Cleft lip is a common birth defect. It occurs when a baby's lip tissue doesn't completely join before birth, resulting in an opening in the upper lip. This opening can range from a small notch in the lip to a large opening that extends into the nose. The Centers for Disease Control and Prevention (CDC) estimates that about 4,440 babies are born with a cleft lip (with or without a cleft palate) every year in the United States. Fortunately, the outlook for children born with these conditions is excellent thanks to cleft lip treatments.
Cleft Lip Repair
Cleft lip surgery is usually performed by a plastic surgeon when babies are between 3 and 6 months old, explains the Children's Hospital of Philadelphia. The surgeon carefully stitches together the two sides of the lip. Often, a primary nasal repair is performed at the same time if the cleft lip affects your child's nose.
Sometimes, a second surgery is needed. For example, another procedure may be required for babies with bilateral cleft lips, meaning their lips have an opening in two places. Your child's surgeon will let you know if additional surgeries are necessary.
Cleft Palate Repair
Some children with a cleft lip also have a cleft palate. Cleft palate occurs when the roof of the mouth doesn't completely join together, resulting in an opening. According to the Children's Hospital of Philadelphia, surgery generally occurs around 1 year of age for children with cleft palate. The surgery is performed after the cleft lip has been successfully repaired.
Surgeons can use a variety of different techniques to close a cleft palate. Generally, they close several layers of the palate and also realign the muscles of the palate. However, they usually leave a portion of the palate open. This gives the child's mouth, palate and jaw room to grow. Later, surgeons can close this opening.
Additional Surgical Procedures for Cleft Lip or Palate
When children with cleft lip or cleft palate get older, they may need additional surgical procedures. These procedures will vary from one child to another depending on the type and severity of the cleft, but your child's care team will let you know what treatments are required. For example, your child may need bone grafting procedures to build up their dental arches. Other children may need a rhinoplasty to adjust the look of the nose and to improve the airway.
Post-Surgery Therapies for Cleft Lip or Palate
After your child's cleft has been surgically repaired, they may need additional treatments to manage complications that may arise.
The American Academy of Otolaryngology explains that ear infections and hearing loss can be a complication of clefts. Fluids can accumulate in the middle ear and cause repeat infections. An ear, nose and throat specialist can insert tubes in the ears to reduce the fluid.
Young children with clefts may also have difficulty feeding. Special feeding devices are available to help with this, and professionals like speech therapists may be helpful, too.
If the cleft affects the gums and jaw, dental problems may occur. Missing or sideways teeth, crowding and an overbite are some of the possible problems. For this reason, children with clefts should see a pediatric dentist before their first tooth erupts. The dentist may bring in a team of specialists, including orthodontists, prosthodontists and oral surgeons, as the teeth develop.
Children with a cleft lip are also more likely to get cavities. That's because the teeth closest to the cleft can have defective enamel. To help keep your child's mouth healthy, wipe their teeth after bottle feedings. For kids 2 and older, brush regularly with an age-appropriate toothpaste.
Cleft lip treatments will vary from one child to another. Your child's care team can explain the specific cleft lip treatments your child will need, now and in the future.