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Cleft Lip and Palate: What Happened?

The Anatomy of an Unfinished Masterpiece

It's typical to view a cleft condition as something that "went wrong." However, it's more accurate to view it as something "unfinished." A cleft results from incomplete joining (fusion) of some embryo body areas very early in a baby's development. This failure to fuse typically occurs during the sixth to 11th week of pregnancy. After a couple of windows of opportunity, those particular sections of the body have no further chance to fuse. The body moves on to other development and the area of unfinished fusion becomes the basis for a cleft.

Cleft Cause?

Statistics reassure us that having a child with a cleft does not mean you'll have other children with the same condition. In fact, your chances only increase by 2 to 5 percent compared to couples with no cleft-affected kids. Variations in the programmed information packets (genes) that determine a baby's development enable clefts to occur in either gender and any race. It tends to affect boys more often than girls, and is slightly more common in some races as compared to others. While cleft lip/palate conditions occur alone, we also see them as a subset of other craniofacial (cranio=head/skull; facial=face) syndromes and conditions.

Studies point to external and/or controllable factors that might contribute to the risk of having a child with this condition. Mothers between the ages of 19 and 35 statistically have a lower incidence of conceiving a baby with a cleft, as do moms who practice preventive measures such as taking supplemental folic acid, and eating a healthy diet with adequate vitamins and minerals. Women can take steps to reduce risk by avoiding environmental factors that may contribute to the likelihood of conceiving a baby with a cleft, including: pesticides, cigarettes, lead, and all varieties of drugs (prescription drugs, over-the-counter medications, illegal drugs, anti-convulsant medications, alcohol and any form of nicotine).

You can determine your approximate risk of conceiving a child with a cleft condition by obtaining genetic counseling prior to conception. Genetic counselors are highly educated in understanding how your health and family medical history relate to having a baby with a cleft. It is becoming the norm, rather than the exception, for cleft palate treatment team referral to occur during pregnancy following ultrasound diagnosis, rather than after the child's birth.