HealthyCanada.com

Overview

Cleft is a congenital deformity caused by a failure in facial development before birth. It is the most common of all birth defects, occurring in an estimated one in 700 babies. Sometimes it is severe, sometimes not. Depending on where the deformity is, it will be categorized as either cleft lip or cleft palate. Most infants with this condition are otherwise healthy.

Symptoms

As a mother, the first thing you may notice is that is it difficult to feed your baby. While some babies with cleft lip or palate can breast feed, it is impossible for others because they can't suck properly. Bottle feeding can also be a problem. As a result, your baby may not get enough to eat and may be underweight for the first 6 months of life.

Other symptoms will come up later. For example, your child may have problems with speech. When the cleft is repaired, they will be able to speak normally. They may also develop ·glue ear' - a condition that occurs when sticky fluid builds up behind the eardrum during middle ear infections. Some children with cleft palate will also have problems with their jaw and teeth.

Causes

During the first six to eight weeks of pregnancy, a baby's lips and palate are formed separately from tissues on either side of the tongue. Later they grow towards each other, meeting in the middle where they fuse or join together. If, however, some of the parts don't match up correctly, the result is a split or separation in the lip or palate.

Why this cleft occurs is still a mystery. There may be a genetic link as cleft lip and palate can run in families. Certain types of drugs may increase the risk.

In some cases, a cleft lip or palate is associated with Stickler's syndrome, a group of inherited tissue disorders affecting collagen levels in the body.

Treatment

Surgeons can close the gap in the lip and palate. This is usually done in the first six months of life. Later, as the child grows older, more surgery can be performed to improve the appearance of their face and the function of the palate. A bone graft can be used to close any gap in the gum. Through surgery, specialized dental treatment and speech therapy, the problem can eventually be corrected eventually. However, these treatments can be very expensive.

To help families of children and young adults who must cope with this expense, the Ontario Ministry of Health and Long-Term Care has established the Cleft Lip and Palate Program. Through this program, the ministry will provide 75 per cent of the cost of dental treatment by a certified specialist who is associated with correcting the cleft lip and/or palate. The Program also covers 75 per cent of treatment costs of severe acquired (non-genetic) dental dysfunction for patients up to 22 years of age. You can find full details about the program here.

Prevention

Because some drugs increase the risk of cleft lip and palate, be sure to tell your doctor about any anticonvulsive, corticosteroid or benzodiazepine medications you may be taking. While there is no evidence that taking a folic acid supplement in early pregnancy can help prevent this condition, you should ask your doctor about it because research has shown that folic acid does lower the risk of some other birth defects.