrected when children are
young, they can also interfere with a child's ability to speak
properly. And, when the cleft is in the front of the mouth, it
interferes with the development of the teeth, said Swibel
Rosenthal, who added that sometimes, surgery is needed to move the
It's not clear exactly what causes oral clefts, according to the
March of Dimes. Some factors that have been associated with an
increased risk for cleft lip and palate include changes in some
genes, a deficiency of folic acid before pregnancy, taking certain
medications while pregnant, drinking alcohol during pregnancy and
having certain infections during pregnancy.
But the biggest risk factor linked to oral clefts is smoking
during pregnancy. About one in five babies born with a cleft lip or
palate is born to a mother who smoked, according to the March of
Shin noted, however, that "sometimes you can do everything
right, and you can still have a child with cleft lip or
For babies born with a cleft lip or palate, surgery is the main
treatment. For cleft lip, he said, surgery is generally scheduled
when the child is about 3 months old. For a cleft palate, surgery
is usually done at about 1 year old or slightly younger so that
there are fewer issues with speech, he said.
"The sooner you can do the repair, the better babies heal," Shin said.
Besides the procedures to repair the cleft lip or palate,
children often also need surgeries for ear tubes to keep their ears
clear of fluids while the repair is healing. Depending on the
severity of the cleft palate and how the initial surgery has
healed, children sometimes need a second surgery on their palates
when they're 3 to 7 years old, according to Swibel Rosenthal. Also,
cleft lips sometimes require a second surgery to get a better
cosmetic outcome, she said. Most kids also will need braces, she
"Parents shouldn't be nervous about these conditions," Swibel Rosenthal said. "Although they sometimes require multiple surgeries, there are ways to treat cleft lip and cleft palate that are simple, and children do very well."
Because cleft lip and palate can be genetic conditions, it's
possible that subsequent pregnancies may result in another baby
being born with cleft lip or palate, though the odds are relatively
low, she said. "If there's only one family member affected, the
chances of another child having an oral cleft are about 4 percent,"
she noted. "If two or more family members are affected, the chances
of another child having it are about 9 percent."
The March of Dimes Foundation has more about
cleft lip and palate.
To learn how one family dealt with an oral birth defect, read
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