Cleft palate and cleft lip are congenital defects. They occur when the upper lip and palate do not develop properly in the first months of pregnancy. A baby may have a cleft palate ("cleft" means 'separate') or cleft lip or both.
During fetal development, it may happen that the tissue that forms the palate and upper lip does not come together before birth, which causes an opening in the upper lip. The opening that occurs can be of variable size, small or large if it goes from the lip to the nose. It can happen on both sides of the lip and, less frequently, is in the middle.
The term "cleft" refers to the hare that has a natural cleft in the center of the lip, and although it is a popularized adjective, it is not as used by professionals, since it is an inaccurate term. The correct description of this condition is "cleft lip".
Some babies with a cleft lip may have a cleft palate (in their anterior or posterior part) if the tissue that forms the palate does not bind properly. Children with cleft lip and cleft palate often have problems feeding and language development. They are also more likely to suffer from ear infections, hearing loss and dental problems.
In Babies and more An anonymous person pays the operation of a baby's fissure after seeing that they made fun of him in the netsLip malformation occurs between weeks 4 and 7 of pregnancy. It is at that stage when the tissues of your body and special cells on each side of the head grow towards the center of the face and come together to form facial features such as lips and mouth. The cleft lip is produced when the tissue that forms the lips does not bind completely before birth.
On the other hand, the malformation of the palate happens between weeks 6 and 9 of pregnancy, when the tissue that forms the palate does not completely join during pregnancy.
These problems can be diagnosed during pregnancy by routine ultrasound, although the cleft palate is harder to see and is sometimes diagnosed after the baby is born. Only some types of cleft palate (such as submucosal cleft palate and bifida uvula) may not be diagnosed until later in life.
Risk factors of cleft lip
According to the Spanish Society of Reconstructive and Aesthetic Plastic Surgery (SECPRE), these anomalies affect approximately one in 700 births. According to the Cleft Palate Foundation, every year in the United States, one in every 600 babies is born with a palate and / or cleft lip.
The exact cause of orofacial clefts is not fully known.. The cleft lip, cleft palate or both are caused by multiple genes inherited from both parents, as well as environmental factors not yet determined. It is believed that elements with which the mother comes into contact, or what she eats or drinks, or certain medications she uses during pregnancy may be important.
When a combination of genes and environmental factors causes a condition, inheritance is called "multifactorial" (many factors contribute to the cause).
In Babies and more A father shares the story of his son, who was born with a cleft palate, to raise awareness about this malformation. When genes are involved, the chances of these deformations coming back in a family are high, depending on the number of members who have cleft lip and / or cleft palateAccording to the Centers for Disease Control and Prevention, there are research studies that point out some factors that increase the chances of having a baby with an orofacial cleft, risks we have discussed in our pages:
Smoking: women who smoke during pregnancy are more likely to have a baby with orofacial clefts than women who do not smoke.
Diabetes: Women with diabetes diagnosed before pregnancy have a higher risk of having a child with a cleft lip, with or without a cleft palate, compared to those without diabetes.
Use of certain medications: women who used certain medications for the treatment of epilepsy, such as topiramate or valproic acid, during the first trimester of pregnancy (the first three months) are at greater risk of having a baby with a cleft lip, with or without cleft palate, compared to women who did not take these medications.
Management and treatment of cleft lip
The most frequent is that a surgical operation can close the lip and palate and the child can make a normal life. Surgery for the cleft lip is usually performed before twelve months of age, while for the cleft palate it is performed before 18 months. Surgical repair can improve the appearance of the child's face and can also improve his breathing, hearing and speech and language development.
If the child accumulates other complications such as those just mentioned, they may need other surgeries, dental care and orthodontics. For language development they may need speech therapy. In short, depending on the severity of the cleft, the age, the needs of the child and the presence of associated syndromes or other birth defects, the orofacial clefts will receive a certain management.
In the United States, the Association of Cleft and Craniofacial Palate recommends the services and treatments provided by teams that specialize in clefts and craniofacial conditions, since Ideally, a coordinated approach to the care of children with orofacial clefts.
There are also specialized equipment and centers for clefts and craniofacial conditions in other countries, although it is in developing places where adequate attention is still lacking. In Spain, SECPRE also insists that there will be many people from different fields involved in controlling the anomaly of the cleft lip or cleft palate of the child, since knowledge of many different areas is needed.
We must be clear that through treatment, most children with orofacial clefts have good results and a healthy life.The ignorance of this point or the fear of not taking risks has caused abortions to triple due to the baby's cleft lip in some places.
Regarding the possible self-esteem problems when the child grows, they may worry about the visible differences they have with other children, but there we parents have to do a job from the beginning so that, like any other child, they can grow with confidence and self-esteem. Fathers and mothers support groups can also be useful for families of babies with birth defects of the head and face, such as orofacial clefts.
Feed the child with cleft lip
About Feeding the baby with a cleft lip (only), many can breastfeed without difficulty, depending on the degree of malformation and the patience and help the mother receives. It is recommended that a breastfeeding specialist help the mother find the best position to breastfeed the baby. If the baby is taking weight accordingly, there will be no need to use special bottles (and if there is one, they can also be extracted breast milk).
When the baby has a cleft palate, special bottles are needed to feed, since the baby will not be able to exert enough force to suck due to the malformation. In any case, it is recommended that they be breast milk to provide all its benefits to the health of the baby.
Therefore, although a baby with a cleft has normal breast and swallow reflexes, it needs bottles and special teats to allow milk to flow without the help of adequate suction. Syringes can be used in hospitals after cleft lip and / or palate surgery and can also be used at home. Normally, a soft rubber tube is placed at the end of the syringe, which will be placed in the baby's mouth.
During feeding, milk may flow through the baby's nose, which is called "nasal regurgitation" (should be in an upright position). The baby can also swallow too much air during the feeding (it is necessary to help him to expel the gases frequently). From this booklet published in Spanish by the Cleft Palate Association of the United States we can see more tips on posture and special bottles.
Prevent cleft lip
As we have seen, some risk factors for cleft lip and cleft palate are known, so from our pregnancy we can help prevent the disorder from taking vitamin A and folic acid (even before becoming pregnant, when it is planned to have a baby), not testing alcohol and eating a balanced diet.
Smoking is also not recommended (for this and many other reasons) and of course you do not have to self-medicate in any case. It is advisable to make a preconception visit to the gynecologist (that consultation that is made to the doctor before becoming pregnant, when we plan to have a child) and especially if you suffer from any chronic disease.
Photos | iStock
More information | CDC, SECPRE
In Babies and more | They identify the first genetic variant associated with the cleft lip, Drinking alcohol during pregnancy increases the risk of cleft lip, controversial in the United Kingdom after tripling abortions due to having the baby's cleft lip
