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Born with a bilateral complete cleft lip and palate, Ryan Haeberle was just 6 hours old when he was whisked by ambulance to UPMC Children’s Hospital of Pittsburgh.
A cleft lip or cleft palate is a split, or opening, in the mouth and face. They're both congenital conditions, meaning babies are born with them. They're also sometimes called "isolated conditions" because a child can have either condition and be otherwise healthy.
If your baby has a cleft lip or cleft palate, they may have trouble eating. If left untreated, they may also have issues later on with speaking and with their teeth.
A cleft lip is an opening or split in the upper lip. A baby can have a cleft on one side or both sides of their lip. A cleft lip can also extend up into the nose.
Nearly 4,500 children are born each year with the condition, making it one of the most common congenital abnormalities.
A cleft palate is an opening in the roof of the mouth. A cleft palate can involve only the soft palate (back of the mouth) or both the hard (front of mouth) and the soft palate.
A submucous cleft palate can also occur when the muscles within the soft palate are separated but the skin or mucous membrane is closed. At times the uvula may be bifid, or divided into two parts.
Each year, about 2,500 babies are born with a cleft palate.
With both cleft lip and palate, an opening forms because the facial structure doesn't close completely during development. A child can be born with one or both of these conditions.
The different types of cleft defects are categorized according to the location of the cleft (unilateral or bilateral) and how much of the lip or palate is involved (incomplete or complete):
Both of these conditions form during early pregnancy. Experts aren't sure what causes them, but the conditions could develop if:
Both non-preventable factors, such as family history, and lifestyle risks, such as smoking, can increase your chance of having a child with cleft lip or cleft palate. You may be more likely to have a baby with one or both of these conditions if:
Babies with cleft lip or cleft palate may struggle to feed because they can't suck or swallow properly. As the child grows, they may have problems with:
If you're planning to become pregnant, you may be able to reduce the chance of having a child with these conditions by:
Many babies with cleft lip or cleft palate are diagnosed before birth, during ultrasound exams, though it's easier to see a cleft lip than a cleft palate on an ultrasound scan.
If your doctor thinks your baby may have one of these conditions, you may need more tests.
The UPMC Children’s Hospital of Pittsburgh Cleft Craniofacial Center is available to provide prenatal consultations if a cleft or craniofacial condition is diagnosed during pregnancy. This consultation will allow the family to meet the care team and allow our specialists determine if further testing is required.
Your doctor may offer to perform an amniocentesis to see if there's a genetic cause for the cleft lip and/or palate and to determine if your baby has any other health problems.
If these conditions aren't diagnosed during pregnancy, the doctor who examines your baby at birth will probably find them. A submucous cleft palate is hardest to detect since the cleft is hidden by the mouth's lining.
The symptoms of both conditions include feeding difficulties, such as not being able to suck. Children with cleft palate may also have problems with swallowing and food coming out of their nose.
The Cleft-Craniofacial Center at UPMC Children's Hospital has a 70-year history of treating children with cleft lip and cleft palate.
Your care team may consist of doctors and specialists in the following fields:
The goal of treatment is to make sure that your child can:
Because your child may have trouble feeding, a member of our team will give you special instructions on how to best feed your baby. Feeding a baby with one of these conditions can be stressful and requires patience and the use of special bottles or nurses.
Most children with cleft lip or cleft palate require surgery, but it probably won't happen right away. Cleft lips are usually treated between three and six months of age; cleft palates are often treated a little later, usually between nine and 18 months of age. The doctor may put tubes in the baby's ears during one of these surgeries to help prevent ear infections.
Most babies with cleft lip and palate need more than one surgery, but the doctors may not know until after the first surgery is done.
If your baby's cleft lip includes a cleft in the gum, the lip may be repaired first, and the gum repaired after several more years. The lip is repaired earlier to normalize appearance. Gum openings are typically not repaired until 7 – 10 years of age.
Before your child has surgery, it's important that they get the nutrition they need for normal development. Your baby may need special bottles or even a feeding tube to help them feed normally.
Some babies may benefit from nasoalveolar molding. This process uses plastic plates to help reshape the palate, nose, gums, and/or lip before surgery and can help reduce the number of surgeries your child might need.
Our team can also provide information about a special kind of tape that can temporarily close a lip cleft.
Children with a cleft palate or cleft lip need follow-up for many years, as some problems aren't noticeable until they're older. Most children who have surgery attain a normal appearance and are able to speak and eat normally.
Meet our team at UPMC Children's Hospital of Pittsburgh's Cleft-Craniofacial Center and learn about our treatment options, or contact UPMC Children's Hospital of Pittsburgh at 412-692-8650.
Children's Hospital's main campus is located in the Lawrenceville neighborhood. Our main hospital address is:
UPMC Children’s Hospital of Pittsburgh One Children’s Hospital Way 4401 Penn Ave. Pittsburgh, PA 15224
In addition to the main hospital, Children's has many convenient locations in other neighborhoods throughout the greater Pittsburgh region.
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