The roof of the mouth (palate) is formed between the sixth and ninth weeks of pregnancy. A cleft palate happens if the tissue that makes up the roof of the mouth does not join together completely during pregnancy. For some babies, both the front and back parts of the palate are open. For other babies, only part of the palate is open.
Causes and Risk Factors
The causes of orofacial clefts among most infants are unknown. Some children have a cleft lip or cleft palate because of changes in their genes. Cleft lip and cleft palate are thought to be caused by a combination of genes and other factors, such as things the mother comes in contact with in her environment, or what the mother eats or drinks, or certain medications she uses during pregnancy. Indeed, many scientists and physicians who have studied Zofran and birth defects have come to the conclusion that taking Zofran during early pregnancy significantly increases the risk of cleft lip and cleft palate.
Recently, the CDC reported on important findings from research studies about some factors that increase the chance of having a baby with an orofacial cleft:
• Smoking―Women who smoke during pregnancy are more likely to have a baby with an orofacial cleft than women who do not smoke.
• Diabetes―Women with diabetes diagnosed before pregnancy have an increased risk of having a child with a cleft lip with or without cleft palate, compared to women who did not have diabetes.
• Use of certain medicines―Women who used certain medications during the first trimester (the first 3 months) of pregnancy have an increased risk of having a baby with cleft lip with or without cleft palate, compared to women who didn’t take these medicines.
Orofacial clefts, especially cleft lip with or without cleft palate, can be diagnosed during pregnancy by a routine ultrasound. They can also be diagnosed after the baby is born, especially cleft palate. However, sometimes certain types of cleft palate (for example, submucous cleft palate and bifid uvula) might not be diagnosed until later in life.
Management and Treatment
Children with a cleft lip with or without a cleft palate or a cleft palate alone often have problems with feeding and speaking clearly, and can have ear infections. They also might have hearing problems and problems with their teeth. Services and treatment for children with orofacial clefts can vary depending on the severity of the cleft; the child’s age and needs; and the presence of associated syndromes or other birth defects, or both.
Surgery to repair a cleft lip usually occurs in the first few months of life and is recommended within the first 12 months of life. Surgery to repair a cleft palate is recommended within the first 18 months of life or earlier if possible.
Many children will need additional surgical procedures as they get older. Surgical repair can improve the look and appearance of a child’s face and might also improve breathing, hearing, and speech and language development. Children born with orofacial clefts might need other types of treatments and services, such as special dental or orthodontic care or speech therapy.
Because children with orofacial clefts often require a variety of services that need to be provided in a coordinated manner throughout childhood and into adolescence and sometimes adulthood, the American Cleft Palate - Craniofacial Association recommends services and treatment by cleft and craniofacial teams. Cleft and craniofacial teams provide a coordinated approach to care for children with orofacial clefts. These teams usually consist of experienced and qualified physicians and health care providers from different specialties.
Cleft and craniofacial teams and centers are located throughout the United States.
With treatment, most children with orofacial clefts do well and lead a healthy life. Some children with orofacial clefts may have issues with self-esteem if they are concerned with visible differences between themselves and other children. Parent-to-parent support groups can prove to be useful for families of babies with birth defects of the head and face, such as orofacial clefts
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