Everything you need to know about cleft lip and palate in babies

Cleft lip and palate is a congenital abnormality affecting approximately 1 in 700 births in France. It is characterised by a gap in the upper lip and/or palate, causing difficulties with feeding, communication, and appearance for the child. In this article, we discuss the causes, symptoms, and possible treatments for cleft lip and palate.

Possible causes of cleft lip and palate in babies

Although the exact causes of cleft lip and palate are still not fully understood, they are thought to be primarily due to genetic and environmental factors that interact and trigger the abnormality during pregnancy.

Here are some possible factors:

Genetic factors: some studies have shown that certain genes may be involved in the development of cleft lip and palate, although no single gene responsible for the condition has yet been identified.

Environmental factors: these may include exposure to certain toxic substances, smoking or drinking alcohol during pregnancy, as well as certain medications.

Folic acid deficiency: insufficient folic acid intake during pregnancy appears to increase the risk of cleft lip and palate in babies.

Advanced maternal age: women who become pregnant after the age of 35 may be at greater risk of having a child with this abnormality.

Symptoms and consequences of cleft lip and palate

This congenital malformation is characterised by a cleft or split in the upper lip, often accompanied by a cleft palate (a hole in the roof of the mouth). This deformity can lead to:

Feeding difficulties: the cleft lip and palate interferes with sucking and swallowing, which can cause growth and nutrition problems for the infant.

Delayed speech and language development: the cleft palate leads to poor closure of the palate, making it difficult to pronounce certain sounds. Speech therapy sessions are often necessary to address this issue.

Altered facial appearance: the deformity caused by cleft lip and palate can have an impact on the child's psychological development, particularly in terms of self-confidence and social relationships.

Medical management of cleft lip and palate

Treatment for cleft lip and palate generally involves surgery, with the aim of correcting the abnormality and improving facial function. This treatment is carried out by a specialist medical team including, amongst others, a maxillofacial surgeon, an orthodontist, a speech therapist, and a psychologist.

Reconstructive surgery

Surgical treatment for cleft lip and palate is generally carried out in several stages:

Cheiloplasty: this procedure involves closing the cleft lip by bringing the two edges of the lip together. It is performed between 3 and 6 months after birth.

Palatoplasty: this operation aims to close the cleft palate, generally between 9 and 18 months after birth, in order to improve swallowing function and prevent speech delays.

Additional procedures may be required throughout the child's growth to refine the aesthetic and functional results achieved previously.

Orthodontic follow-up

From the age of 6, and alongside reconstructive surgery, orthodontic treatment may be put in place to correct dental problems and occlusal abnormalities (poor positioning of the teeth) associated with the malformation. This orthodontic follow-up may continue through to adolescence.

Psychological support and help for families

Finally, it is essential to provide psychological support to the child with cleft lip and palate, as well as to their family. Associations and support groups can help parents to share their experiences and find solutions to support their child in the best possible environment.

Prevention of cleft lip and palate in babies

There is no foolproof method to prevent this abnormality, as it often results from a combination of genetic and environmental factors. However, certain measures can be taken to reduce the risk:

Sufficient folic acid intake: taking a folic acid supplement before and during pregnancy could reduce the risk of abnormalities such as cleft lip and palate.

Limiting exposure to teratogenic agents: avoiding tobacco, alcohol, and medications not prescribed by a doctor during pregnancy would help to limit the risks of cleft lip and palate.

Regular antenatal check-ups: these appointments allow the progress of the pregnancy to be closely monitored and any possible abnormalities in the foetus to be detected.

In short, cleft lip and palate is a congenital abnormality affecting approximately 1 in 700 births in France. Although there is no absolute prevention against this condition, certain measures can be taken to reduce the risks. Specialist medical management is necessary to correct the abnormality and allow the child to develop in the best possible conditions.