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Cleft lip and cleft palate

• The fourth most common type of birth defect in the United States.
• Occurs when there is not enough tissue in the mouth or palate and the available tissues don't fuse together normally during early fetal development.

Symptoms

Cleft lip
• Characterized by a narrow opening or gap in the skin of the upper lip that reaches to the base of the nose, often extending to include the upper jaw and/or upper gum
• Can also appear as a bilateral cleft lip, which involves two wide gaps in the upper lip and a collapsed and stretched nose (though this is much less common)
• The majority of cleft lips occur with a cleft palate.

Cleft palate
• A split or opening in the roof of the mouth and the nasal cavity that can involve the front of the palate or both the front and back
• Can only be seen when the baby's mouth is open

Cleft lip and palate
• Can occur on one or both sides of the mouth
• Some babies will have both a cleft lip and cleft palate – or just one or the other.

What causes cleft lip and palate?

In the majority of cases, the cause of cleft lip and cleft palate is unknown.
• Experts believe they occur as a result of a combination of genetic and environmental factors.
• In some cases, cleft lip and palate have a genetic component, however a gene has not been identified.
• More than 40 percent of cleft palates are associated with malformation syndromes such as van der Woude syndrome for cleft lip and velocardiofacial syndrome for cleft palate.

Approximately 60 percent of cleft lips and palates are not linked to incidents or lifestyle during pregnancy, except in a few exceptions:
• Exposure to the drug phenytoin (Dilantin) during pregnancy increases the incident of cleft lip by ten-fold.
• Smoking while pregnant doubles the rate of cleft lip.
• Alcohol, anticonvulsants and retinoic acid (vitamin A) are associated with other birth malformations that include cleft lip and palate.

You are at greater risk of having a child with clefting if:
• One of the parents has clefting
• The parents have already had one child with clefting
• A parent and child in your family have clefting
• A parent or other child has both a cleft lip and palate