Diseases & Conditions


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Cleft lip and palate


Surgery for cleft lips takes place in the first few months after birth BBC News Online looks at cleft lips and palates, and how the condition is treated. A 'cleft' or split forms parts of the face which developed separately during early pregnancy, do not then join together properly. A cleft can affect the lip, the palate and the gum. The severity of the condition can vary. A cleft lip creates an opening between the mouth and the nose, and can look as though there is a split in the lip. It can range from a slight 'notch' in the coloured part of the lip to a complete separation in one or both sides of the lip extending up and into the nose. Some babies who have a cleft lip may also have a cleft in the gum. Again, that can either be a small split, or complete division. The palate can also be affected by a cleft. In less severe cases, the soft palate towards the front of the mouth has a small split at the back of the soft palate. In more serious cases, there can be almost a complete separation of both the soft and hard palate, further back in the mouth. Cleft palates can also leave a baby with a small lower jaw, which can lead to breathing difficulties, a condition sometimes known as Pierre Robin Sequence. Treatment A specialist team which may include a surgeon, a nurse, a speech and language therapist and a geneticist, will decide on treatment. A short operation to repair a cleft lip usually takes place before a baby is three months old. The skin and muscles if the lip are rearranged to repair the split. Operations to repair a cleft palate using the tissues of the palate normally take place before a baby is one-year-old. Development It is not known why clefts occur. Sometimes they run in families, but in other cases a baby is born with the condition when no-one else in the family is affected. Babies with a cleft palate may need some help to feed properly. The condition can make it difficult for the baby to form a vacuum in the mouth. This can mean a baby may feed too slowly, take in too much air while feeding, bring milk up through their noses. If the baby also has breathing difficulties, it must learn how to breath and eat at the same time. Bottle feeding is usually the best way to feed the infant. Babies with a cleft lip do not usually have any feeding problems. For the majority of children, speech is not affected, but some can have problems pronouncing some sounds clearly. They will receive help from speech and language therapists. Cleft palates can also be linked to hearing problems because of middle ear infections, such as "Glue ear" - the build up of fluid in the middle ear. Teeth development can also be affected.