Cleft lip and palate are birth defects of the upper lip, the roof of the mouth and the soft tissue in the back of the mouth (the soft palate). A cleft occurs when certain body parts and structures do not properly fuse during a baby's development. About 1 in 2,500 people have a cleft palate. Surgery to close the cleft lip is frequently performed when a child is between 6 weeks and 9 months old and additional surgery may be needed later in life if the problem severely affects the nose area. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002046/

According to SmileTrain.org, "Clefts are a major problem in developing countries where there are millions of children who are suffering with unrepaired clefts." Some of those children cannot eat or speak properly and because of their deformity, they frequently aren't allowed to attend school or hold a job. In the U.S., it's hard for us to imagine that kind of heartache, but it's real. The clefts of those children usually go untreated because their families are often too poor to pay for a simple surgery that has been developed for decades.   http://www.smiletrain.org/

There are many causes of cleft lip and palate.  Research shows certain genes are passed down from parents to children (a family history of cleft lip or palate and other birth defect) as well as risk factors such as drugs, viruses, and other toxins. Each of these contributing factors, or one or more of them occurring together, can cause these kinds of birth defects in children. 

There are things parents can do, however, that may help prevent the occurrence of cleft lip and palate. Experts agree that a few basic actions by pregnant mothers especially can help to lower the risk of having a child with these kinds of birth defects.  One major risk factor for cleft lip and palate is smoking.  A woman smoking tobacco during pregnancy has been associated with adverse outcomes, such as low birth weight, pre-term birth, certain diseases in newborns, and with oral cleft defects. 

The increased risk for cleft lip and palate has been estimated at 200 percent when there is maternal smoking during pregnancy.  According to OperationSmile, a worldwide initative dedicated to reducing cleft lip and palate in children, the more cigarettes a mother smokes during pregnancy, the greater the risk. Because tobacco contains nicotine and other substances--such as aromatic hydrocarbons, N nitrosamines, and carbon monoxide--it interferes with normal embryonic and fetal development as the substances are absorbed into the mother's bloodstream and can reach the developing baby.

Consumption of alcohol by pregnant women also has been shown to be another risk factor to normal fetal development. The cells that develop to form the structures of the face may be damaged by a pregnant mother's consumption of alcohol during embryonic development.  Women who drink five or more alcoholic drinks even one day a week--have an increased risk of having a child with isolated oral cleft.

Certain medications when taken during pregnancy are risk factors for giving birth to a child with cleft lip and palate.  Pregnant women should consult their physicians to learn which medications to avoid.  It is well-documented that retinoids, such as Isotretinoin--better known as Accutane used to treat acne--taken even in the first few months of pregnancy can cause severe congenital malformations.  Also anticonvulsants and steroids have been shown to add to the risk of having a child with cleft lip and palate.

Some multivitamin supplements have been shown to help decrease the risk of birth defects, including cleft lip and palate in children. Folic acid taken during pregnancy also can play an important role in a baby's development, especially during the first four months, and has been shown to protect against some cardiovascular and neural defects and may lower the risk of clefting as well.

The good news for parents who have children with cleft lip and palate--in countries like the U.S. and Canada, where it is available--is that surgery can repair the defect.  A child's pediatrician and plastic surgeon can work with parents to help choose the optimum time in a child's development to perform such a repair. It is generally accepted that a cleft lip should be repaired by the time a baby is 3 months old and repairing the partition of mouth and nose as early as possible, between the ages of 12 and 18 months. 

For additional information on cleft lip and palate in children or to find out what you can do to help reduce the risk or provide a smile to a needy child, please visit http://www.operationsmile.org and http://www.SmileTrain.org

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1 Generous thanks to www.SmileTrain.org, PubMed (NIH) and OperationSmile for their good information on Cleft Lip and Palate.