A common birth defect, cleft lip is when a baby’s upper lip doesn’t form completely and has an opening in it. A cleft palate is another type of birth defect in which a baby’s palate (roof of the mouth) doesn’t form completely and has an opening in it. Left untreated, babies and children with cleft lip or palate may have dental problems, ear infections and hearing problems, feeding and breastfeeding problems, or speech problems.
July is National Cleft and Craniofacial Awareness and Prevention Month, making it the perfect time to learn more about these conditions, including how to treat them and differences in care that may negatively impact treatment.
How common are cleft lip and palate?
In the United States:
- About 1 in every 1,600 babies is born with cleft lip and cleft palate
- About 1 in every 2,800 babies is born with cleft lip but not cleft palate
- About 1 in every 1,700 babies is born with cleft palate
Boys are twice as likely as girls to have cleft lip with or without cleft palate. Girls are more likely than boys to have cleft palate without cleft lip. Higher rates of both conditions have been reported in Asian and Native American ethnic groups. Lower cleft lip and palate rates have been reported in African-American babies.
What causes cleft lip and cleft palate?
We don’t know for sure what causes cleft lip and palate. They may be caused by a combination of things, like genes and things in your environment, such as what you eat or drink and medicines you take.
Things that may increase your chances of having a baby with cleft lip or palate include:
- A family history of cleft lip and cleft palate
- Smoking or drinking alcohol during pregnancy
- Not getting enough nutrients, like folic acid, before and during pregnancy
- Having diabetes before pregnancy
- Taking certain medicines, like anti-seizure medicines, during pregnancy
- Being affected by obesity (BMI of 30 or higher) during pregnancy
How are cleft lip and cleft palate treated?
In most cases, your baby can have surgery to repair these defects. While each baby is different, it’s typically best if a baby has surgery for cleft lip before they’re 1 year old and surgery for cleft palate before they’re 18 months old. Because early treatment is best, it’s important not to delay your baby’s care.
Research shows that there are disparities—differences in health outcomes for different groups of people—when it comes to diagnosing and treating cleft lip and palate. These differences in care are linked to social, economic and environmental factors. For pregnant people, these factors can include not having access to quality prenatal care, health insurance, healthy food and clean water, racially and ethnically diverse health care providers and culturally appropriate health information available in your language of choice.
Recent studies have found that certain racial and ethnic groups experience disparities when it comes to treating cleft lip and cleft palate:
- Cleft palate repair rates are lower in Black/African-American, Hispanic and Asian babies compared with White babies.
- Asian babies are significantly less likely to have timely surgical treatment for cleft conditions.
- Black/African-American and Hispanic patients are charged more for cleft repair surgery than White patients.
- Black and Asian/Pacific Islander patients are more likely to experience complications during surgery than White patients.
- Black/African-American and Hispanic children are significantly more likely to need to be readmitted to the hospital after cleft repair surgery.
With treatment, most children with clefts do well and lead healthy lives.